title: Regionalization and political dynamics of Brazilian health federalism.
abstract: The implications from the Brazilian federal structure on the regionalization of health actions and services in the National Unified Health System (SUS) were analyzed, considering that the regional health planning in Brazil takes place within the context of intergovernmental relations as an expression of cooperative federalism in health. The analysis was based on a historical approach to Brazilian health federalism, recognizing two development periods, decentralization and regionalization. Regional health planning of SUS was explored in light of the theoretical framework of federalism. It is concluded that relative centralization of the process is needed in intergovernmental committees to actualize federal coordination and that it is essential to consider formalizing opportunities for dissent, both in regional management boards and in the intergovernmental committees, so that the consensus decision-making can be accomplished in healthcare regionalization.
authors.affiliation: Programa de Pós-Graduação em Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil. dadourado@usp.br
authors.forename: Daniel de Araujo
authors.initials: Dde A
authors.lastname: Dourado
authors.forename: Paulo Eduardo Mangeon
authors.initials: PE
authors.lastname: Elias
mesh_terms: D001938:Brazil; D019058:Community Networks / Q000458:organization & administration; D006291:Health Policy / Q000639:trends*; D006801:Humans; D009313:National Health Programs / Q000458:organization & administration*; D011057:Politics; D012040:Regional Health Planning / Q000458:organization & administration*