title: [The voice of municipal administrators on access to health in management practices].
abstract: Universal access to health services is a challenge for municipal administration in a society that treats health as a commodity and gives preference to the individual consumer to the detriment of the citizen. This study sought to identify the social representations in the narrative of local health managers in a micro-region of southeast Brazil about access to health services. It consists of qualitative research with interviews conducted with 16 managers. The Collective Subject Discourse technique was employed with the use of Qualiquantisoft software in the data analysis. Four core ideas were identified: coordination between federal states; reorganization of admission procedures; user service and the precariousness of guaranteed access. It was revealed that the quality, resolvability, approach to the user's needs and the care network organization are poorly addressed, which reflects an understanding that does not consider 'access quality and resolution.' It is understood that the managers' impotence to make changes and the lack of society and worker engagement in management bolster the supremacy of market interests and contribute to 'limited access' and the continuity of the hegemonic model of care.
authors.affiliation: Secretaria Estadual de Saúde do Estado do Espírito Santo, Vitória, ES, 29931-420, Brazil. belasilva@saude.es.gov.br
authors.forename: Bela Feiman Sapiertein
authors.initials: BF
authors.lastname: Silva
authors.forename: Gladys Amelia Vélez
authors.initials: GA
authors.lastname: Benito
mesh_terms: D000288:Administrative Personnel; D000328:Adult; D001938:Brazil; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged