Article



Dados vol. 59 n. 3 Rio de Janeiro jul./set. 2016

Cooperation and Coordination in the Implementation of Social Public Policies: The Case of Health Policy

Menicucci, Telma - Marques, Alisson Maciel de Faria

Abstract

ABSTRACT This article compares the degree of implementation of healthcare regionalization in Brazil based on an in-depth study on a sample of states. The management of social policies in the federal context is considered to create a need for combining autonomy and cooperation among federated bodies, leading to the age-old challenge of collective action. Although the nationally-defined institutional regulations favor cooperation, they are unable to account for the variations between the federal units. To interpret these differences, a regression model was built identifying explanatory factors across two levels, with structural factors considered on a municipal level (resources that affect the ability to provide healthcare services) and the role played by the state as a coordinator or facilitator of cooperation on a second level. Both structural factors and the role played on a state level exert important effects on regionalization, with federal incentives unable to guarantee complete adhesion by federal bodies, nor the elimination of structural obstacles.

Keywords: regionalization, health, federalism, cooperation, coordination

DOI: 10.1590/00115258201693

Full text

Cooperation and Coordination in the Implementation of Social Public Policies: The Case of Health Policy