DECENTRALIZATION AND FEDERAL COOPERATION IN THE UNIFIED HEALTH SYSTEM: THE CASE OF THE PUBLIC HEALTH CONSORTIUM OF THE MICROREGION OF JUAZEIRO DO NORTE – CE
Decentralization; Inter-federative Cooperation; Public Consortia; Health.
Decentralization, as a constitutional directive, has reshaped the management architecture of social policies in Brazil by transferring administrative and operational responsibilities to states and municipalities. However, the persistence of financial and decision-making centralization at the federal level poses significant challenges to the effective implementation of public policies at the local level, requiring institutional strategies that promote cooperation among the federative entities. In this context, public consortia have gained relevance as mechanisms of joint Governance, especially in the health sector, aiming to enhance efficiency, equity, and intergovernmental coordination. Although consortia-based experiences are present across several units of the federation, there remains a noticeable gap in systematized studies on governance models, decision-making flows, and mechanisms of intergovernmental cooperation, particularly in the state of Ceará. In light of this issue, this project aims to analyze the role of the Public Health Consortium of the Juazeiro do Norte Microregion as an instrument of decentralization and inter-federative cooperation in the implementation of public health policies in Ceará. The choice of the CPSMJN is justified by its unique configuration as a vertical consortium, coordinated by the Government of the State of Ceará and operated by member municipalities, in accordance with the guidelines of the Brazilian Unified Health System (SUS). This research adopts a qualitative case study approach, incorporating document analysis and semi-structured interviews. Institutional documents such as laws, decrees, agreements, meeting minutes, bylaws, and official reports will be analyzed. Interviews will be conducted with approximately 16 key actors, including the Director, Executive Secretary, and President of the CPSMJN; mayors and health secretaries from the member municipalities (Barbalha, Crato, Juazeiro do Norte, Caririaçu, Missão Velha, Jardim, among others); and a representative from the State Health Secretariat of Ceará. The analysis will be conducted through methodological triangulation, combined with the actor-arena approach, and supported by the Iramuteq software. Expected outcomes include: the systematization of data on the consortium’s functioning; identification of best practices, institutional constraints, and challenges; and the formulation of recommendations aimed at improving intergovernmental governance within the SUS. Thus, the research seeks to produce theoretical-methodological and practical contributions that may benefit both academic scholarship and public management at the state and municipal levels.