Health policies and federative gaps in Brazil: An analysis of regional capacity of services delivery

Abstract

This paper analyzes Brazilian health regions according to their service delivery capacity from the debate on the crisis of cooperative federalism in the SUS that resulted from decentralizing process established in the 1988 Constitution. Service delivery capacity tracer indicators were selected by regions and statistical analyses evidenced greater regional capacity in hospital care and large asymmetries with regard to the availability of physicians, high complexity equipment and private insurance coverage. In conclusion, we argue that further solutions are required to strengthen governmental capacity to reduce regional inequalities throughincreased central coordination.