Casanova Angela Oliveira, Giovanella Lígia, Cruz Marly Marques da, Ferreira Milena Farah Damous Castanho
Programa de Pós-Graduação em Saúde Pública, Escola Nacional de Saúde Pública, Fiocruz. R. Leopoldo Bulhões 1480, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil.
Secretaria de Estado de Saúde do Pará. Belém PA Brasil.
Cien Saude Colet. 2018 Oct;23(10):3163-3177. doi: 10.1590/1413-812320182310.15442018.
Governance is a concept with different hues in public policies. In this study, it is conceived as a policy network, with stakeholders who manage interests depending on available resources, mediated by rules and by their degree of influence. This paper analyzes the stakeholders, spaces of articulation, norms, and processes in health governance in two regions of the Legal Amazon and how managers shape their social network. This is a qualitative study with regional analysis plan, using as sources documents and interviews. An analysis matrix was formulated with adapted realms of conceptual models of governance and policy networks. Results point to differentiated policy networks. In the metropolitan region, stakeholders' diversity was more associated with state management and capital, given the articulation capacity and available resources. In the international border region, the policy network of municipal managers integrates stakeholders from diverse sectors in the face of regional specificity and articulation capacity. Regions, living territories, single out technical processes, leading stakeholders to seek partners and spaces beyond those established, to weave strategies closer to reality.
治理在公共政策中是一个具有不同色彩的概念。在本研究中,它被构想为一个政策网络,其中利益相关者根据可用资源来管理利益,由规则及其影响力程度进行调节。本文分析了法定亚马逊地区两个区域卫生治理中的利益相关者、表达空间、规范和过程,以及管理者如何塑造其社会网络。这是一项采用区域分析计划的定性研究,使用文件和访谈作为资料来源。构建了一个分析矩阵,采用了治理和政策网络概念模型的适配领域。结果表明存在不同的政策网络。在大都市地区,鉴于表达能力和可用资源,利益相关者的多样性与国家管理和资本联系更为紧密。在国际边境地区,面对区域特殊性和表达能力,市政管理者的政策网络整合了来自不同部门的利益相关者。各地区,即生活区域,突出技术流程,促使主要利益相关者寻求既定范围之外的合作伙伴和空间,以制定更贴近现实的战略。