title: [Universal health systems and territory: challenges for a regional policy in the Brazilian Legal Amazon].
abstract: 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.
authors.affiliation: Faculdade de Medicina, Universidade de São Paulo, Avenida Dr. Arnaldo 455, São Paulo, SP 01246-903, Brazil. anaviana@usp.br
authors.forename: Ana Luiza d'Avila
authors.initials: AL
authors.lastname: Viana
authors.forename: Cristiani Vieira
authors.initials: CV
authors.lastname: Machado
authors.forename: Tatiana Wargas de Faria
authors.initials: TW
authors.lastname: Baptista
authors.forename: Luciana Dias de
authors.initials: LD
authors.lastname: Lima
authors.forename: Maria Helena Magalhães de
authors.initials: MH
authors.lastname: Mendonça
authors.forename: Luiza S
authors.initials: LS
authors.lastname: Heimann
authors.forename: Mariana Vercesi
authors.initials: MV
authors.lastname: Albuquerque
authors.forename: Fabíola Lana
authors.initials: FL
authors.lastname: Iozzi
authors.forename: Virna Carvalho
authors.initials: VC
authors.lastname: David
authors.forename: Pablo
authors.initials: P
authors.lastname: Ibañez
authors.forename: Samuel
authors.initials: S
authors.lastname: Frederico
mesh_terms: 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*