Politics of health's regionalization: from the transaction rules to the Pact for Health

das normas operacionais ao Pacto pela Saúde

Abstract

This is a literature review that aims at identifying the trajectory of the decentralization process and regionalization of the Brazilian Unified Health System, (in Portuguese, SUS) through its structuring legislation; the new municipalities' responsibilities according to the SUS current regionalization policy; and the difficulties and challenges reported by specific literature on the responsibilities of local managers in the process of SUS regionalization. The Scientific Electronic Library Online (Scielo) database was used as well as material published by the Brazilian Health Department. Eight articles on management or regionalization, dating from 2001 to 2009, were found. Thematic content analysis identified three topics addressing decentralization and regionalization. Analyses of articles and current legislation enabled to understand the advances in the consolidation of the SUS as well as the difficulties faced for the construction of a health system that offers services encompassing all levels of care and that guarantee easy access to a comprehensive health care to the population, greater equity and resolvability.