Decentralization and regionalization: dynamics and conditioning factors for the implementation of the Health Pact in Brazil

Decentralization and regionalization represent constitutional guidelines for the organization of the Unified Health System, which in the last 20 years has required the adoption of mechanisms to coordinate and accommodate federative tensions in Brazil's healthcare sector. This paper analyzes the national implementation of the Health Pact between 2006 and 2010 involving a strategy that reconfigures intergovernmental relations in the sector. The study involved the analysis of documents, official data and interviews with federal, state and municipal managers in the Brazilian states. The content of the national proposal is initially discussed, including its implications for health policy. The different rhythms and degrees of implementation of the Health Pact are then reviewed, with respect to adherence by states and municipalities and the formation of Regional Management Boards. Lastly, the conditioning factors for the multiplicity of experiences observed in the country are identified and the challenges facing progress toward a decentralized and regionalized health system in Brazil are discussed.

IMPLEMENTATION OF PROTECTED AREAS FORCENTRAL CORRIDOR OF ATLANTIC FORESTIN BAHIA: CHALLENGES AND LIMITS

In Brazil, Protected Areas (PAs) are considered the cornerstone for development of national strategies for biodiversity conservation. Considering this point of view we analyzed thirty protected areas belonging to Atlantic Central Corridor of Atlantic Forest in Bahia, aiming to identify and analyze its current level of implementation. Lemos de Sa and Ferreira (2000) methodology which consist of applying a standard scale, where the variation of the level of implementation conforms to a range of 0 to 5 points was used, with appropriate adaptations. After obtaining the data from the implementation level we use the aggregation method of Ward to help visualize the dissimilarity between the protected areas studied. We used an international classification proposed by IUCN (International Union for Conservation of Nature) for that the UCs to be compared with works done in another countries, the UCs considered are in the groups Ia, II, V and VI da IUCN. As results, 50% of protected areas analyzed are reasonably implemented, 40% inadequately implemented, 6.7% are presented only on paper and only 3.3% can be classified as satisfactorily implemented. These areas presents problems in their regularization; deficiency in infrastructure, human and financial resources. Given the results its clear the recurrent fact that conservation areas under study must be effectively implemented and for this to occur environmental policies should be focused on actions to consolidate the goals of conservation strategy.