Gestão estratégica de políticas públicas pelos governos subnacionais: regionalização, parceria, e cooperação intergovernamental na área da saúde no Estado de São Paulo

A pesquisa objetiva: a) compreender o novo papel dos Estados subnacionais, especialmente de nível regional, no contexto de globalização, fragmentação, enfraquecimento do estado-nação e emergência de instâncias supranacionais de poder; b) suprir a carência de estudos atuais voltados para a regionalização da gestão da saúde - dado que a ênfase vem recaindo sobre o processo de municipalização; c) analisar experiências inovadoras visando subsidiar a formulação de propostas de reforma que levem em conta as mudanças recentes no padrão de relacionamento estado-sociedade e as novas formas de provisão dos serviços de saúde, as quais demandam um maior esforço de coordenação ao nível regional. É analisado o papel desempenhado pela Secretaria de Estado da Saúde de São Paulo na implantação do processo de regionalização, especialmente a partir da promulgação, pelo MS, da NOAS-2001 - que define padrões para a regionalização da assistência, no contexto de municipalização e descentralização. O estudo detalhará as possibilidades de se estabelecer parcerias entre estados e municípios, uma vez que os primeiros estão desenvolvendo sua capacidade de coordenação e regulação no âmbito intraestadual e supramunicipal; enquanto estes últimos estão assumindo gradativamente a provisão direta e a organização dos serviços de saúde no nível municipal, ao mesmo tempo em que se unem em instâncias associativas intermunicipais.

Centros históricos e desenvolvimento urbano: um estudo comparativo entre os programas Monumenta no Brasil e Polis em Portugal

Both the end of the twentieth century and the beginning of the twenty-first century have been characterized as a period of major political, economic, social and cultural transformations. Two of the major consequences of the political-economical crisis of the end of last century are the restructuring of capitalist production, and the consolidation of neoliberalism as a worldwide phenomenon. This new world political-economical scenario has influenced, in a dialectic way, the contemporary urban development. In that sense, "new" spatial processes and new paradigms in both urban management and urban planning have gained shape. In this context of urban transformations, the central areas of western cities, also known as historic centers, are being increasingly (re)valued. Since the Second World War, the historic centers urban areas which have great infrastructure and symbolic relevance had been undergoing a process of evasion of population and activities, undeniably linked to the neglect of government authorities. However, in recent decades, the question of historic centers rehabilitation has acquired a growing interest, academically and in political agendas. The object of this dissertation is to focus on how the government of each Brazil and Portugal has dealt with the issue of historic center rehabilitation through programs of urban rehabilitation

Gestão compartilhada de P&D em petróleo:a interação entre a Petrobrás e a Universidade Federal do Rio Grande do Norte

This work addresses the relationship between University-Firm aims to understand the model of shared management of R&D in petroleum of Petrobras with UFRN. This is a case study which sought to investigate whether the model of cooperation established by the two institutions brings innovation to generate technical-scientific knowledge and contribute to the coordination with other actors in the promotion of technological innovation. In addition to desk research the necessary data for analysis were obtained by sending questionnaires to the coordinators of projects in R&D at the company and university. Also, interviews were conducted with subjects who participated in the study since its inception to the present day. This case study were analysed through the Resource-Based View and Interorganizational Networks theory. The sample data also stands that: searches were aligned to the strategic planning and that 29% of R&D projects have been successful on the scope of the proposed objectives (of which 11% were incorporated into business processes); which was produced technical and scientific knowledge caracterized by hundreds of national and international publications; thesis, dissertations, eleven patents, and radical and incremental innovations; the partnership has also brought benefits to the academic processes induced by the improved infrastructure UFRN and changing the "attitude" of the university (currently with national prominence in research and staff training for the oil sector). As for the model, the technical point of view, although it has some problems, it follows that it is appropriate. From the viewpoint of the management model is criticized for containing an excess of bureaucracy. From the standpoint of strategic allocation of resources from the legal framework needs to be reassessed, because it is focused only on the college level and it is understood that should also reach the high school given the new reality of the oil sector in Brazil. For this it is desirable to add the local government to this partnership. The set of information leads to the conclusion that the model is identified and named as a innovation of organizational arrangement here known as Shared Management of R&D in petroleum of Petrobras with UFRN. It is said that the shared management model it is possible to exist, which is a simple and effective way to manage partnerships between firms and Science and Technology Institutions. It was created by contingencies arising from regulatory stand points and resource dependence. The partnership is the result of a process of Convergence, Construction and Evaluation supported by the tripod Simplicity, Systematization and Continuity, important factors for its consolidation. In practice an organizational arrangement was built to manage innovative university-industry partnership that is defined by a dyadic relationship on two levels (institutional and technical, therefore governance is hybrid), by measuring the quarterly meetings of systematic and standardized financial contribution proportional to the advancement of research. These details have led to the establishment of a point of interaction between the scientific and technological-business dimension, demystifying they are two worlds apart

