Political and operational challenges in the perception of managers on health regionalization in Acre

Abstract

One of the strategies for the implementation of the SUS is the regionalization of health. It is a guiding principle of the process of negotiations and agreements between public entities in health regions through shared management. This article analyzes the perceptions of the municipal managers on the political and operational challenges of the implementation of regionalization in health in the state of Acre. For this, three focus groups were held with the municipal health secretaries, one in each health region of the state. The results showed that the municipal secretaries consider the Regional Interagency Commission (CIR) a cartorial space, at the same time as evidencing the lack of technical, financial and physical capacity of the municipalities to fulfill the goals of the Organizational Contract of Public Health Action (COAP). They also highlight geographical barriers and assistance to foreigners in municipalities located in border regions. There is a need for empowerment of decisions in health regions by building proposals related to ensuring funding and resource management at the regional level, to existing geographical barriers in municipalities and to revising the demographic criterion for the transfer of resources in regions border.