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Oral health care and health decentralization in Brazil: two case studies in Bahia State

A comparative case study was performed in two selected municipalities in the State of Bahia, Brazil, to discuss the relationship between health system decentralization and characteristics of oral health services. A logical model was developed and submitted to an expert panel. Data were gathered through in-depth interviews, field observation, and analysis of secondary data from the National Health System database. The results point to the influence of municipal government characteristics on oral health practice. One municipality was classified as having an intermediate standard of oral health system implementation (50%), while the other showed only 11% implementation. The study showed that the decentralization process has not been accompanied by an effort to improve management capacity in the local oral health services, despite the transfer of funds to this area.

Oral Health; Health Evaluation; Health Policy


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