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关于健康区域治理的理论思考

Theoretical reflections on governance in health regions.

作者信息

Bretas Nilo, Shimizu Helena Eri

机构信息

Departamento de Enfermagem, Faculdade de Ciências da Saúde, Universidade de Brasília. Asa Norte, Campus Darci Ribeiro. 70910-900 Brasília DF Brasil.

出版信息

Cien Saude Colet. 2017 Apr;22(4):1085-1095. doi: 10.1590/1413-81232017224.30532016.

Abstract

This article analyzes governance in health regions, through the contributions of two studies: one on a governance model and the other on duties in the management of public policies networks. The former conducted a meta-analysis of 137 case studies in the literature on collaborative governance aimed at preparing an explanatory and analytical model. Authors identified critical variables that will influence the results: a previous history of conflict or cooperation, incentives for participation, power imbalances, leadership and institutional design. They also identified key factors: face-to-face dialogue, trust building and development of commitment and shared vision. The latter study examined networks of public policies in the analytic tradition and the perspective of governance, incorporating concepts from the field of political science, economics and interorganizational relations, in order to support the management of public policies networks. The study identified network management as equivalent to a strategic game involving functions: network activation, framework of relations, intermediation, facilitation and consensus building and mediation and arbitration. The combination of the two reflections provides a conceptual reference for better understanding of governance in health regions.

摘要

本文通过两项研究的成果分析了卫生区域的治理情况

一项是关于治理模式的研究,另一项是关于公共政策网络管理职责的研究。前者对文献中137个旨在构建解释性和分析性模型的合作治理案例研究进行了荟萃分析。作者确定了将影响结果的关键变量:冲突或合作的既往历史、参与激励、权力失衡、领导力和制度设计。他们还确定了关键因素:面对面对话、信任建立以及承诺和共同愿景的发展。后者从分析传统和治理视角研究了公共政策网络,纳入了政治学、经济学和组织间关系领域的概念,以支持公共政策网络的管理。该研究将网络管理等同于一场涉及以下职能的战略博弈:网络激活、关系框架、调解、促进与共识建立以及调解与仲裁。这两种思考方式的结合为更好地理解卫生区域的治理提供了概念性参考依据。

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