Health management and the implications of the municipal health secretary in sus: an approach from institutional analysis

Lia Bissoli Malaman Solange L´Abbate Carla Aparecida Spagnol Daniel Vannucci Dobies About the authors


The Unified Health System (SUS) defines health as the right of every citizen and the duty of the State. SUS actions in the municipalities are implemented by the health secretary in order to articulate, negotiate, monitor, evaluate and audit the health services and teams under his responsibility. The pressure inherent to the position with the demands of the population, the chief executive, the legislative body and the segments of workers can cause suffering or even lead to illness. In view of this tensioning of forces that cross health management, this theoretical essay was developed with the objective of providing reflections on the importance of analyzing the concept of implication, considering the correlation of political and technical forces developed in daily life of the work of the health secretaries and the suffering that this situation can cause, especially when the implication turns into over-implication. For this, we use the theoretical-methodological framework of Institutional Analysis, with emphasis on the concept of implication that refers to our involvement affective, ideological and professional, always present, even unconscious, with everything we do. The absence of an analysis of the implications, or alienation at work, may impact the implementation of health policies, which reinforces the relevance of this type of study.

Public Health; Health Management; Institutional Analysis

IMS-UERJ PHYSIS - Revista de Saúde Coletiva, Instituto de Medicina Social Hesio Cordeiro - UERJ, Rua São Francisco Xavier, 524 - sala 6013-E- Maracanã, 20550-013 - Rio de Janeiro - RJ, Tel.: (21) 2334-0504 - ramal 268 - Rio de Janeiro - RJ - Brazil