PROMOTION OF MECHANISMS TO STRENGTHEN VERTICAL ACCOUNTABILITY IN BRAZILIAN LOCAL GOVERNMENTS
Vertical Accountability; Municipal Health; Political-Party Profile; Professional Profile; Social Control.
This study identifies the influence of the professional and political party profile of the bureaucrat managing the health area on the improvement of vertical accountability mechanisms in the health area in Brazilian local governments. It is a descriptive qualitative research carried out through the application of questionnaires to municipal health secretaries from 22 states of the Federation, and the documentary analysis of all official portals of the municipalities surveyed and the literature review on Accountability. Data were collected on professional and political-party characteristics, education and experience in the public service of the health secretary, and on some of the main instruments that promote social control available to the citizen, previously described in national and international literature. At the end of the analyses and considering the results of the questionnaires applied, there is a profile of the local health manager mostly characterized as political, partisan and specialized in the area of activity, with reasonable experience in management in the department, but who in most cases do not aspire to occupy prominent elective positions in governments or in the legislative branch. Although there is a good perception of the implementation and use of social control instruments by those evaluated, in practice it was found through documentary research that the municipalities do not have good practices in instruments to strengthen vertical accountability in the health area, or if they do have them, they fail to disclose their practices in the space of greatest transparency today, the world wide web. By crossing data from ideological profiles with instruments to strengthen vertical accountability, it was concluded that there is an insignificant advance of the group characterized as right-wing in relation to the pole considered left-wing, but that does not hide the scenario of fragility of these instruments in the general context of health in local governments. It was concluded that the profile of the inexperienced manager and with training different from the health area promotes less social control, performing less well when compared to the other groups analyzed. In conclusion, it can be concluded that the political-partisan and professional profile of health secretaries can influence the promotion of popular participation, monitoring, control and accountability in the health area of local entities, but it does not explain or resolve the low commitment of local health bureaucrats to guaranteeing the right to citizen involvement and participation in government actions. While weaknesses are detected in the context of accountability in local health, opportunities for correction and improvements are also highlighted to create the ideal environment for citizen participation in the development of public policies that are more aligned with the will of the people.