Abstract
The Regional Intermanagers Commission (CIR) configures the space for agreement, articulation, cooperation and strengthening of the health region. The aim of this study was to reflect on the normative provisions that underlie the construction of the commission as a place of consolidation of regional management attenuating interfederative conflicts. Having as a guide question: how do the Regional Inter-Management Commissions provide local spaces of agreement and interfederative articulation? Qualitative study, based on documentary research, based on the analysis of the resolutions of the Regional Inter-Management Commissions of Alagoas, corresponding to the period from 2017 to 2019, using Decree 7.508/11 as a reference standard. The results were organized into four categories: Regional Health Planning; organization of health care actions and services: health region; Federalism, CIR and the financing of health services; governance and CIR: channel of negotiation and decision between municipal managers and the State within the Health Region. The Regional Inter-Management Commissions develop significant work in the discussions of regional policies, being a fundamental tool for strengthening governance in the territories, by negotiating the allocation and distribution of resources, essential for planning, interfederative pacts, and health financing, playing a key role for the regional health system of Alagoas, democratic, political and cooperative space.
Highlights
IntroductionOne of the main achievements refers to the operationalization of the SUS within the regional territory, from the validation of the spaces of agreement and deliberation, with a view to the definition of shared management rules, called Regional InterManagement Commissions (CIR), being the process of decentralization of public health, one of the constitutional premises, intensifies with the legitimation of regional spaces of agreement
A major advance in this sense was the regulation of the Organic Health Law (Law 8.080/90) through Federal Decree No 7,508 published in July 2011 considered the regulatory framework densifying the constitutional and legal provisions related to the realization of the fundamental right to health in Brazil, nodits regarding the decentralization of public health, with the organization of the SUS, the planning of health care actions and interfederative articulation
The results clearly show the organization of health services by care networks and federative agreements for the execution of services, contemplating the needs of health regions
Summary
One of the main achievements refers to the operationalization of the SUS within the regional territory, from the validation of the spaces of agreement and deliberation, with a view to the definition of shared management rules, called Regional InterManagement Commissions (CIR), being the process of decentralization of public health, one of the constitutional premises, intensifies with the legitimation of regional spaces of agreement This political-administrative process of the SUS in Brazil, a victorious model in the National Constituent Assembly (1986-1988), was the consectarian of one of the main demands of the Movement for Sanitary Reform, built due to the various criticisms of the centralizing model in force in the country, executed at the time by the National Institute of Social Security Medical Assistance (INAMPS). The increasing financial centralization of the State, along with the continued exercise of fiscal regulation of states and municipalities, and a decisive role in policy formulation produced a combination of state centralization, with decentralizing sectoral policies that, in the case of health, were always dependent on federal induction (VIANA et al, 2002)
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