SciELO - Scientific Electronic Library Online

vol.21 issue5Educational techniques in diabetes treatmentDental caries in 15-to-19-year-old adolescents in São Paulo State, Brazil, 2002 author indexsubject indexarticles search
Home Page  

Services on Demand




Related links


Cadernos de Saúde Pública

On-line version ISSN 1678-4464Print version ISSN 0102-311X


COELHO, Thereza Christina Bahia  and  PAIM, Jairnilson Silva. Decision-making process and administrative practice: managing the State Health Secretariat in Bahia, Brazil. Cad. Saúde Pública [online]. 2005, vol.21, n.5, pp.1373-1382. ISSN 1678-4464.

This case study is based on research performed by the Bahia State Health Secretariat (SESAB), aimed at analyzing management practices during the implementation of a State government administrative reform. The institutional agenda shows evidence of limited participation by civil society and technical and operational staff in problem selection and prioritization, resulting from a work process pressured by high-level executive government staff. Decisions regarding "output" (projects, services, and activities) were made under the responsibility of subordinate operational levels and did not appear as issues in the institutional routine. Concerns related to "input" (financial and human resources) consumed most of the high-level efforts, with internal and external negotiations and compromises to assure access to them. Meanwhile the possible "outcome", namely public health status, represents the "occult subject" of the institutional discourse. Information emerges in institutional disputes as a technical "power resource" in its medical, epidemiological, health, and administrative dimensions. The issue of government "representation" and allied interests is based on ideological dispositions and authoritarian practices, thus contradicting the need for management transparency and modernization.

Keywords : Health Resources; Resources Management; Organizational Policy.

        · abstract in Portuguese     · text in Portuguese     · Portuguese ( pdf )