Ouverney Assis Mafort, Ribeiro José Mendes, Moreira Marcelo Rasga
Departamento de Ciências Sociais, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz. R. Leopoldo Bulhões 1480/9º, Manguinhos. 21041210 Rio de Janeiro RJ
Cien Saude Colet. 2017 Apr;22(4):1193-1207. doi: 10.1590/1413-81232017224.03002017.
This paper analyzes the implementation process of the Public Action Organizational Contract (Coap) and its impacts on state agendas of SUS regionalization, comparing the different institutional reactions of the states to the strategy proposed by Decree 7.508/11. The comparison of developing dynamics of state agendas took as reference a normative baseline structured in eight strategic political-institutional moments in the implementation of the Coap in accordance with the logic defined in Decree 7.508/11. We collected data through a questionnaire containing 35 questions (1 open, 25 closed and 9 mixed) and extensive documentary research in 2013 and 2014 in all states, except for the Federal District. Results showed that state agendas were distributed around three differentiated developing patterns: six states maintained greater distance from the national agenda established by Decree 7.508/11, engaging in a very fragmented way; 12 states engaged in the Coap agenda, selectively focusing on specific moments or stages, strengthening the process they have been developing; and 10 states maintained greater performance regularity during the eight moments of the Coap implementation cycle.
本文分析了公共行动组织契约（Coap）的实施过程及其对单一卫生系统（SUS）区域化国家议程的影响，比较了各州对第7508/11号法令提出的战略的不同制度反应。国家议程发展动态的比较以一个规范性基线为参考，该基线按照第7508/11号法令所定义的逻辑，在Coap实施过程中的八个战略政治-制度时刻构建而成。我们于2013年和2014年通过一份包含35个问题（1个开放式、25个封闭式和9个混合式）的问卷以及除联邦区外所有州的广泛文献研究收集了数据。结果显示，国家议程围绕三种不同的发展模式分布：六个州与第7508/11号法令确立的国家议程保持较大距离，参与方式非常分散；12个州参与Coap议程，有选择地关注特定时刻或阶段，加强其一直在推进的进程；10个州在Coap实施周期的八个时刻保持了较高的绩效规律性。
