Political coalition
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PT and PMDB Parties, at federal and state level. Federal: Presidency / Health Ministry (Lula / Administration José Temporão); |
PT and PMDB Parties: federal, state and municipal levels. Federal: Presidency / Health Ministry (Lula / Administration José Temporão); |
PT and PMDB Parties: federal, state and municipal levels. Federal: Presidency / Health Ministry (Dilma / Administration Padilha); |
PT and PMDB Parties: federal/state/municipal. Presidency / Health Ministry (Dilma / Administration Padilha); |
State: Rio state government, and state Health Dept. (Sergio Cabral / Administration Sérgio Côrtes). |
State: Rio state government, and state Health Dept. (Sergio Cabral / Administration Sérgio Côrtes); |
Rio state government, and state Health Dept. (Sergio Cabral / Administration Sérgio Côrtes); |
Rio state government, and state Health Dept. (Sergio Cabral / Administration Sérgio Côrtes); |
City: prefecture of Rio / Municipal Health Service (Eduardo Paes / Hans Domann). |
City: prefecture of Rio / Municipal Health Service (Eduardo Paes / Hans Domann). |
City: prefecture of Rio / Municipal Health Service (Eduardo Paes / Hans Domann). |
Dynamics of inter-governmental relations
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Political conflicts between state government and city of Rio (Administration: Cesar Maia). |
Relations of cooperation between federal, state and city governments. Cooperation and conflicts between state and municipal governments (in metropolitan region and in regions of the interior). |
Relations of cooperation between federal, state and city governments. Cooperation and conflicts between state and municipal governments (in metropolitan region and in regions of the interior). |
Relations of cooperation between federal, state and city governments. Important politicalparty changes in some prefectures of the Baixada Fluminense region (result of 2012 elections). |
Directionality
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Predominance of the state executive in conduct of the policy in the state. Policy basically directed to the city of Rio and the Baixada Fluminense, aiming to make good areas with ‘absence of care’, and reduce demand on emergency services, with the state taking over management of the UPAs. |
Greater balance between the federal and state executives in conduct of the policy in the state. State/city partnership in the conduct of policy in the municipality of Rio. Expansion of implantation of UPAs in the regions of the interior of the state, with municipalization and efforts for regionalization. Implementation of UPAs under the initiative of the municipality in the city of Rio. |
Greater balance between the federal and state executives in conduct of the policy in the state. State/city partnership with stronger activity of the Municipal Health Service in conduct of the policy in the municipality of Rio. Strengthening of implementation in the metropolitan region and support for the constitution of the RAUs in the health regions |
Greater balance between the federal, state and municipal executives in conduct of the policy in the state. State-city partnership, with: predominance of the Municipal Health Service in the conduct of the policy in the municipality of Rio de Janeiro; influence of municipal policy over the state policy; and stagnation of the process of implementation of the UPAs. |
Institutionality
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Creation of SESDEC (2007). Rules and incentives predominantly coming from the state. |
Rules and incentives coming from state and federal government. Transfer to municipalities, and strategies to articulate the process of regionalization (start of implementation of the Regional Management Committees – CGRs – in 2009). Creation of the Municipal Health and Civil Defense Department in the city of Rio. Adoption of the Social Organizations (SO) model in the UPAs, under management of municipality in Rio de Janeiro city. |
Rules and incentives coming from state and federal government (Emergency Care Network – RAU). Separation of SESDEC (2011) and creation of the RAU Coordination Unit (2012). Fiotec removed from the process of hiring of staff (2012). Adoption of the SO model in the UPAs under management of the municipality in Rio de Janeiro city. Creation of Regional Emergency Centers in the municipality of Rio. |
Rules and incentives coming from state and federal government (RAU). Start of implementation of the SO model in the UPAs under management of the state. |
Number of UPAs created in the period, by location
|
City of Rio: 15 |
City of Rio: 9 |
City of Rio: 7 |
City of Riol: 0 |
Metropolitan region: 4 |
Metropolitan region: 6 |
Metropolitan region: 4 |
Metropolitan region: 0 |
Regions of the interior: 1 |
Regions of the interior: 12 |
Regions of the interior: 3 |
Regions of the interior: 0 |
Total: 20 |
Total: 27 |
Total: 14 |
Total: 0 |