Author:

• Vanessa Costa e Silva - Costa e Silva,V. - Rio de Janeiro, RJ - Escola Nacional de Saúde Pública - Fiocruz - <vanessa@ensp.fiocruz.br>

Co-author(s):

• Ana Escoval - Escoval,A. - Escola Nacional de Saúde Pública/Universidade Nova de Lisboa - <anaescoval@ensp.unl.pt>
• Virginia Alonso Hortale - Virginia Alonso Hortale - Rio de Janeiro, RJ - Escola Nacional de Saúde Pública - Fiocruz - <virginia@ensp.fiocruz.br>
ORCID: https://orcid.org/0000-0002-4224-9838

Thematic Area:

Planejamento e Gestão em Saúde

Abstract:

The contractual arrangements developed at the Family Health Strategy has few scientific studies. It is introduced in Brazil in different models, accordingly to the contractor entity and the legal status of contracted service provider; and in Portugal, from a model of public-public contracting with the Family Healthcare Units.
It is presented in this article the current situation of contractual arrangements in both countries and is discussed their attributes of colaborative planning, accountability with autonomy and performance-bonus payment.
Their main contributions are: better coordination of health organizations; replacement of the hierarchical command-control logic by the one with greater participation; and accountability of professionals with better performance of their activities.
It is concluded that one of the facilitators is the gradually construction, in an environment of continuous learning, with the leading role of health professionals; and that its biggest challenges is the transparency in the processes conduction, the strengthening of auditing mechanisms and information systems, as well as the continuous review of indicators and their adequateness to the population health needs.

Keywords:

primary healthcare family health health management contracts

Content:

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