Performance of the local health system and contingent influences in Northeast-Brazil: breaking vicious and virtuous circles

Detalhes bibliográficos
Autor(a) principal: Medeiros,Regianne Leila Rolim
Data de Publicação: 2013
Outros Autores: Atkinson,Sarah
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Ciência & Saúde Coletiva (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232013001100032
Resumo: Organizational theory has long emphasized the importance of contingent, environmental influences on organizational performance. Similarly, research has demonstrated the importance of local political culture and informal management on the performance of the local health system, establishing vicious and virtuous circles of influence that contribute to increasing inequalities in performance among decentralized local health systems. A longitudinal ethnography studied the relationship between these elements in the same rural municipality in Northeast Brazil after a four-year interval. The second study found the local health system performance much improved. Two main factors appear to have interacted to bring this about: leadership vision and power to implement of one individual; professionalization of the local health system by hiring a significant number of senior health staff. The origins of these influences combine initiatives at local, state and federal levels.
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spelling Performance of the local health system and contingent influences in Northeast-Brazil: breaking vicious and virtuous circlesSanitary reformPublic policiesDecentralizationClientelismLocal governmentBrazilOrganizational theory has long emphasized the importance of contingent, environmental influences on organizational performance. Similarly, research has demonstrated the importance of local political culture and informal management on the performance of the local health system, establishing vicious and virtuous circles of influence that contribute to increasing inequalities in performance among decentralized local health systems. A longitudinal ethnography studied the relationship between these elements in the same rural municipality in Northeast Brazil after a four-year interval. The second study found the local health system performance much improved. Two main factors appear to have interacted to bring this about: leadership vision and power to implement of one individual; professionalization of the local health system by hiring a significant number of senior health staff. The origins of these influences combine initiatives at local, state and federal levels.ABRASCO - Associação Brasileira de Saúde Coletiva2013-11-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232013001100032Ciência & Saúde Coletiva v.18 n.11 2013reponame:Ciência & Saúde Coletiva (Online)instname:Associação Brasileira de Saúde Coletiva (ABRASCO)instacron:ABRASCO10.1590/S1413-81232013001100032info:eu-repo/semantics/openAccessMedeiros,Regianne Leila RolimAtkinson,Saraheng2013-11-05T00:00:00Zoai:scielo:S1413-81232013001100032Revistahttp://www.cienciaesaudecoletiva.com.brhttps://old.scielo.br/oai/scielo-oai.php||cienciasaudecoletiva@fiocruz.br1678-45611413-8123opendoar:2013-11-05T00:00Ciência & Saúde Coletiva (Online) - Associação Brasileira de Saúde Coletiva (ABRASCO)false
dc.title.none.fl_str_mv Performance of the local health system and contingent influences in Northeast-Brazil: breaking vicious and virtuous circles
title Performance of the local health system and contingent influences in Northeast-Brazil: breaking vicious and virtuous circles
spellingShingle Performance of the local health system and contingent influences in Northeast-Brazil: breaking vicious and virtuous circles
Medeiros,Regianne Leila Rolim
Sanitary reform
Public policies
Decentralization
Clientelism
Local government
Brazil
title_short Performance of the local health system and contingent influences in Northeast-Brazil: breaking vicious and virtuous circles
title_full Performance of the local health system and contingent influences in Northeast-Brazil: breaking vicious and virtuous circles
title_fullStr Performance of the local health system and contingent influences in Northeast-Brazil: breaking vicious and virtuous circles
title_full_unstemmed Performance of the local health system and contingent influences in Northeast-Brazil: breaking vicious and virtuous circles
title_sort Performance of the local health system and contingent influences in Northeast-Brazil: breaking vicious and virtuous circles
author Medeiros,Regianne Leila Rolim
author_facet Medeiros,Regianne Leila Rolim
Atkinson,Sarah
author_role author
author2 Atkinson,Sarah
author2_role author
dc.contributor.author.fl_str_mv Medeiros,Regianne Leila Rolim
Atkinson,Sarah
dc.subject.por.fl_str_mv Sanitary reform
Public policies
Decentralization
Clientelism
Local government
Brazil
topic Sanitary reform
Public policies
Decentralization
Clientelism
Local government
Brazil
description Organizational theory has long emphasized the importance of contingent, environmental influences on organizational performance. Similarly, research has demonstrated the importance of local political culture and informal management on the performance of the local health system, establishing vicious and virtuous circles of influence that contribute to increasing inequalities in performance among decentralized local health systems. A longitudinal ethnography studied the relationship between these elements in the same rural municipality in Northeast Brazil after a four-year interval. The second study found the local health system performance much improved. Two main factors appear to have interacted to bring this about: leadership vision and power to implement of one individual; professionalization of the local health system by hiring a significant number of senior health staff. The origins of these influences combine initiatives at local, state and federal levels.
publishDate 2013
dc.date.none.fl_str_mv 2013-11-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232013001100032
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232013001100032
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/S1413-81232013001100032
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv ABRASCO - Associação Brasileira de Saúde Coletiva
publisher.none.fl_str_mv ABRASCO - Associação Brasileira de Saúde Coletiva
dc.source.none.fl_str_mv Ciência & Saúde Coletiva v.18 n.11 2013
reponame:Ciência & Saúde Coletiva (Online)
instname:Associação Brasileira de Saúde Coletiva (ABRASCO)
instacron:ABRASCO
instname_str Associação Brasileira de Saúde Coletiva (ABRASCO)
instacron_str ABRASCO
institution ABRASCO
reponame_str Ciência & Saúde Coletiva (Online)
collection Ciência & Saúde Coletiva (Online)
repository.name.fl_str_mv Ciência & Saúde Coletiva (Online) - Associação Brasileira de Saúde Coletiva (ABRASCO)
repository.mail.fl_str_mv ||cienciasaudecoletiva@fiocruz.br
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