Implementation evaluation of regional health consortia in Bahia, Brazil
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Departamento de Ciências da Vida (DCV), Universidade do Estado da Bahia, Brazil
Departamento de Ciências da Vida, Universidade do Estado da Bahia, Salvador, Brazil
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A1771
Background: Although Brazil has a universal health system, the inequity of access to health care persists, especially to specialised services. To overcome it and guarantee full and equal access to health care, a federative (intergovernmental) cooperation strategy has been adopted: the regional health consortium. The implementation of these consortia, as a promising strategy, deserves research attention. Objective: Estimate the degree of implementation of health consortia in three regions of the state of Bahia, in Brazil. Methods: To estimate the actual degree of implementation of health consortia, we created an Evaluation Matrix of the Degree of Implementation, considering three dimensions: normative, managerial and services provision. Document analysis and interviews were carried out with key informants, with each consortium finally classified as totally, partially or incipiently implemented. Results: The Bahia state government and municipalities formed the regional health consortia. The three evaluated consortia started their activities in 2017 by building and managing regional health polyclinics, which offer specialised medical care. Considering the normative, managerial and services provision dimensions, all consortia were classified as totally implemented. There was an increase in the services provision of all consortia, and the differences related to the access to services were reduced between the state regions. Conclusions: The three health consortia are effectively implemented, increasing services provision and reducing access-related inequity. The federative (intergovernmental) cooperation was fundamental to organising the consortia and establishing the regional health polyclinics. Most importantly, it minimised the gap related to access to specialised clinical care in the different regions of Bahia.