Introduction The public health sys

Introduction
The public health system in Brazil has been undergoing for the past 22 years, through a process of reform aimed at building the Unified Health System (SUS), whose political and doctrinal bases were established in the Federal Constitution of 1988 this, the right to health is right to citizenship, correlate to state responsibility for ensuring the universality and comprehensiveness in population access to programs and services.
The institutional trajectory construction of SUS has taken different forms and rhythms in each state, to the extent that it adopted the municipalization of services and during the 90s (Basic Operational Standards - NOB 01/91; 01/93; 01/96) 1.2 and later, the regionalization of health (Operational Standard for Health Care Services - NOAS 2001-2001), aiming to promote the organization of the care model based on the principle of comprehensive care 3 4. From 2006, the development of SUS began to be based on the Pact for Life, in defense of the NHS and management 5, guidance and political-managerial conduct document approved by the Tripartite Commission, reinforcing the regionalization of services and the proposal of forming integrated networks that articulate different levels of care.
In the balance of the construction process of SUS, Realize up advances and difficulties in operationalizing its principles and guidelines. This has stimulated the mobilization of several political actors who advocate its implementation, as well as raising issues and conducting studies on the factors that influence the process of formulation and implementation of public policies in general and health policy in particular. So come to questioning the political and operational arrangements that, in every state and / or county, determine the advance or retreat of the incorporation of these proposals in SUS, especially with regard to decentralization of resources and decision-making power and responsibility on the organization and production of 6,7,8,9 services.
One aspect that has drawn particularly attention of managers and researchers is the issue of human resources, considered one of the "critical nodes" of the change of management and the health care process in the country. In fact, the shortage of qualified to exercise the management of systems and services frameworks, besides the casualization of labor relations, together with the profiles of inadequacy and lack of commitment of most professionals and health workers to the SUS and are Today, one of the great challenges to its consolidation.
Facing these difficulties has sparked the development of several proposed solutions and arrangements for the management of health workers, particularly at the state and municipal level, because of the decentralization process. If, on the one hand, it facilitates the definition of proposals best suited to local and regional issues, on the other, have evidenced the existence of structural and economic problems that impact on the management capacity of many state departments and municipalities in the area of management labor and health education.
Considering that this area is strategic, since the investment and prioritization of its institutional development are likely to trigger changes in the political and institutional practices at managerial level as well as in the organization and delivery of services, it is important to rescue the experience that has been developed by health departments. Therefore, it is worth noting the efforts made by the State Department of Health of Bahia (SESAB) the redirection of SUS implementation process in the state, in the later conjuncture for the October 2006 elections.
In fact, the political scene set in Bahia from January 2007, the ruling group adopted as guiding principles of government expansion of health democracy, participatory governance and collective bargaining around the strategies for economic and social development 10. The management team SESAB assumed, among other commitments, overcoming precarious employment relationships and working conditions and remuneration of health workers; the organization of services and performance of health professionals; accountability of managers, managers and professionals to provide the best care possible within the limited conditions in financial and operational terms 10.
The area of human resources, therefore, was considered a priority, which has resulted in the formulation of Policy Management Labour and Health Education (PGETES), developed under the coordination of the Superintendent of Human Resources SESAB. Investigate how did this process may contribute to understanding the role of government in a situation in which it seeks to encourage political participation of different actors.
In this perspective, this study aims to: (a) identify and characterize the political actors who participated in the process of formulating the PGETES; (B) describe and analyze the moments of this process; (C) discuss some of the limitations encountered and the possibilities of improving the practice of formulating and implementing policies at the state level.

ผลลัพธ์ (อังกฤษ) 3:

Introduction
The public health system in Brazil has been undergoing for the past, 22 years through a process of reform. Aimed at building the Unified Health System (SUS), whose political and doctrinal bases were established in the Federal Constitution. Of 1988 this the right, to health is right, to citizenshipCorrelate to state responsibility for ensuring the universality and comprehensiveness in population access to programs. And services.
The institutional trajectory construction of SUS has taken different forms and rhythms in, each state to. The extent that it adopted the municipalization of services and during the 90s (Basic Operational Standards - NOB 01 / 91;? 01 / 93; 01 / 96), 1.2 and laterThe regionalization of Health (Operational Standard for Health Care Services - NOAS 2001-2001), aiming to promote the. Organization of the care model based on the principle of comprehensive care 3 4. From 2006 the development, of SUS began. To be based on the Pact, for Life in defense of the NHS and, management 5Guidance and political-managerial conduct document approved by the Tripartite Commission reinforcing the, regionalization. Of services and the proposal of forming integrated networks that articulate different levels of care.
In the balance of. The construction process, of SUS Realize up advances and difficulties in operationalizing its principles and guidelines.This has stimulated the mobilization of several political actors who advocate its implementation as well, as raising issues. And conducting studies on the factors that influence the process of formulation and implementation of public policies in. General and health policy in particular. So come to questioning the political and operational arrangements that in every,, State and / or, countyDetermine the advance or retreat of the incorporation of these proposals in SUS especially with, regard to decentralization. Of resources and decision-making power and responsibility on the organization and production of 6 7 8 9,,, services.
One. Aspect that has drawn particularly attention of managers and researchers is the issue of, human resourcesConsidered one of the "critical nodes" of the change of management and the health care process in the country. In, fact. The shortage of qualified to exercise the management of systems and services frameworks besides the, casualization of labor. Relations together with, the profiles of inadequacy and lack of commitment of most professionals and health workers to the. SUS and, are TodayOne of the great challenges to its consolidation.
Facing these difficulties has sparked the development of several proposed. Solutions and arrangements for the management of, health workers particularly at the state and, municipal level because. Of the decentralization process. If on the, one hand it facilitates, the definition of proposals best suited to local and. Regional issues on the other,,Have evidenced the existence of structural and economic problems that impact on the management capacity of many state. Departments and municipalities in the area of management labor and health education.
Considering that this area, is strategicSince the investment and prioritization of its institutional development are likely to trigger changes in the political. And institutional practices at managerial level as well as in the organization and delivery, of services it is important. To rescue the experience that has been developed by health, Therefore departments.It is worth noting the efforts made by the State Department of Health of Bahia (SESAB) the redirection of SUS implementation. Process in, the state in the later conjuncture for the October 2006 elections.
In fact the political, scene set in Bahia. From January 2007 the ruling, group adopted as guiding principles of government expansion of, health democracyParticipatory governance and collective bargaining around the strategies for economic and social development 10. The management. Team SESAB assumed among commitments overcoming, other, precarious employment relationships and working conditions and remuneration. Of health workers; the organization of services and performance of health professionals; accountability, of managersManagers and professionals to provide the best care possible within the limited conditions in financial and operational. Terms 10.
The area of, human resources therefore was considered, a priority which has, resulted in the formulation of. Policy Management Labour and Health Education (PGETES), developed under the coordination of the Superintendent of Human. Resources SESAB.Investigate how did this process may contribute to understanding the role of government in a situation in which it seeks. To encourage political participation of different actors.
In this perspective this study, aims to: (a) identify and characterize. The political actors who participated in the process of formulating the PGETES; (B) describe and analyze the moments of. This process;(C) discuss some of the limitations encountered and the possibilities of improving the practice of formulating and implementing. Policies at the state level.
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