PUBLIC PROCUREMENT IN HEALTH CARE: FROM PUBLIC GOVERNANCE AND COMPLIANCE TO ACCOUNTABILITY
Public governance; Accounting compliance; Accountability; Procurement fraud; Public health; Auditing; Public contracting; Transparency; Internal controls; Artificial intelligence
This research examines the factors that influence public governance, accounting compliance, and accountability in preventing and mitigating fraud in health care procurement. Considering the institutional characteristics and vulnerabilities of Brazilian municipalities, the study adopts a qualitative, applied, and collaborative approach grounded in action research methodology. The analysis includes formal and informal management structures such as internal controls, information systems, organizational culture, and accountability mechanisms. Through interviews, focus groups, and situational diagnostics in two municipalities with different levels of institutional maturity, variables such as administrative capacity, the use of technologies like AI and blockchain, and civil society engagement in oversight are explored. The research also draws on fraud explanatory models, such as the Fraud Triangle and Diamond, to understand how pressure, opportunity, rationalization, and capacity factors manifest in public sector reality. The new Brazilian Procurement Law (Law No. 14.133/2021) is discussed as a regulatory milestone for promoting integrity. As a result, the study proposes a simplified integrity assessment roadmap tailored for small municipalities, with potential to guide audits, improve administrative workflows, and increase risk awareness among public officials. The findings are expected to contribute to strengthening transparency and efficiency in health care procurement, offering practical recommendations to enhance institutional transformation through evidence-based public policies.