0306/2018 - Governança regional do sistema de saúde no Brasil: Configurações de atores e papel das Comissões Intergovernamentais. Regional governance of the health system in Brazil: Configurations of actors and the role of the Intergovernmental Committees.
O foco da análise é o papel exercido pelas Comissões Intergestores Regionais, considerando a diversidade de atores que influenciam a política de saúde em contextos regionais específicos. A pesquisa envolveu a realização de cinco estudos de caso em cada uma das macrorregiões brasileiras, com aplicação de 128 questionários a gestores, prestadores e representantes da sociedade civil, entre agosto de 2015 e agosto de 2016. Adotou-se a perspectiva comparada, considerando três eixos de análise: configurações de atores (governamentais e não governamentais; públicos e privados) nas decisões e conflitos regionais, dinâmica de funcionamento e atuação, e contribuições das comissões para a política e a organização do sistema de saúde. Verificou-se a diversidade de atores com alto grau de influência nas regiões e a função das Comissões Intergestores Regionais na coordenação das políticas e na resolução de conflitos. Estas favorecem a negociação intergovernamental e a organização do Sistema Único de Saúde frente à estrutura federativa brasileira. Contudo, possuem atuação limitada como espaço de governança regional da saúde, sendo incapazes de incorporar as diversas configurações de atores públicos e privados com poder e influência sobre as decisões de saúde.
Palavras-chave:
Política de Saúde; Governança; Regionalização; Sistema Único de Saúde; Relações intergovernamentais.
Abstract:
The analytical focus is on the role of the Regional Intergovernmental Committees (CIR), considering the diversity of actors that influence health politics in specific regional contexts. The research developed through five case studies in each one of the Brazilian regions, with the application of 128 questionnaires to public managers, service providers and civil society representatives, between August 2015 and August 2016. A comparative perspective was adopted, considering three analysis axes: actor’s configuration (governmental and non-governmental; public and private) on regional decisions and conflicts, operation dynamics and contributions of commissions to health system politics and organization. The results showed the diversity of actors with a high degree of influence in the regions and the role of Regional Interagency Commissions in policy coordination and conflict resolution. The Commission favors the intergovernmental negotiation and the organization of the Unified Health System in front of the Brazilian federal structure. However, they have limited performance as a space for regional health governance and are unable to incorporate the different configurations of public and private actors with power and influence over health decisions.
Keywords:
Health Politics; Governance; Regional Health Planning; Unified Health System; Intergovernmental relations.
Regional governance of the health system in Brazil: Configurations of actors and the role of the Intergovernmental Committees.
Resumo (abstract):
The analytical focus is on the role of the Regional Intergovernmental Committees (CIR), considering the diversity of actors that influence health politics in specific regional contexts. The research developed through five case studies in each one of the Brazilian regions, with the application of 128 questionnaires to public managers, service providers and civil society representatives, between August 2015 and August 2016. A comparative perspective was adopted, considering three analysis axes: actor’s configuration (governmental and non-governmental; public and private) on regional decisions and conflicts, operation dynamics and contributions of commissions to health system politics and organization. The results showed the diversity of actors with a high degree of influence in the regions and the role of Regional Interagency Commissions in policy coordination and conflict resolution. The Commission favors the intergovernmental negotiation and the organization of the Unified Health System in front of the Brazilian federal structure. However, they have limited performance as a space for regional health governance and are unable to incorporate the different configurations of public and private actors with power and influence over health decisions.
Palavras-chave (keywords):
Health Politics; Governance; Regional Health Planning; Unified Health System; Intergovernmental relations.
Albuquerque, Mariana Vercesi de, Lima, L.D, Oliveira, RD, Scatena, J.H.G., Martinelli, N.L., Pereira, A.M.M.. Governança regional do sistema de saúde no Brasil: Configurações de atores e papel das Comissões Intergovernamentais.. Cien Saude Colet [periódico na internet] (2018/jun). [Citado em 22/12/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/governanca-regional-do-sistema-de-saude-no-brasil-configuracoes-de-atores-e-papel-das-comissoes-intergovernamentais/16839?id=16839&id=16839
