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dc.creatorVargas, Ingrid 
dc.creatorMogollón-Pérez, Amparo-Susana 
dc.creatorUnger, Jean-Pierre 
dc.creatorda-Silva, Maria Rejane Ferreira 
dc.creatorDe Paepe, Pierre 
dc.creatorVázquez, María-Luisa 
dc.date.accessioned2020-05-26T00:09:53Z
dc.date.available2020-05-26T00:09:53Z
dc.date.created2015
dc.identifier.issn14602237
dc.identifier.issn02681080
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/24186
dc.description.abstractBackground Regional-based Integrated Healthcare Networks (IHNs) have been promoted in Brazil to overcome the fragmentation due to the health system decentralization to the municipal level; however, evaluations are scarce. The aim of this article is to analyse the content of IHN policies in force in Brazil, and the factors that influence policy implementation from the policymakers' perspective. Methods A two-fold, exploratory and descriptive qualitative study was carried out based on (1) content analysis of policy documents selected to meet the following criteria: legislative documents dealing with regional-based IHNs; enacted by federal government; and in force, (2) semi-structured individual interviews were conducted to a theoretical sample of policymakers at federal (eight), state (five) and municipal levels (four). Final sample size was reached by saturation of information. An inductive thematic analysis was conducted. Results The results show difficulties in the implementation of IHN policies due to weaknesses that arise from the policy design and the performance of the three levels of government. There is a lack of specificity as to the criteria and tools for configuring and financing IHNs that need to be agreed upon between involved governments. For their part, policymakers emphasize the difficulty of establishing agreements in a health system with disincentives for collaboration between municipalities. The allocation of responsibilities that are too complex for the capacity and size of the municipalities, the abandonment of essential functions such as network planning by states and the strategic role by the Ministry, the 'invasion' of competences among levels of government and high political turnover are also highlighted. Conclusions The implementation of regional-based IHN policy in Brazil is hampered by the decentralized organization of the health system to the municipal level, suggesting the need to centralize certain functions to regional structures or states and to define better the role of the government levels involved. © 2014 Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.
dc.format.mimetypeapplication/pdf
dc.language.isoeng
dc.relation.ispartofHealth Policy and Planning, ISSN:14602237, 02681080, Vol.30, No.6 (2015); pp. 705-717
dc.relation.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-84937402653&doi=10.1093%2fheapol%2fczu048&partnerID=40&md5=bff66733b7144ae5b863062092bba0ce
dc.titleRegional-based Integrated Healthcare Network policy in Brazil: From formulation to practice
dc.typearticle
dc.publisherOxford University Press
dc.subject.keywordAdministrative personnel
dc.subject.keywordintegrated
dc.subject.keywordBrazil
dc.subject.keywordGovernment
dc.subject.keywordHealth care planning
dc.subject.keywordHealth care policy
dc.subject.keywordHuman
dc.subject.keywordIntegrated health care system
dc.subject.keywordInterview
dc.subject.keywordOrganization and management
dc.subject.keywordProgram development
dc.subject.keywordPsychology
dc.subject.keywordPublic health
dc.subject.keywordQualitative research
dc.subject.keywordAdministrative personnel
dc.subject.keywordBrazil
dc.subject.keywordDelivery of health care
dc.subject.keywordHealth policy
dc.subject.keywordHumans
dc.subject.keywordInterviews as topic
dc.subject.keywordLocal government
dc.subject.keywordNational health programs
dc.subject.keywordProgram development
dc.subject.keywordQualitative research
dc.subject.keywordRegional health planning
dc.subject.keywordBrazil
dc.subject.keywordCo-ordination of care
dc.subject.keywordDecentralization
dc.subject.keywordHealth policy
dc.subject.keywordIntegrated delivery networks
dc.subject.keywordRegionalization
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.type.spaArtículo
dc.rights.accesoAbierto (Texto Completo)
dc.type.hasVersioninfo:eu-repo/semantics/publishedVersion
dc.identifier.doihttps://doi.org/10.1093/heapol/czu048
dc.relation.citationEndPage717
dc.relation.citationIssueNo. 6
dc.relation.citationStartPage705
dc.relation.citationTitleHealth Policy and Planning
dc.relation.citationVolumeVol. 30
dc.source.instnameinstname:Universidad del Rosario
dc.source.reponamereponame:Repositorio Institucional EdocUR


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