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Item Avanços e desafios da institucionalização da democracia participativa em Belo Horizonte a partir das conferências municipais de políticas para as mulheres realizadas no período de 2004 a 2010(Fundação João Pinheiro, 2012-03-27) Oliveira, Girlene Galgani Reis de; Brasil, Flavia de Paula Duque; http://lattes.cnpq.br/4666930977365902; Brasil, Flávia de Paula Duque; Cunha, Eleonora Shettini Martins; Costa, Bruno Lazarotti DinizThis dissertation analyzes the social participation in the process of elaboration of policies at the Conferences of Public Policies held in Brazil principally on the Lula Government and more specifically from the case study of the Municipal Conferences of Policies for Women in Belo Horizonte. Among the various participatory institutions that guarantee the exercise of democracy, the Conferences of Public Policies are important instances of participation and deliberation, as they offer to the public the opportunity to directly intervene in governmental decisions, presenting guidelines for planning and public management according to the demands presented by different segments of Civil Society. They occur at specific intervals, usually every other year, and they seek the normative direction of thematic areas in Public Policy. The Conferences are organized at the three levels of government (municipal, state and national), and at each level the discussions of the problems perceived by the participants who elaborate proposals occurs, pointing the demands that are collectively approved. The Dissertation has the Municipal Conferences for Politics for Women of Belo Horizonte realized in 2004, 2007 and 2010 as focus and seeks to verify if in the understanding of the councilors of the Municipal Council of Women's Rights the proposals approved at these conferences were used as reference in the elaboration of Public Policies for the Municipal Health Area and if this participatory institution promoted the political and social inclusion of women in the city. Towards this goal, I addition to the relevant literature review, the research turned to documentary surveys and semi-structured interviews with counselors.Item Judicialização da saúde: como decide o Poder Judiciário Federal?: análise das demandas de saúde na seção judiciária de Minas Gerais(Fundação João Pinheiro, 2013-11-25) Junqueira, Silvana Regina Santos; Batitucci, Eduardo Cerqueira; http://lattes.cnpq.br/9562452176702956The Brazilian Constitution of 1988 enshrined the right to health as a fundamental right and a duty of the State, to be guaranteed by social and economic policies. The public health policy is developed by the principles and guidelines that the Constitution establishes and the creation of the Sistema Único de Saúde, under protection of the principles of universality, comprehensiveness and equality, the right to health is now claimed in court by those who understand that the State is not accomplishing these principles. The growth of lawsuits demanding treatments and medications directly impacts the management of public health policy and provokes discussion on the role of the judiciary in the face of administrative choices, questioning the legitimacy of its interference in public policies, the phenomenon known as judicialization of health, derived from judicialization of politics. In the trial of Suspensão de Tutela Antecipada nº 175, the Supreme Court indicates parameters for the decision on legal public health demands and became a paradigm for judicial action in such cases. Therefore, the research focuses on health claims in federal court, seeking to identify, in their sentencing, the fundamentals that guide and compliance with the criteria outlined by the Supreme Court, to contribute with some reflection for the defense of the Union in these claims.Item A atuação da burocracia de médio escalão na resposta à pandemia de Covid-19: um estudo de caso sobre a estratégia de ampliação dos leitos hospitalares do SUS/MG(Fundação João Pinheiro, 2023-03-29) Vale, Larissa Meneghini; Souza, Letícia Godinho de; http://lattes.cnpq.br/4333929511296586; Souza, Letícia Godinho; Cruz, Marcus Vinícius Gonçalves; Menicucci, Telma Maria GonçalvesThe central theme of the work is the middle-level bureaucracy, focusing on its performance in network governance in a crisis management scenario. The objective was to analyze the performance of the middle-ranking bureaucrat of the State Department of Health of Minas Gerais (SES-MG) in the expansion of hospital beds of the Unified Health System (SUS-MG), in response to the COVID-19 pandemic. The theoretical references addressed in the study are the literature of the middle-level bureaucracy - considering its role, influence, and relational dimension of analysis of its performance -, as well as the literature on governance in networks- raising general concepts on the theme to introduce the subject of SUS governance-, and lastly the literature of crisis management, to understand the impacts of crisis management in the case proposed for study. The methodology is based on a case study that uses surveys, analysis of quantitative and documentary data, and conducting interviews. The results point to significant transformations in the governance structure and functioning of SES-MG, carried out by middle-ranking bureaucrats during the crisis situation. It also points to its relational role, emphasizing above all the strengthening of bonds, approximation, and intense articulation with internal and external actors for the formulation and implementation of the strategy for expanding beds. This revealed a way of acting as facilitators of connections in a complex network of managers in a crisis scenario. This action changes the traditional slowness and typical reactivity of Public Administration. Finally, attention was drawn to the unseen professionals who compose this segment of the bureaucracy.Item Efeitos distributivos das políticas sociais: a focalização da política de saúde por mesorregiões de Minas Gerais a partir da Pesquisa por Amostra de Domicílios (PAD-MG)(Fundação João Pinheiro, 2019-03-28) Sousa, Audrey Verônica Freitas Nunes de; Ferreira, Frederico Poley Martins; http://lattes.cnpq.br/1448397981510363; Ferreira, Frederico Poley Martins; Ferreira Júnior, Sílvio; Motta, Carolina Portugal Gonçalves daThe situation of inequality that persists in Brazilian society must be considered in studies of social policies. In Brazil, despite the advances, remains with high levels of inequality. Inequalities in health, in turn, occur due to environmental and demographic determinants and are presented as one of the major social problems in the country. In this context, the Brazil’s Unified Health System (SUS) was structured in accordance with the principles of decentralization, integral care and community participation, as well as equal and universal access to health care and services, without hindrance or limitations. However, despite three decades of its creation, the Brazil’s Unified Health System has difficulties to materialize the social rights enshrined in the Constitution of universal access to health presenting, in fact, as a focused policy. In this context, this dissertation sought to observe the distributive aspect of health policy, especially regarding the access and provision of services to the population belonging to the lower income groups for the mesoregions of Minas Gerais, as well as private spending for access to health goods and services in Minas Gerais and state mesoregions through the degree of targeting of access and expenditures using the Household Sample Survey of Minas Gerais for the years 2009, 2011 and 2013. The results suggest a high level of latent inequality in the population of Minas Gerais, especially among mesoregions. The greater access to public health services observed for the lower tenths of income demonstrates that the same is focused, especially in the more developed regions. However, it also shows that the distributive effect of health policy does not occur as expected, since the poorest regions are the ones that most perform direct disbursement for access to health products and services, despite access to health care of Brazil’s Unified Health System and have low health insurance coverage.Item Regionalização da assistência à saúde no estado de Minas Gerais: capacidade de provisão de serviços hospitalares de média complexidade(Fundação João Pinheiro, 2019-03-25) Morais, Márcia Moreira de; Ferreira Júnior, Sílvio; http://lattes.cnpq.br/7789533222493903; Cruz, Marcus Vinicius Gonçalves da; http://lattes.cnpq.br/3678172153181366; Cruz, Marcus Vinicius Gonçalves da; Ferreira Júnior, Sílvio; Fortes, Fátima Beatriz Carneiro Teixeira Pereira; Machado, José ÂngeloThe regionalization of attention to health and operational and administrative decentralization of the Unified Health System (SUS) are constitutional guidelines established with the enactment of the 1988 Federal Constitution in principle the pro-municipalization movement was more intense during the first decade of organization of SUS and decentralization was more incisive than the strategy of regionalization, without which the guiding principles of the SUS, namely, universality of access, integrality of care and equity, are not achieved. The federated entities, by the nature of the SUS, are obliged to relate and complement each other, since no entity is self-sufficient in the provision of health services and, even if it were, health and epidemiological issues could be affected by an epidemic that began in another municipality or Health Region. In this way, the Brazilian health system is unique and presents itself with a social policy that induced the formation of federative arrangements capable of enforcing the aforementioned principles and guidelines. Thus, in a country of triune and singular federalism, the SUS has induced the formation of intergovernmental relations, which require mechanisms of cooperation and coordination, organized in a process of solidary governance of a network of health services that surpasses or inhibits free rider or opportunists, which weaken the relations and the achievement of health policy objectives. For this, it becomes indispensable control instruments capable of curbing actions motivated only by self-interest or that favors competitive and predatory federalism, which is not cohesive with the solidarity stance of federated entities inherent in the institutional design of SUS. In order to study the dynamics of the regionalization process, this study chose the state of Minas Gerais as a case study and, through the indicator of resolvability of hospital care of medium complexity, sought to identify the level of regionalization achieved. We analyzed the care flows between Health Regions of hospital procedures of medium complexity, MCH1 and MCH2, established by the Regionalization Master Plan of Minas Gerais (PDR / MG) as hospital services portfolio assigned to the territory of 77 (seventy-seven ) Health Regions of the state, as well as the origin of the migrant patient. Statistical analyzes were performed to analyze the cause and effect relationships between the resolvability index reached by the Health Regions and a set of variables that favored the understanding of the results. It was observed that more than 50% (fifty percent) of the Health Regions of Minas Gerais meet with critical and regular resolubility, demonstrating the low responsiveness of the Health Regions to the hospital demand of medium complexity of resident patients and pointing to a high migratory flow of patients between Regions and, in many cases, between Extended Health Regions as well. The temporal analysis between the years 2009 and 2017 showed that the heterogeneity between the Health Regions has increased, as well as the inequality. In addition, it was observed that the supply index created by factor analysis, combining dimensions of infrastructure, human resources and financing is the variable that most explains the variations of the regional resolubility. Migration flows between Regions have shown that the origin of the migrant patient is concentrated, in most cases, in the non-polo municipalities of the Health Region, suggesting weak intergovernmental cooperation and a low territorial governance capacity. In order to overcome uncooperative behavior, the institutionalization of strong legal instruments and the performance of the role of the coordinating, regulating and compensating state entity of inequalities, presents itself as a path towards a strong and solidary regionalization.