This study analyzes the management innovations that occurred during the health policy decentralization process in Brazil, based on research focusing on health policy municipalization and innovations in the State of Rio de Janeiro. After an exhaustive analysis of the Unified Health System (SUS) in Rio de Janeiro, five municipalities from the State were selected which presented good performance in health system management: Angra dos Reis, Duque de Caxias, Niterói, Resende, and Volta Redonda. Based on interviews with health system managers, the first part of the article analyzes how the decision-making process takes place in the five Municipal Health Departments. The second part of the study draws on the results of the implementation of health services as perceived by health professionals providing care to users at the municipal level. We felt that exploring policy innovations incorporated into the municipal health system and the issue of provision of health care to patients would provide a relevant basis of comparison for establishing parameters or indicators allowing for future evaluation of health policy at the local level.
Management innovation; Implementation; Decentralization
