Governança do SUS : análise do perfil das Comissões Intergestores Regionais do Nordeste

Abstract

The CIRs are constituted as a space for SUS governance, presenting strong articulation power to build strategies that aim to overcome obstacles imposed in the regionalization process. Therefore, they are configured as regional spaces and instances of co-management, strengthening the process of planning, agreements and negotiation, resulting in a space for decisions and filling the governance gap in health regions. Territorial governance facilitates the organization of health actions and services carried out by municipalities, states and regions based on collective interests in a cooperative manner between different actors with joint involvement in the social, economic and institutional fields. Therefore, the present study is justified by its importance for health management, as governance with decentralization and regionalization are fundamental dimensions of the SUS, as fields open to reflection, such processes must be strengthened in a governance system with greater decisionmaking and assertive power in regional demands. This is a qualitative, descriptiveexploratory research, based on secondary data from the “National Survey of Regional Intermanagerial Commissions (CIR)”, with the 133 regional managers of the SUS as participants. Data were collected through an online electronic questionnaire addressed to the presidents, coordinators and/or directors of the CIRs, between 2017 and 2018. The results of the study show that the CIRs are mostly represented by women, with training in nursing and serving of regional manager in his first term. As for the implementation process, managers participate in the CIR implementation process and this was done through a legal act by the CIB with immediate and complete adherence by the municipalities in the health regions. Regarding the implementation process, it can be seen that the initiative, guidance and space for management were carried out by the regional management board and state health departments. Regarding the political-institutional organization, the data demonstrated that the most frequent meeting agendas are based on municipal requests and CIB decisions and that discussions occur more frequently with topics focused on adherence to public policies and agreement on flows. Considering the discussions raised, it is understood that the structuring of the CIR is still incipient, with dependence on state spaces, demonstrating a weakening of decentralization and the absence of fixed and exclusive spaces for the CIR. Regarding financing, it was evident that there is no contribution of federal resources to these commissions and that the vast majority of them do not have budgetary allocation of resources to cover the expenses of these commissions, often making planning unfeasible and weakening the functioning of the CIRs.