Poder local e a gestão da educação municipal no contexto de Altamira-Pará

Com base nas discussões que tomam como eixo central a temática a ressignificação do poder local, enquanto força mobilizadora, e sua relação com a gestao da educação municipal, esta Dissertação busca problematizar se as definições institucionais e as práticas efetivadas pela Secretaria de Educação do Município de Altamira-PA tem contribuído para o fortalecimento do poder local, a fim de compreender ate que ponto o processo educativo possibilita a formação e inserção de agentes sociais nos processos de democratização da sociedade. Tendo como corpus de investigação a gestão da política educacional instituída nessa localidade, denominada de Programa Rede Vencer (antiga Escola Campeã), desenvolvida em parceria com o Instituto Ayrton Senna, avalia-se as estratégias e práticas propostas pela SEMEC no que tange a participação e o protagonismo da comunidade altamirense, examinando, para tanto, a natureza das redes relacionais constituídas entre esse orgão e os atores e segmentos sociais. Ao estabelecer uma articulação entre a metodologia das redes sociais e alguns princípios da análise do discurso, esta pesquisa identifica percepções e posicionamentos contraditórios em relações ao sentido de governança democrática e de descentralizacao e autonomia, bem como ao envolvimento da população nos processos de deliberaties e de partilha de poder, de modo que as definições instituídas pela Secretaria de Educação revelam o caráter centralizante na forma de gerir a política educacional ao ignorar a comunidade escolar e externa em sua definições e implementação. Este trabalho evidencia, ainda, que a gestão da educação assenta-se em um modelo racional/burocrático, fundamentado no controle dos resultados de desempenhos, o que favorece a concentração das decisões no ambito da SEMEC e da própria Prefeitura Municipal e, conseqüentemente, o afastamento e alheamento dos sujeitos escolares e da sociedade. Por fim, constata-se que o processo educativo, em sua dimensões curricular e administrativa, ainda não tem ainda proporcionado a formação socio-política dos sujeitos, como também nao tem contribuído para a criação de canais participativos com vistas a conquistar a democratização do poder local em Altamira.

A New Symbiosis: Municipalities, Private Contractors and Non-Governmental Organisations for the Provision of Local Public Services"

This project considered the second stage of transforming local administration and public service management to reflect democratic forms of government. In Hungary in the second half of the 1990s more and more public functions delegated to local governments have been handed over to the private or civil sectors. This has led to a relative decrease of municipal functions but not of local governments' responsibilities, requiring them to change their orientation and approach to their work so as to be effective in their new roles of managing these processes rather than traditional bureaucratic administration. Horvath analysed the Anglo-Saxon, French and German models of self-government, identifying the differing aspects emphasised in increasing the private sector's role in the provision of public services, and the influence that this process has on the system of public administration. He then highlighted linkages between actors and local governments in Hungary, concluding that the next necessary step is to develop institutional mechanisms, financial incentives and managerial practices to utilise the full potential of this process. Equally important is the need for conscious avoidance of restrictive barriers and unintended consequences, and for local governments to confront the social conflicts that have emerged in parallel with privatisation. A further aspect considered was a widening of the role of functional governance at local level in the field of human services. A number of different special purpose bodies have been set up in Hungary, but the results of their work are unclear and Horvath feels that this institutionalisation of symbiosis is not the right path in Hungary today. He believes that the change from local government to local governance will require the formulation of specific public policy, the relevance of which can be proven by processes supported with actions.

