Cooperação intergovernamental na política de saúde: a experiência dos consórcios públicos verticais no Ceará, Brasil
This study analyzed the first experience with vertical health consortia in Ceará State, Brazil, in order to shed light on their implementation. In the theoretical field, the article establishes a dialogue with studies on the state government’s role in federalism and intergovernmental cooperation in...
| Authors: | , |
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| Format: | article |
| Status: | Published version |
| Publication Date: | 2020 |
| Country: | Brasil |
| Institution: | Fundação Oswaldo Cruz (FIOCRUZ) |
| Repository: | Cadernos de Saúde Pública |
| Language: | Portuguese |
| OAI Identifier: | oai:ojs.teste-cadernos.ensp.fiocruz.br:article/7319 |
| Online Access: | https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7319 |
| Access Level: | Open access |
| Keyword: | Federalismo Política Pública Política de Saúde Consórcios de Saúde |
| Summary: | This study analyzed the first experience with vertical health consortia in Ceará State, Brazil, in order to shed light on their implementation. In the theoretical field, the article establishes a dialogue with studies on the state government’s role in federalism and intergovernmental cooperation in health. A qualitative study was based on interviews with administrators associated with the consortia at the municipal, regional, and state levels, in addition to document analysis and a literature review. The results indicate that the implementation of consortia was designed by the state government and conducted initially in centralized fashion. A relationship of coordination was established with the definition of the arrangement’s institutional design. We identified four factors that favor vertical cooperation in the state: (i) the history of health policy in Ceará; (ii) action by the state government as the coordinating body in the regionalization process; (iii) the existence of policy leaders and cohesion in the bureaucracy; and (iv) juxtaposition between the consortia’s institutional design and the decision-making structure of the Brazilian Unified National Health System (SUS). Vertical consortia represent a step forward in overcoming the negative effects of decentralization. |
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