Abstract
This article is a conceptual essay aimed at supporting analyses of the regionalization processes implemented in Brazil's Unified Health System, from the perspective of regional governance. The authors conducted a literature review in the social sciences, public administration, and critical geography, focusing on the concepts of governance, territorial governance, and regional governance in the debate on development. In dialogue with these contributions to the analysis of recent regulation and implementation of health sector regionalization in Brazil, with special reference to use of the Organizational Contract for Public Action (COAP) in the country's health regions, the article concludes that the research on governance as a modern approach to linking public policies highlights the timeliness of developing methodologies and critical reflection on the relevant national processes in Brazil for future health sector proposals, thereby pointing to a new stage in the improvement of the Unified Health System.
Highlights
Regionalization has been a recurrent guideline in strategies for decentralization of government provision of healthcare in Brazil since the 1980s
This article is a conceptual essay aimed at supporting analyses of the regionalization processes implemented in Brazil’s Unified Health System, from the perspective of regional governance
The authors conducted a literature review in the social sciences, public administration, and critical geography, focusing on the concepts of governance, territorial governance, and regional governance in the debate on development. In dialogue with these contributions to the analysis of recent regulation and implementation of health sector regionalization in Brazil, with special reference to use of the Organizational Contract for Public Action (COAP) in the country’s health regions, the article concludes that the research on governance as a modern approach to linking public policies highlights the timeliness of developing methodologies and critical reflection on the relevant national processes in Brazil for future health sector proposals, thereby pointing to a new stage in the improvement of the Unified Health System
Summary
Regionalization has been a recurrent guideline in strategies for decentralization of government provision of healthcare in Brazil since the 1980s. The official signing of negotiated commitments by means of this legal device meet the expectations for legal backing in enforcing the public health obligations of these different levels of government In our view, such formal agreement among the federative bodies in the region through the COAP requires new relations between the Federal, State, and Municipal governments in establishing joint planning in responses with an inter-municipal scope, including the identification of health problems and their causes and necessary interventions and linkage of actions that extend beyond the health sector itself, since this legal instrument expands the political content of intergovernmental relations in the region[5].
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