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With the aim of recovering the process of formation and organization of the health reform movement in Brazil, this article portrays the construction of health policy in the period between the 1970s and the pre-constitutional movement. It is a historical study, based on a literature review and documentary analysis of the Proceedings of the 8th National Health Conference in 1986. The historiographical perspective adopted in this study seeks to present socio-historical elements that demonstrate which values, principles, institutions and lines of discourse were used when building the theoretical and social bases that mobilized the formulation of universal health policy. Despite the numerous publications on the constitution of the Unified Health System, the study's differential consists in showing that the construction of public policy took place in a down-up system, based on the mobilization of actors and institutions that built a line of debate based on the understanding that political mobilization and social actors should be done through the rational use of reasons, incorporating elements of historical materialism, in an action that broke with a solely sectoral debate and communicated with the demands of society as a whole. The arguments used to defend the construction of the right to health ended up influencing the understanding of democracy and the dimensions of rights that society wanted to build at that historical moment. Faced with the current scenario, in which studies show a distancing of social participation and new challenges for the consolidation of democracy, especially with regard to the damage caused by the spread of false health information, systematizing and revisiting the process followed by the health reform movement can point to some ways in which health can be understood as a social right and an integral part of a development project for the country. [ABSTRACT FROM AUTHOR]

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In Brazil, the COVID-19 pandemic revealed a coordination crisis with a strong federative dimension in the political-institutional sphere. This whole context brought several challenges to the usual functioning of social control, notably marked by extended meetings, on-site visits, conferences, and other face-to-face activities. Thus, this article aims to verify whether the COVID-19 pandemic affected social control based on a comparative study of users access to the Brazilian National Health System (SUS) Ombudsman in 2019 and 2020. For this purpose, secondary data was collected from the Business Intelligence Portal (BI) − Health Information of the State of Rio Grande do Sul, State Management version. To treat the data, we sought to identify in the indicators the adequacy to the criteria contained in the matrix elaborated by the Interdisciplinary Group of Studies in Management and Public Policies, Development, Communication and Citizenship (GPDeC) of the Regional University of Northwestern Rio Grande do Sul (UNIJUÍ), social control category and its analysis criteria. As a result, there was a decrease of 5.12% in the total number of events held in 2020. Still, in the same year, there was a significant increase in the number of events pending and with a deadline for responses and a growing approach to the themes concerning Health Surveillance. [ABSTRACT FROM AUTHOR]

Municipalities employ cooperation strategies to build instruments for economic and administrative rationalization and overcome difficulties in public service execution. One of these instruments is inter-municipal public consortia, which simultaneously cover multiple areas of activity. The health sector has the most consortia and participation from municipalities. The Intermunicipal Health Consortium of the Northwest of Rio Grande do Sul (CISA) is one of these consortia; it was established in 1997 and covers 47 municipalities in the northwestern region of the state. CISA establishes agreements with doctors and clinics for consultations and specialized tests and procures medicines for associated and partnered municipalities. Given this context, this article analyzes the relevance of Public Health Consortia for municipalities, particularly small ones. The study uses quantitative methods, such as analyzing reports from CISA and municipalities (Augusto Pestana, Bozano, and Panambi in Rio Grande do Sul), and qualitative methods based on interviews with Municipal Health Secretaries and Consortium managers. The data obtained, both from CISA and the Municipal Health Departments, show the importance of the consortium for the municipalities and the significant values involved in the eight years of training, as well as the fact that it constitutes the alternative with the greatest feasibility in overcoming demands and difficulties, especially in small municipalities. [ABSTRACT FROM AUTHOR]

There are 5,570 municipalities in Brazil, of which 1,253 have less than 5,000 inhabitants. The Proposed Amendment to the Constitution no. 188/2019 proposes incorporating part of these municipalities into neighboring municipalities with more significant financial capacity; the municipality's revenue is the second criterion provided for in this legislative instrument. Given this context, this study sought to show that municipalities with fewer than 5,000 inhabitants collect more than the municipalities of the group with a larger population per inhabitant. Even the administrative expenses of these small municipalities are not significantly higher. The social rights of citizens, which are provided for in the Federal Constitution, are more efficiently served in smaller municipalities if the per capita values are considered. For instance, in some of the budgetary functions (e.g., health), the differences in investment volumes are quite high. Additionally, small municipalities act as promoters of development by encouraging economic activities and do so with larger investments, once again using the citizen as a unit. Therefore, it is not appropriate to prejudge and condemn municipalities solely based on the number of inhabitants and the amounts they collect. The municipalities, first and foremost, are proponents and executors of public policies where financial profit cannot be constituted as an evaluation measure. [ABSTRACT FROM AUTHOR]