Social control in complementary health in a Brazilian municipality of the northwest gaúcho: between social management and strategic management

between social management and strategic management

Abstract

Reflections have been made on the differences and approximations of concepts of social management and strategic management (CANÇADO; VILLELA; SAUSEN, 2016). In this article, the two approaches to complementary health services are analyzed based on the dynamics existing between institutional arrangements and the participation of local actors in the context of contracting SUS services by third sector organizations. It is a policy defined by the Federal Constitution that aims to promote the sustainability of territories in the face of the distribution of resources for the organization of hospital public health, especially in small municipalities, where social demands and dependencies on external resources are more latent. Thus, through bibliographic research, documentary research, and interview, we sought to investigate the management practices and their ways of acting concerning the social control of complementary health, considering the interrelationships between the municipal health council, philanthropic hospital institution, and public power in a small Brazilian municipality, located in the northwest of the State of Rio Grande do Sul. The results show that social management takes the form of few actions and social control is not effective. Meanwhile, strategic management strives for the optimization of available resources, permeating the political and institutional relations to which the council and the other local actors involved are submitted. Consequently, initiatives to promote more effective transformations in the scope of complementary health at the study's research site are also affected, since there is no horizontal participation.