Health Reform in Ceará: the process of decentralisation in the 1990s.
The objective of this article is to offer an overview of the health reform in Ceará focusing on the decentralisation process in the 1990s. The driving factor behind the Brazilian health reform movement was the necessity to reorganise the national health system and overcome inequalities. For the reformists, decentralisation, and together with it the idea of popular participation, is seen as essential to guarantee the fulfilment of the people's needs and to incorporate their voice in the decision-making processes of the health system. In the state of Ceará, after the 1986 elections, health reform movement members took control over the management of the state Health Secretariat. This is the main cause of the acceleration of the decentralisation process with the transference of responsibility over the management of health care delivery to municipalities.
Regianne Leila Rolim Medeiros é Professora Adjunta do Curso de História e do Mestrado em Políticas Públicas e Sociedade da Universidade Estadual do Ceará-UECE. regiannemedeiros@uece.br . Sarah Atkinson é Professora da Universidade de Durham, Reino Unido. S.J.Atkinson@durham.ac.uk.
Regianne Leila Rolim
RL
Medeiros
Regianne Leila Rolim Medeiros é Professora Adjunta do Curso de História e do Mestrado em Políticas Públicas e Sociedade da Universidade Estadual do Ceará-UECE. regiannemedeiros@uece.br . Sarah Atkinson é Professora da Universidade de Durham, Reino Unido. S.J.Atkinson@durham.ac.uk.
Sarah
S
Atkinson
Decentralisation; Health Reform Ceará; Policy