Subject(s)
Humans , Male , Female , Health Expenditures , Regional Health Planning , Unified Health System , Health PolicyABSTRACT
This article presents the results of a study on Federal health policy in the Brazilian Legal Amazon (BLA) from 2003 to 2005, aimed at backing the development of regional health policies. The region has peculiar dynamics, an extensive border area, and adverse social indicators. The methodology included documental and financial analysis, participatory observation, interviews with heads of various Federal Ministries and State and Municipal health secretaries from the BLA; characterization of geographic situations in the BLA; and field studies in 15 municipalities. Institutional consolidation of health policy proved to be low in the Amazon during the study period, due to structural, institutional, and political difficulties. The identification of six geographic situations was useful for systematizing land use differences with repercussions on health, and which should be considered when implementing public policies. There is a certain gap between Federal actions and territorial dynamics, expressed as a mismatch between the current policy and its recognition by local administrators. In addition to establishing a regional policy for the Amazon, there is an evident need for differentiated policies within the region.
Subject(s)
Environment , Environmental Health , National Health Programs/organization & administration , Public Policy , Regional Health Planning/organization & administration , Brazil , Data Collection , Federal Government , Geographic Information Systems , Government Agencies , Health Policy , Humans , Local GovernmentSubject(s)
Health Planning , Health Policy , Health Services , International Cooperation , European Union , Health Workforce , Humans , Politics , Socioeconomic Factors , South AmericaSubject(s)
Humans , Health Workforce , Health Planning , Health Policy , Health Services , International Cooperation , European Union , Politics , Socioeconomic Factors , South AmericaABSTRACT
O artigo apresenta os resultados de uma pesquisa sobre a política federal de saúde para a Amazônia Legal de 2003 a 2005, visando fornecer subsídios para o desenvolvimento de políticas regionais na saúde. Tal região é marcada por uma dinâmica peculiar, extensa área de fronteira e indicadores sociais desfavoráveis. A metodologia envolveu: análise documental e financeira, observação participante, entrevistas com dirigentes federais de vários ministérios, secretários estaduais e municipais de saúde da Amazônia; caracterização de situações geográficas na Amazônia e estudos de campo em 15 municípios. Observou-se uma baixa institucionalidade da política de saúde para a Amazônia, no período, por dificuldades estruturais, institucionais e políticas. A identificação de seis situações geográficas foi útil para a sistematização de diferenças nos usos do território que repercutem na saúde e devem ser considerados na condução de políticas públicas. Há certo distanciamento entre as ações federais e a dinâmica territorial, expressa no descolamento entre a política em curso e seu reconhecimento pelos gestores locais. Além da construção de uma política regional para a Amazônia, fica evidente a necessidade de políticas diferenciadas dentro da região.
This article presents the results of a study on Federal health policy in the Brazilian Legal Amazon (BLA) from 2003 to 2005, aimed at backing the development of regional health policies. The region has peculiar dynamics, an extensive border area, and adverse social indicators. The methodology included documental and financial analysis, participatory observation, interviews with heads of various Federal Ministries and State and Municipal health secretaries from the BLA; characterization of geographic situations in the BLA; and field studies in 15 municipalities. Institutional consolidation of health policy proved to be low in the Amazon during the study period, due to structural, institutional, and political difficulties. The identification of six geographic situations was useful for systematizing land use differences with repercussions on health, and which should be considered when implementing public policies. There is a certain gap between Federal actions and territorial dynamics, expressed as a mismatch between the current policy and its recognition by local administrators. In addition to establishing a regional policy for the Amazon, there is an evident need for differentiated policies within the region.
Subject(s)
Humans , Environment , Environmental Health , National Health Programs/organization & administration , Public Policy , Regional Health Planning/organization & administration , Brazil , Data Collection , Federal Government , Geographic Information Systems , Government Agencies , Health Policy , Local GovernmentSubject(s)
Male , Female , Adult , Middle Aged , Aged , Humans , Accidents, Traffic , Violence , MortalityABSTRACT
O livro apresenta o resultado de uma pesquisa sobre os caminhos para a concretização da autonomia municipal. O enfoque é dado sobre a saúde: os processos de planejamento e programação, a estruturação do modelo de atenção, a reformulação do financiamento, a participação da população e as relações entre gestores. Documento em formato pdf.
Subject(s)
Public Health , Health Policy, Planning and Management , Health Planning , Public Health Administration , 16763 , Local Health Systems , Policy Making , Health Programs and Plans , Healthcare Financing , Community ParticipationABSTRACT
This article discusses the trends and limits of the Brazilian health system decentralization process, identifying the three elements that constitute the strategic induction performed by the national system administrator in accordance with the guidelines contained in the Operational Norms of the Unified National Health System: systemic rationality, intergovernmental and service provider financing, and health care model. The effects of the Federal regulations are analyzed based on the results of the evaluation study focused on the implementation of the full management scheme at the Municipal level. The decentralization strategy induced by Basic Operational Norm 96 has succeeded in improving institutional conditions, management autonomy, and supply, as measured by the Federal resources transferred, installed capacity, production, and coverage of outpatient and hospital services, with the Municipalities authorized to conduct fully autonomous management, without altering the existing patterns of inequity in the distribution of funds to poorer Municipalities.
