Cooperação intermunicipal? Um estudo sobre o consórcio de saúde da região do Médio Paraíba do Rio de Janeiro

Abstract

This study discusses the process of intermunicipal co-opoeration created after the municipal consortiums, focusing on actions developed by the Health Instermunicipal Consortium of the Médio Paraíba Region, Rio de Janeiro (CISMEPA). This consortium appeared in the 90 s, as a result of the regional discussion about the need for organization and adjustment of services offer among the twelve municipalities which form this region. This research proposes the analysis of the CISMEPA, its technical and administrative organization, main projects and services. It also assesses the results of the consortium s actions. Based on the analysis of the technical and political region articulation within the SUS, we intend to gather subsides for the ongoing process of SUS decentralization and the regionalization strategy. The methodological course was the qualitative analysis, based on bibliographical research, analysis of the consortium s legal documents, analysis of projects development, semi-structured interviews with those who helped elaborate, implement and follow all projects, and also participating observation in meetings. Projects developed by CISMEPA were successful, and the consortium played an important role not only in management but also in fund-raising. The success is mainly due to the participating way projects have been elaborated and developed by managers and technicians. Although the region has organized and elaborated its PPI, the CISMEPA did not organize the micro and macrorregional services offer, one of its first objectives. However, it became an important forum for debate and agreement, despite the low adhesion and State participation. This characteristic reinforces the CISMEPA as a strategy for the SUS regionalization.