Valorization of agrobiodiversity products and strengthening of local identities in the Peruvian Andes: Experiences from the BioAndes Programme

In the Peruvian Andes, a long history of interaction between the local populations and their natural environment has led to extraordinary levels of agrobiodiversity. However, in sharp contrast with this biological wealth, Andean indigenous populations live under most precarious conditions. Moreover, natural resources are undergoing severe degradation processes and local knowledge about biodiversity management is under serious pressure. Against this background, the BioAndes Programme is developing initiatives based on a biocultural approach that aim at fostering biodiversity through the enhancement of cultural processes. On the basis of intercultural dialogue, joint learning and capacity development, and transdisciplinary action-research, indigenous communities, development practitioners, and researchers strive for the creation of innovative ways to contribute to more sustainable economic, socio-cultural, and political valorization of Andean biodiversity. Project activities are diverse and range from the cultivation, transformation, and commercialization of organic Andean fruits in San Marcos, Cajamarca Department, to the recuperation of natural dying techniques for alpaca wool and traditional weaving in Pitumarca, Cusco Department, and the promotion of responsible ecotourism in both regions. Based on the projects’ first two-years of experience, the following lessons learnt will be presented and discussed: 1. The economic valorization and commercialization of local products can be a powerful tool for the revival and innovation of eroded know-how; at the same time it contributes to the strengthening of local identities, in parallel with the empowerment of marginalized groups such as smallholders and women. 2. Such initiatives are only successful when they are embedded within activities that go beyond the focus on local products and seek the valorization of the entire natural and cultural landscape (e.g. through the promotion of agrotourism and local gastronomy, more sustainable management of local resources including the restoration of ecosystems, and the realization of inventories of local agrobiodiversity and the knowledge related to it). 3. The sustainability of these initiatives, which are often externally induced, is conditioned by the ability of local actors to acquire ownership of projects and access to the knowledge required to carry them out, which also means developing the personal and institutional capacities for handling the whole chain from production to commercialization. 4. The confrontation of different economic rationalities and their underlying worldviews that occur when local or indigenous people integrate into the market economy implies the need for a dialogical co-production of knowledge and collective action by local people, experts from NGOs, and political authorities in order to better control the conditions relating to the market economy. The valorization of local agrobiodiversity shows much potential for enhancing natural and cultural diversity in Southern countries, but only when local communities can participate in the shaping of the conditions under which this happens. Such activities should be designed in the mid- to long-term as part of social learning processes that are carefully embedded in the local context. Supporting institutions play a crucial role in these processes, but should see themselves only as facilitators, while ensuring that control and ownership remain with the local actors.

I shouldn't have to do this: Illegitimate tasks as a stressor in relation to organizational control and resource deficits

The performance of tasks that are perceived as unnecessary or unreasonable, illegitimate tasks, represents a new stressor concept that refers to assignments that violate the norms associated with the role requirements of professional work. Research has shown that illegitimate tasks are associated with stress and counterproductive work behaviour. The purpose of this study was to provide insight into the contribution of characteristics of the organization on the prevalence of illegitimate tasks in the work of frontline and middle managers. Using the Bern Illegitimate Task Scale (BITS) in a sample of 440 local government operations managers in 28 different organizations in Sweden, this study supports the theoretical assumptions that illegitimate tasks are positively related to stress and negatively related to satisfaction with work performance. Results further show that 10% of the variance in illegitimate tasks can be attributed to the organization where the managers work. Multilevel referential analysis showed that the more the organization was characterized by competition for resources between units, unfair and arbitrary resource allocation and obscure decisional structure, the more illegitimate tasks managers reported. These results should be valuable for strategic-level management since they indicate that illegitimate tasks can be counteracted by means of the organization of work.

Everyone is; should healthcare? Outsourcing: Issues in strategic planning, organizational culture, and organizational ethics

Expenditures for personal health services in the United States have doubled over the last decade. They continue to outpace the growth rate of the gross national product. Costs for medical care have steadily increased at an annual rate well above the rate of inflation and have gradually outstripped payers' ability to meet their premiums. This limitation of resources justifies the ongoing healthcare reform strategies to maximize utilization and minimize costs. The majority of the cost-containment effort has focused on hospitals, as they account for about 40 percent of total health expenditures. Although good patient outcomes have long been identified as healthcare's central concern, continuing cost pressures from both regulatory reforms and the restructuring of healthcare financing have recently made improving fiscal performance an essential goal for healthcare organizations. ^ The search for financial performance, quality improvement, and fiscal accountability has led to outsourcing, which is the hiring of a third party to perform a task previously and traditionally done in-house. The incomparable nature and overwhelming dissimilarities between health and other commodities raise numerous administrative, organizational, policy and ethical issues for administrators who contemplate outsourcing. This evaluation of the outsourcing phenomenon, how it has developed and is currently practiced in healthcare, will explore the reasons that healthcare organizations gravitate toward outsourcing as a strategic management tool to cut costs in an environment of continuing escalating spending. ^ This dissertation has four major findings. First, it suggests that U.S. hospitals in FY2000 spent an estimated $61 billion in outsourcing. Second, it finds that the proportion of healthcare outsourcing highly correlates with several types of hospital controlling authorities and specialties. Third, it argues that healthcare outsourcing has implications in strategic organizational issues, professionalism, and organizational ethics that warrant further public policy discussions before expanding its limited use beyond hospital “hotel functions” and back office business processes. Finally, it devises an outsourcing suitability scale that organizations can utilize to ensure the most strategic option for outsourcing and concludes with some public policy implications and recommendations for its limited use. ^

