Uma reflexão sobre a descentralização da gestão do Sistema Único de Saúde - SUS: a experiência de um município de pequeno porte

Abstract

This article brings a reflexion about the decentralization of the financial resources management from the Sistema Único de Saúde (SUS) directed to the health assistance in a small town. It is, in fact an experience related from a given situation faced in the management of healthn public resources, once as it occurs in Brazil, the town in question receives resources coming from the federal, state and municipal sphere. Nonetheless there are difficulties in aswering all the needs in the health field of the population due to many aspects as the lack of implementation of the 29/2000 Constitutional law, insufficient financial transferences and sometimes a delay in the arrival of these resources, an increase of the financial, economical, accountancy and administrative responsability of the town, lack of clear rules to the commitment of the federal budgets as well as States and Towns with health policies, generating more responsability to the health of its inhabitants. The town also has in its territory a significant number of indigenous people who need special attention although there is enough resource to take care of this population part. One concludes that the small towns need to gather their efforts in the sense of reaching a larger level of finacial resources to the fied of health and co-responsabilities from federal and state institutions.