Regional governance of the health system in Brazil: configurations of actors and the role of the Interagency Commissions

The analytical focus is on the role of the Regional Interagency Commissions (CIR), considering the diversity of actors that influence health policy in specific regional contexts. The research involved conducting five case studies in each of the Brazilian macroregions, with the application of 128 que...

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Bibliographic Details
Published in:Ciência & saude coletiva 2018-10, Vol.23 (10), p.3151-3161
Main Authors: Albuquerque, Mariana Vercesi de, Lima, Luciana Dias de, Oliveira, Ricardo Antunes Dantas de, Scatena, João Henrique Gurtler, Martinelli, Nereide Lucia, Pereira, Adelyne Maria Mendes
Format: Article
Language:Portuguese
Subjects:
Brazil
Delivery of Health Care - organization & administration
Government Programs - organization & administration
Health Policy
Humans
Interinstitutional Relations
National Health Programs - organization & administration
Private Sector - organization & administration
Public Sector - organization & administration
Surveys and Questionnaires
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Summary:The analytical focus is on the role of the Regional Interagency Commissions (CIR), considering the diversity of actors that influence health policy in specific regional contexts. The research involved conducting five case studies in each of the Brazilian macroregions, with the application of 128 questionnaires to public managers, service providers and civil society representatives, between August 2015 and August 2016. The comparative perspective was adopted, by considering three analytical approaches: the configuration of actors (governmental and non-governmental; public and private) on regional decisions and conflicts, operation dynamics and contributions of commissions to health system policy and organization. The results showed the diversity of actors with a high degree of influence in the regions and the role of the Regional Interagency Commissions in policy coordination and conflict resolution. The commissions favor interagency negotiation and the organization of the Unified Health System vis-à-vis the Brazilian federative structure. However, they have limited scope 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.
ISSN:1678-4561
DOI:10.1590/1413-812320182310.13032018