| Regional governance |
One of the components of a regionalized network. Understood as a process of participation and negotiation between a wide range of subjects with varying degrees of autonomy. It represents diversity of interests (public and private) in a stable institutional framework that encourages cooperation between governments, agents, organizations, and citizens, in order to establish links and networks between subjects and institutions. It must involve the ways of exercise of authority and the processes of integration of social interests in the government agenda, and it may be used as analytical tool for research and transformation of the policy-making processes and health systems management. The analytic use of governance allows one to describe and explain the interactions of actors, processes, and rules of the game and, thus, achieve better understanding of conducts and decision-making in society. |
(Hufty, Bascolo, Bazzani, 2006) (Mendes, 2010) (Santos, Giovanella, 2014) (Viana, Lima, 2011) |
| Health care Networks (HCN) |
Sets of health services, linked to each other by a single mission, by common goals, and by a cooperative and interdependent action, which allow to offer a continuous and integral attention to a particular population, coordinated by primary health care - provided at the right time, in the right place, with the right cost, with right quality, and in a humanized way -, and with sanitary responsibilities for this population, in a given territory. HCNs have as constituent elements the population, the operational structure, and the model of care. The focus on building HCNs with integrated services and coordinated care bases on the PHC teams the leadership to reorientate health systems. |
(Mendes, 2010) (PAHO, 2008) (PAHO, 2009) (WHO, 2008) |
| Health care integration |
It is opposed to fragmented models, i.e., it is the search for fleshing out an organicity to health systems. It is supported on three axes: the service offer, continuously, through several points of health care; the integration of these health care points, by means of a clinical management system, and the existence of a registered population, whose health is unequivocal responsibility of the system. The main points of the health system integration mold a Health care Network. |
(Armitage and col., 2009) (Mendes, 2001) (Vazquez and col., 2009) |
| Primary Health care (PHC) |
PHC is the key component in the organization of HCN, and must be the communication center. It is up to the PHC to coordinate the system's flows and counterflows, be decisive, welcome and be responsible by the demands of the population, with power to coordinate the continuing care, through the appropriate chaining of the other components of the network. This is a set of services of first contact of the user with the health system, of easy access, directed to cover the most common diseases and conditions and solve most health problems of a population. |
Ordinance no. 2,488 (Brasil, 2012) Giovanella, (Mendonça, 2014) (Mendes, 2010) (WHO, 2008) |
| Health Region |
Privileged spaces for integration of health services, having as starting point the Regional Directive Plan, but doing the appropriate compositions that respond appropriately to the dynamics of the territories, encouraging intermanaging cooperative action. The region, therefore, is the result of the dialectic between two types of logic: one that is given by the internal arrangements of each regional division of labor (which is more the result of historical formation, spontaneous of regions) and another that is expressed by the increasingly acute influence of external vectors (whether they are standards, flows of information, of capital, of goods, of investments, etc.), which install on these pre-existing combinations their organizational nexus. |
(Almeida, Santos, Souza, 2015) (Contel, 2015) Decree 7,508 (Brasil, 2011) (Ianni et al., 2012). (Machado, 2009) |
Care integration in a health region: a paradox between regional needs and local interests