Government initiatives to expand access to employer-based health insurance

Employer-based health insurance is declining at records rates, which leaves an increasing number of people without access to affordable health insurance. As a result, municipalities are experiencing financial difficulties to provide health care services for their growing uninsured population. In attempt to combat this issue, three health polices have emerged within the last ten years, called Living Wage with a health insurance provision, Pay or Play, and Health Care Preference. These policies are gaining popularity as civic leaders recognize their ability to promote a public health goal by leveraging the power of city and county contracts to include a health insurance component in the competitive bidding practice for government contracts. ^ This is the first paper to conduct a retrospective analysis on whether these three health policies have been able to increase access to employer-based health insurance and/or support the local health care safety net based on the experiences of six municipalities over a 5-year period from 2001-2006. Although there was variation between the effectiveness of the policies, all three demonstrated success in that a number of contractors extended existing health insurance to employees not previously covered and the increased cost of contracting for the local government was, on average, less than 1 percent of the total operating budget. ^

Public management and regional development

Este trabajo tiene por objetivo analizar los elementos de la gestión pública del desarrollo regional a partir de las condiciones del desarrollo regional y las nociones de desarrollo local y desarrollo sustentable. Bajo estas premisas se avanzan planteamientos esquemáticos en torno a la gestión pública del desarrollo local

El gobierno local como promotor de políticas de participación ciudadana. Aprendizajes y dificultades en dos experiencias municipales

El propósito de este trabajo es analizar el proceso de surgimiento, implementación y resultados alcanzados en dos experiencias locales participativas en municipios de la Pcia. de Buenos Aires a partir de la recuperación de la perspectiva de los propios actores (funcionarios, grupos técnicos profesionales y organizaciones de la comunidad). Para la comparación de los casos se tomaron como ejes de análisis los distintos momentos de la política pública: -el surgimiento de la política: interesó indagar qué actor tuvo la iniciativa y cómo se fundamentó la política (es decir qué concepciones asumieron los procesos participativos); -respecto al proceso de implementación, a través de qué estrategias (metodologías y técnicas) se llevaron a cabo las experiencias y cuáles fueron los actores participantes; -finalmente se describieron los resultados de estas experiencias: el alcance y la calidad de los procesos que desencadenan tanto en el ámbito de la gestión de gobierno como en la relación del municipio con la sociedad

El gobierno local como promotor de políticas de participación ciudadana. Aprendizajes y dificultades en dos experiencias municipales

El propósito de este trabajo es analizar el proceso de surgimiento, implementación y resultados alcanzados en dos experiencias locales participativas en municipios de la Pcia. de Buenos Aires a partir de la recuperación de la perspectiva de los propios actores (funcionarios, grupos técnicos profesionales y organizaciones de la comunidad). Para la comparación de los casos se tomaron como ejes de análisis los distintos momentos de la política pública: -el surgimiento de la política: interesó indagar qué actor tuvo la iniciativa y cómo se fundamentó la política (es decir qué concepciones asumieron los procesos participativos); -respecto al proceso de implementación, a través de qué estrategias (metodologías y técnicas) se llevaron a cabo las experiencias y cuáles fueron los actores participantes; -finalmente se describieron los resultados de estas experiencias: el alcance y la calidad de los procesos que desencadenan tanto en el ámbito de la gestión de gobierno como en la relación del municipio con la sociedad

Public management and regional development

Este trabajo tiene por objetivo analizar los elementos de la gestión pública del desarrollo regional a partir de las condiciones del desarrollo regional y las nociones de desarrollo local y desarrollo sustentable. Bajo estas premisas se avanzan planteamientos esquemáticos en torno a la gestión pública del desarrollo local