Federalismo e regionalização do sistema de saúde: a experiência do estado do Espírito Santo, Brasil

Abstract

This study examines the degree of development of health policies in the state of Espírito Santo, in the context of regionalization experiences conducted since 1990, seeking to assess the state of health management and intergovernmental relations in the organization of the health system on a regional basis. It is supported by research based on interviews with key actors in the process and analysis of management documents and reports of meetings of the state Comissão Intergestores Bipartite and Colegiados Intergestores Bipartites Microrregionais. The results of the analysis depict the tax situation and financial status of the state, the institutional framework and capacity for action of its own State Department of Health and, finally, the trial of different models of regionalization in the period of analysis. The study concludes that for regionalization to be strengthened, the processes of territorial division should harmonize the logic of the health sector and the regionalization of other sectors and institutions. To this end, there shall be established starting points for a more integrated perspective and action