Proceso de descentralización del sistema de salud en Brasil, una revisión de artículos científicos de 1985 a 2015

Abstract

AGRADECIMIENTOSEste trabajo no hubiera sido posible sin el apoyo de mis seres queridos, familia, compañero de vida y amistades que durante este tiempo me acompañaron en este camino de nuevos aprendizajes. A mi tutor, por su apoyo, orientación y paciencia durante este proceso. Al Instituto de Salud Colectiva y la Universidad Nacional de Lanús por brindarme este espacio de aprendizaje y crecimiento profesional. eficiencia en la asignación de recursos; además supondría la democratización de la toma de decisiones, el empoderamiento de los gobiernos locales y mayor participación de actores diversos en la toma de decisiones sobre su situación de salud, todo esto orientado a lograr procesos más democráticos y horizontales. En el contexto de la Reforma Sanitaria en Brasil, la descentralización del sistema de salud se convirtió en el medio por el cual se garantizaría el acceso y la integralidad de la atención de salud de la población. PALABRAS CLAVE: descentralización; sistemas de salud; Brasil ABSTRACTDecentralizing processes predominated in Latin America during the 1990s, many of which coincided with the transition to democracy of those countries that had been under dictatorial regimes. Health was one of the areas of social policy in which the decentralization model was applied more widely and which also represented a pattern to be followed for the different areas of public policy. The objective of this research is to analyze the fundamentals and controversies of the process of decentralization of the Brazilian health system based on the review of scientific articles published between 1985 and 2015. The question that serves as the main theme of the research is: what are the arguments that sustained the decentralization processes in Brazil? To answer this question, a review of scientific articles published between 1985 and 2015 and the analysis of the content of these articles was carried out. The arguments that underpinned the decentralization process in Brazil are of an economic nature, since decentralization is expected to favor efficiency in the allocation of resources; it would also involve the democratization of decision-making, the empowerment of local governments and greater participation of diverse actors in decision-making about their health situation, all aimed at achieving more democratic and horizontal processes. In the context of the Health Reform in Brazil, the decentralization of the health system became the means by which access and comprehensive health care for the population would be guaranteed.