Secretarias de Estado da Saude no Brasil : organizações em processo de mudança

AUTOR(ES)
DATA DE PUBLICAÇÃO

2003

RESUMO

This study identifies and characterizes the current processes of institutional changes occurring in Brazilian State Health Departments at the moment when the Unified Health System is being implemented together with the on-going reform process of the public sector in the country. It works with the hypothesis that the process of changes occurring in the Health System are the result not only of the pressure exercised by the processes themselves, but also by the capability of its managing nucleus to comprehend new attributes and direction transformations and innovations in terms of institutional dynamics. It originated from the concept of institutional change as a complex process that permits difIerent emphases with contributions deduced from various theoretical approaches. The study was made in 10 selected State Health Departments where the focus was on elements related to the managing nucleus or group of the Health Department, existing and operating organizational structures and the organization of work processes. This study made possible the identification of a set of questions related to the used methodology as wellas a legal theoretical framework which supports the SUS itself and, particularly, a state govemment management system turned to the actual changing processes at the SES seen as organizations. The study points out that the 10 State Health Departments studied are today involved in redirecting their institutional projects in order to improve the performance of the attributes given to them by the Health System. Furthermore, it identified a great heterogeneity in the capability for implementing these changes in function of the understanding of the directors with respect to health policy and organizational requirements

ASSUNTO(S)

descentralização administrativa politica de saude

ACESSO AO ARTIGO

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