Bureaucracy and Policy Implementation

Abstract

The enactment of the 1988 Constitution aroused pessimistic interpretations regarding the chances of fulfilling its promises. Some considered that the institutions established or re-established by the constitution would make the country ungovernable. Furthermore, they also argued (and still argue) that the list of constitutionalized social policies did not fit into the government budget. Others, however, faced the challenge of designing a complex institutional architecture capable of putting into practice some of the constitutionalized social rights. The most challenging task was to provide universal access to public health services, previously limited to those who had formal jobs.Academic research detailing the trajectory of health policy experts, explaining their activism and the challenges they faced is now available; hence it is here only enough to highlight its importance. Similarly, the reconstruction of similar health policy experiences, tested in other countries and in smaller territorial areas, and that led to the construction of the current model of healthcare, is also already mapped and analysed.What is still not known is, however, what happened to this institutional architecture, i.e. how and by whom health policy is implemented. Gabriela Lotta's book faces this issue. The book's topic is the work of community health workers that make up the Family Health Strategy. The focus is on the bureaucracies that implement this strategy. Mainly based on the contribution of Michael Lipsky on the dilemmas of a public servant that comes in direct contact with the citizen at the time of implementing policies, the book begins with a review of the literature on the implementation of public policies and their agents, or street-level bureaucrats, as ___________________________________________________________________________ * http://dx