The new profile of local managers in the decentralized health system in Brazil

ABSTRACT This article analyzes the impact of decentralization on the recruiting standards for the position of municipal health secretary, aiming to understand the extent to which local power has been democratized, as a consequence of the Unified Health System (SUS) implementation. Municipal health s...

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Main Authors: Sonia Fleury, Assis Luiz Mafort Ouverney
Format: Article
Language:English
Published: Centro Brasileiro de Estudos de Saúde
Series:Saúde em Debate
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-11042018000400809&lng=en&tlng=en
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author Sonia Fleury
Assis Luiz Mafort Ouverney
author_facet Sonia Fleury
Assis Luiz Mafort Ouverney
author_sort Sonia Fleury
collection DOAJ
description ABSTRACT This article analyzes the impact of decentralization on the recruiting standards for the position of municipal health secretary, aiming to understand the extent to which local power has been democratized, as a consequence of the Unified Health System (SUS) implementation. Municipal health secretaries all over the country answered a questionnaire at two different times in the decentralization process - 1996 and 2006 - achieving representative results. The goal was to collect data about their socioeconomic, professional profile, political trajectory and public life. Results show that there are more women, brown (‘pardos’) and low-income people holding the position, and that the qualification of municipal health secretary improved in the period between the two surveys. However, this does not apply to the larger cities and more developed regions, where competition for this position has led to a recruiting standard that combines high levels of professionalism with restricted access for disadvantaged groups. We also found that municipal health secretary are now more politically engaged in manager’s associations than in their previous insertion in civil society networks.
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spelling doaj.art-77ac4aa30cd444bcbafa1627179a29da2022-12-21T23:56:45ZengCentro Brasileiro de Estudos de SaúdeSaúde em Debate2358-28984211980982510.1590/0103-1104201811902S0103-11042018000400809The new profile of local managers in the decentralized health system in BrazilSonia FleuryAssis Luiz Mafort OuverneyABSTRACT This article analyzes the impact of decentralization on the recruiting standards for the position of municipal health secretary, aiming to understand the extent to which local power has been democratized, as a consequence of the Unified Health System (SUS) implementation. Municipal health secretaries all over the country answered a questionnaire at two different times in the decentralization process - 1996 and 2006 - achieving representative results. The goal was to collect data about their socioeconomic, professional profile, political trajectory and public life. Results show that there are more women, brown (‘pardos’) and low-income people holding the position, and that the qualification of municipal health secretary improved in the period between the two surveys. However, this does not apply to the larger cities and more developed regions, where competition for this position has led to a recruiting standard that combines high levels of professionalism with restricted access for disadvantaged groups. We also found that municipal health secretary are now more politically engaged in manager’s associations than in their previous insertion in civil society networks.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-11042018000400809&lng=en&tlng=enSistema Único de SaúdeDescentralizaçãoGoverno local
spellingShingle Sonia Fleury
Assis Luiz Mafort Ouverney
The new profile of local managers in the decentralized health system in Brazil
Saúde em Debate
Sistema Único de Saúde
Descentralização
Governo local
title The new profile of local managers in the decentralized health system in Brazil
title_full The new profile of local managers in the decentralized health system in Brazil
title_fullStr The new profile of local managers in the decentralized health system in Brazil
title_full_unstemmed The new profile of local managers in the decentralized health system in Brazil
title_short The new profile of local managers in the decentralized health system in Brazil
title_sort new profile of local managers in the decentralized health system in brazil
topic Sistema Único de Saúde
Descentralização
Governo local
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-11042018000400809&lng=en&tlng=en
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