Federative relation and the process of regionalization in Brazil: strength to resist

Abstract

Abstract The federative relation is an essential tool to face the current challenges in Brazil and defends the public health system, threatened by measures of totalitarianism and individualism. Some of the barriers to promote an effective federative relation on the regional territories based on collective action are the devaluation of the deliberation spaces, the verticalization in making-decision process and marks of submission on federative relation. In this sense, one of the most important factors to structure democratic spaces is the regionalization, what subsidizes the construction of a regional identity, through dialogical strategies. In order to consolidate the regionalization, is important to characterize and apply instruments and strategies of negotiation, agreement and cooperative relations, by the entities. This study aims to identify and understand cooperation strategies, if present or potential on the counties of region practices and propose its sharing and implementation between them. The research has a qualitative, exploratory and interventional approach and it was submitted to the ethics committee approval process. The methodology way contemplates the collect of dates by questionnaires applied during a sixty-hour extension course. The participants are counties managers and supporters of their teams from the five regions of health on the north of the state of Parana, organized on small groups. After this, some individuals are invited for complementary interviews with semi-structured scripts. The adopted methodology for the analysis of the results is the discourse analysis. After identified and categorized the initiatives, they are shared among the participants through some workshops. In this way, the expected results of the study is to allow the strengthening of regionalization process in the territories and contribute for the establishment of a new order on the federative relation, boosting a democratic process of decision-making, cooperation and solidarity. Key messages The current challenges in political scenario on Brazilian health system requires new strategies to boost a democratic, cooperative e solidary process of decision-making and federative relation. One of the most important factors to structure democratic spaces on Brazil is the regionalization, which can be strengthened by federative relation based on cooperation and solidariety.