[Universal health systems and territory: challenges for a regional policy in the Brazilian Legal Amazon].
This article presents the results of a study on Federal health policy in the Brazilian Legal Amazon (BLA) from 2003 to 2005, aimed at backing the development of regional health policies. The region has peculiar dynamics, an extensive border area, and adverse social indicators. The methodology included documental and financial analysis, participatory observation, interviews with heads of various Federal Ministries and State and Municipal health secretaries from the BLA; characterization of geographic situations in the BLA; and field studies in 15 municipalities. Institutional consolidation of health policy proved to be low in the Amazon during the study period, due to structural, institutional, and political difficulties. The identification of six geographic situations was useful for systematizing land use differences with repercussions on health, and which should be considered when implementing public policies. There is a certain gap between Federal actions and territorial dynamics, expressed as a mismatch between the current policy and its recognition by local administrators. In addition to establishing a regional policy for the Amazon, there is an evident need for differentiated policies within the region.
Viana
Ana Luiza d'Avila
AL
Faculdade de Medicina, Universidade de São Paulo, Avenida Dr. Arnaldo 455, São Paulo, SP 01246-903, Brazil. anaviana@usp.br
Machado
Cristiani Vieira
CV
Baptista
Tatiana Wargas de Faria
TW
Lima
Luciana Dias de
LD
Mendonça
Maria Helena Magalhães de
MH
Heimann
Luiza S
LS
Albuquerque
Mariana Vercesi
MV
Iozzi
Fabíola Lana
FL
David
Virna Carvalho
VC
Ibañez
Pablo
P
Frederico
Samuel
S
D001938:Brazil; D003625:Data Collection; D004777:Environment; D004782:Environmental Health; D035082:Federal Government; D040362:Geographic Information Systems; D006077:Government Agencies; D006291:Health Policy; D006801:Humans; D009111:Local Government; D009313:National Health Programs / Q000458:organization & administration*; D011640:Public Policy; D012040:Regional Health Planning / Q000458:organization & administration*