Health micro-regionalization in a State reform context:

a pilot project implementation experience

Abstract

This article discusses the health micro-region implementation process in Ceará, Brazil, focusing on the pilot project proposed by the municipality of Baturité. The study aimed to register the relationships between the various leading characters of the process, as well as the implementation ‘stages’ of this pilot project, whose purpose was providing a reference matrix for health micro-regionalization in the state. This is a qualitative research, with a case study approach, carried out through bibliographical, documentary, and field investigation. The results indicate that this matrix was constituted in the context of the 1990 State reform, which served as a model for the national health policy, according to the 2001 Brazilian Health Care Operational Standard (NOAS), by strengthening negotiation forums, municipal health councils, and bipartite inter-agency committees. It is concluded that, in the context of this State reform, with managed administration, the implementation of health micro-regions has triggered positive changes in the organization of health services. Municipal administrations went beyond the purpose of rationalizing resources, showing service quality improvement; later, the definitions of health region and the regionalization processes have acquired new elements.