Paradoxos das políticas de descentralização de saúde no Brasil Paradoxes of health decentralization policies in Brazil
The constitution of Brazil directs that the country’s health system, the Unified Health System (Sistema Único de Saúde), be politically and administratively decentralized. Nevertheless, handing over competencies, responsibilities, and resources to subnational levels, especially to municipal governme...
| Main Authors: | , , , |
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| Format: | Article in Journal/Newspaper |
| Language: | English Spanish Portuguese |
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Pan American Health Organization
2006
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| Subjects: | |
| Online Access: | https://doaj.org/article/6f95ec4ce8484bcea1ba43f2131ba6e6 |
| Summary: | The constitution of Brazil directs that the country’s health system, the Unified Health System (Sistema Único de Saúde), be politically and administratively decentralized. Nevertheless, handing over competencies, responsibilities, and resources to subnational levels, especially to municipal governments, has been a slow process, lasting almost two decades. Advances have been brought about by the Unified Health System, which, from a analytical perspective, is a public and universal system. Despite that, the decentralization process needs to overcome norms that keep all levels of management dependent on Brazil’s federal Government. The subnational levels have consistently faced difficulties in performing their macromanagement functions with autonomy, especially when it comes to financing and to the establishment or organization of health care networks. Boldness and responsibility will be needed to prevent Brazil’s health decentralization process from leading to fragmentation. New political agreements between different levels of government, with a reassignment of responsibilities and the enhancement of a culture of technical cooperation, are fundamental requisites to making the Unified Health System have a health policy that is truly public and universal. |
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