Decentralization in health surveillance: history and mismatch

• Autor(a) principal: Lucena, Regina Célia Borges de
• Data de Publicação: 2015
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Revista de Administração Pública
• Texto Completo: https://periodicos.fgv.br/rap/article/view/54962
• topic: decentralization; unified health system; health surveillance.; descentralización; sistema de salud; vigilancia sanitaria.; descentralização; sistema único de saúde; vigilância sanitária.

This paper describes characteristics of the decentralization process in the Unified Health System (SUS) and in health surveillance regarding the relationship among levels of management: centralization and decentralization. It was used an analytical approach focused on the relationship among levels of government as a constituent factor in the management of a social policy. The results indicate that the health surveillance developed a slow and uneven process of decentralization, which expresses a clear mismatch with the same process in SUS, in relation to the institutional structure, strategies for negotiation and relationship among the spheres. We conclude that the difficulties faced in the process of decentralization are also related to the tensions arising from different political projects that coexist in these institutional spaces.