SUS Brasil: a região de saúde como caminho

Abstract

The present article addresses the need to have regionalization of decentralization, in order to cluster together what this could supposedly have broken apart. On revisiting the constitutional guidelines on decentralization, the authors propose measures to provide assurance thereof, in addition to administrative tools that allow the formation of health regions to supply at least 95% of the health needs of the regional territory, to ensure sanitary independence. The authors suggest solutions that include the establishment of regional and associative corporate institutions resulting from the clustering of the federative institutes operating in the health area. The authors also state what has not worked out in the Brazilian National Health System (Sistema Único de Saúde -SUS), due to mistakes that have originated in the best of intentions, as also the opportunism that these mistakes have generated. The authors defend the need to bring judicial and administrative answers to a SUS that is interfederative in character, both in management, which requires some sharing, as also in financing which also remains interdependent. The conclusion reached is that the only way in which the SUS can be national is to regionalize it, and to give the health region all the instruments that are necessary for shared, interfederative and responsible management. Keywords: Regionalization; Health Region; Brazilian National Health System; SUS. In the SUS, we need to think of real goals that generate real services, responding to real needs.

Regionalização no SUS: uma revisão crítica

“…That same year, 'Saúde & Sociedade' published a thematic number with eight articles on this theme [21][22][23][24][25][26][27][28] .…”

Avaliação da rede de atenção ao portador de hipertensão arterial: estudo de uma região de saúde

“…A insuficiência de recursos financeiros inviabiliza o cumprimento das ações pactuadas e a execução da proposta de RAS, além de fomentar as desigualdades sociais e regionais 11,41,42 . Para favorecer a organização dos serviços em RAS, torna-se iminente a necessidade de ultrapassar a governança meramente política 43 .…”

Percepções de gestores estaduais da saúde sobre o Contrato Organizativo da Ação Pública da Saúde no Ceará, Brasil

“…The Public Health Action Organizational Contract (Contrato Organizativo de Ação Públi-ca da Saúde -COAP), prescribed by Decree 7.508/2011 1 , provides the legal framework for the cooperative governance and management 2,3 of the Unified Health System (Sistema Único de Saúde -SUS), strengthening the logic behind Brazil's health care federalism 4,5 . The COAP is a plurilateral health agreement between federated entities that sets out responsibilities and functions that are defined through a process of integrated planning of health actions and services at Health Region (Regiões de Saúde -RS) level.…”

“…There is a notable lack of consensus among health service managers as to which sphere of government is responsible for ensuring access to higher technology services in the region 6 . Certain authors [7][8] have problematized the lack of a regional health authority, discussing the most appropriate institutional arrangements for managing the equipment used in the health region, while others 5 suggest possible ways to overcome these limitations through regional management models based on the COAP.…”