Análise das práticas de governança recomendadas pelo TCU na gestão do SUS em municípios brasileiros: um estudo de caso em Recife.

Abstract

Health is a fundamental right linked to economic and social determinants, requiring integrated management. Sustainable Development Goal (SDG) 3 emphasizes the need to strengthen health systems in the face of new emerging diseases. In Brazil, the Unified Health System (SUS) plays a crucial role, offering universal and free services and adopting decentralization to improve accessibility, although it has faced challenges in local management. In 2018, the Federal Court of Accounts (TCU) identified failures in the administration of the SUS and recommended a governance guide to improve leadership, strategy, and control mechanisms. This study aimed to analyze governance in the health management of Recife (SESAU) through a qualitative case study. Classified as exploratory and analytical-descriptive, the study used documentary analysis and content analysis. The documents analyzed included sources such as the transparency portal, health councils and official reports. The analysis revealed an integrated network of governance practices, despite limitations due to the lack of detailed information on internal processes. The research provided information on how the practices interact and contribute to improving public health management and services. This research sought to contribute to theoretical knowledge by relating the observed practices to existing concepts and models, offering a more detailed view of the implementation and integration of governance mechanisms. This study highlights the importance of more complex and adaptive approaches for an effective understanding of public health governance.