This study deals with public health management in small Brazilian municipalities with low HDI-M through analysis of financial resources. Findings indicated some innovations, but not enough, with managers needing specific administration learning, although they state their desire to improve services. Unstructured reports do not contribute to health planning, showing no relationship between the scope of health actions and financial resources. Management needs to evolve to intersectoral decisions, with social participation in planning. This would make it possible to solve more health problems and provide a universal and equitable service to the population in the process of National Health System decentralisation.