title: [Managing comprehensive care: a case study in a health district in Bahia State, Brazil].
abstract: This study analyzed management of comprehensive care in a health district in Bahia State, Brazil, at the political, institutional, organizational, and healthcare practice levels and the challenges for establishing coordinated care between municipalities. The information sources were semi-structured interviews with administrators, focal groups with healthcare professionals and users, institutional documents, and observations. A comprehensive and critical analysis was produced with dialectical hermeneutics as the reference. The results show that the Inter-Administrators Regional Commission was the main regional governance strategy. There is a fragmentation between various points and lack of communications linkage in the network. Private interests and partisan political interference overlook the formally agreed-upon flows and create parallel circuits, turning the right to health into currency for trading favors. Such issues hinder coordination of comprehensive care in the inter-municipal network.
authors.affiliation: Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista, Brazil.
authors.forename: Adriano Maia
authors.initials: AM
authors.lastname: dos Santos
authors.affiliation: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
authors.forename: Ligia
authors.initials: L
authors.lastname: Giovanella
mesh_terms: D001938:Brazil; D003191:Comprehensive Health Care / Q000941:ethics / Q000458:organization & administration; D003695:Delivery of Health Care / Q000941:ethics / Q000458:organization & administration*; D005192:Family Health; D006291:Health Policy; D006298:Health Services Administration; D006801:Humans; D009111:Local Government; D009313:National Health Programs / Q000941:ethics / Q000458:organization & administration; D015980:Public Health Practice; D012040:Regional Health Planning