Albuquerque Mariana Vercesi de, Lima Luciana Dias de, Oliveira Ricardo Antunes Dantas de, Scatena João Henrique Gurtler, Martinelli Nereide Lucia, Pereira Adelyne Maria Mendes
Departamento de Administração e Planejamento em Saúde, Escola Nacional de Saúde Pública Sérgio Arouca, Fiocruz. R. Leopoldo Bulhões 1480/709, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil.
Instituto de Informação e Comunicação Científica e Tecnológica em Saúde, Fiocruz. Rio de Janeiro RJ Brasil.
Cien Saude Colet. 2018 Oct;23(10):3151-3161. doi: 10.1590/1413-812320182310.13032018.
The analytical focus is on the role of the Regional Interagency Commissions (CIR), considering the diversity of actors that influence health policy in specific regional contexts. The research involved conducting five case studies in each of the Brazilian macroregions, with the application of 128 questionnaires to public managers, service providers and civil society representatives, between August 2015 and August 2016. The comparative perspective was adopted, by considering three analytical approaches: the configuration of actors (governmental and non-governmental; public and private) on regional decisions and conflicts, operation dynamics and contributions of commissions to health system policy and organization. The results showed the diversity of actors with a high degree of influence in the regions and the role of the Regional Interagency Commissions in policy coordination and conflict resolution. The commissions favor interagency negotiation and the organization of the Unified Health System vis-à-vis the Brazilian federative structure. However, they have limited scope as a space for regional health governance and are unable to incorporate the different configurations of public and private actors with power and influence over health decisions.
分析重点是区域跨部门委员会（CIR）的作用，同时考虑到在特定区域背景下影响卫生政策的行为主体的多样性。该研究在巴西各宏观区域分别开展了五个案例研究，于2015年8月至2016年8月期间，向公共管理人员、服务提供者和民间社会代表发放了128份调查问卷。研究采用了比较视角，考虑了三种分析方法：行为主体（政府和非政府；公共和私人）在区域决策和冲突中的构成、委员会对卫生系统政策和组织的运作动态及贡献。结果显示，在各区域具有高度影响力的行为主体具有多样性，以及区域跨部门委员会在政策协调和冲突解决方面的作用。这些委员会有利于跨部门谈判以及针对巴西联邦结构构建统一卫生系统。然而，作为区域卫生治理的空间，它们的范围有限，无法纳入对卫生决策具有权力和影响力的公共和私人行为主体的不同构成。
