Map of municipal public governance and management of budgetary dynamics in raising additional resources: from PAB to Previne Brazil.
public governance; health financing; primary care; Previne Brasil; equity.
This study analyzes the relationship between public governance and the financing of basic healthcare in Brazil, focusing on raising additional resources – rigid and flexible – in the context of the structural changes implemented by the Previne Brasil program (2013-2023). Based on a theoretical-empirical framework, this thesis explores how different levels of municipal governance influence the raising of financial resources for public health. The methodology adopted uses a quantitative approach, with panel regressions applied to the Municipal Public Governance Index (IGovPM, in the Portuguese acronym). This index development was based on multiple governance dimensions, using variables extracted from public databases of secondary data. The analyses were performed in Python, using advanced libraries, such as pandas, statsmodels, and scikit-learn, ensuring accuracy in calculations and efficiency at processing large volumes of data. The statistical model incorporated control variable to capture structural specificities, allowing a analysis of budgetary dynamics in Brazilian municipalities.
The results show that high levels of public governance are positively associated with better fundraising, both in the fixed PAB (Portuguese acronym for primary healthcare funds) and in the variable PAB. Municipalities with greater governance capacity perform better in adapting to the requirements of the Previne Brasil program, which introduced performance criteria and weighted fundraising. However, small municipalities, especially the most vulnerable, face challenges to access transfers, highlighting the need for redistributive policies to mitigate local
and regional inequalities. This research contributes to the Accounting field by highlighting governance as a strategic factor for the financial sustainability of the Unified Health System (SUS). The conclusion is that governance practices based on transparency, accountability, legality, equity, effectiveness, and social participation are crucial to reducing inequalities and consolidating more inclusive and effective public policies.