Labor relations under decentralized health management and dilemmas in the relationship between work expansion and casualization in the Brazilian Unified National Health System

This article analyzes the logic behind human resources management in primary health care from the perspective of municipal health systems administrators in Brazil, rethinking the decentralization process based on mediation between Federal government guidelines and the health services' daily pra...

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Bibliographic Details
Published in:Cadernos de saúde pública 2010-05, Vol.26 (5), p.918-928
Main Authors: Junqueira, Túlio da Silva, Cotta, Rosângela Minardi Mitre, Gomes, Ricardo Corrêa, Silveira, Suely de Fátima Ramos, Siqueira-Batista, Rodrigo, Pinheiro, Tarcísio Márcio Magalhães, Sampaio, Rosana Ferreira
Format: Article
Language:Portuguese
Subjects:
Adult
Brazil
Collective bargaining
Contracts
Cross-Sectional Studies
Decentralization in government
Educational Status
Family
Female
Health Personnel - organization & administration
Health Personnel - statistics & numerical data
Health policy
Health Services Administration - legislation & jurisprudence
Health Services Administration - statistics & numerical data
Humans
Legislation
Male
Medical service
Middle Aged
Primary Health Care - organization & administration
Public health
Questionnaires
Surveys and Questionnaires
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Summary:This article analyzes the logic behind human resources management in primary health care from the perspective of municipal health systems administrators in Brazil, rethinking the decentralization process based on mediation between Federal government guidelines and the health services' daily practice. This was a cross-sectional study using a semi-structured questionnaire applied to municipal health secretaries in the Southeastern Health Macro-Region (Minas Gerais State). The municipal health secretaries had a mean age of 39.4 years and low schooling, and a large proportion did not belong to the health field. As for the workforce in the Family Health Program, the municipal governments hired 93.3% of the health professionals, mostly on temporary contracts. The findings confirm gaps in the workers' political and social rights. Paradoxically, the government itself, through the municipal administration, is responsible for failing to comply with the prevailing labor legislation.
ISSN:0102-311X
1678-4464
DOI:10.1590/S0102-311X2010000500014