Health Reform in Ceará: the process of decentralisation in the 1990s

Regianne Leila Rolim Medeiros, Sarah Atkinson


The objective of this article is to offer an overview of the health reformin Ceará focusing on the decentralisation process in the 1990s. The driving factorbehind the Brazilian health reform movement was the necessity to reorganise thenational health system and overcome inequalities. For the reformists,decentralisation, and together with it the idea of popular participation, is seen asessential to guarantee the fulfilment of the people's needs and to incorporate theirvoice in the decision-making processes of the health system. In the state of Ceará,after the 1986 elections, health reform movement members took control over themanagement of the state Health Secretariat. This is the main cause of the accelerationof the decentralisation process with the transference of responsibility over themanagement of health care delivery to municipalities.

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O público e o privado - Revista do PPG em Sociologia da Universidade Estadual do Ceará - UECE