In tackling pandemic, Brazilian municipalities circumvented resource limitations through shared management
Faced with the unexpected health crisis caused by the arrival of COVID-19 in Brazil, municipal government health managers experienced a reactive cycle. At first, a feeling of unpreparedness and a focus on solving urgent issues, such as adding intensive care beds and implementing social distancing measures, prevailed. However, by adapting to new conditions with innovative practices, shared management of processes and the involvement of health surveillance teams in initiatives, it was possible to achieve some good results in the fight against the pandemic. These are some of the findings of a study conducted by researchers at Fundação Getulio Vargas’ Sao Paulo School of Business Administration (FGV EAESP), presented in an article published in the magazine “Saúde Debate.”
The study was based on interviews carried out in December 2020 with health managers in three medium and large Brazilian municipalities – Fortaleza (Ceará), Pelotas (Rio Grande do Sul) and Uberlândia (Minas Gerais). The objective was to evaluate the public health system’s response to COVID-19. To define the municipalities to be analyzed, the authors started with an initial sample of 50 municipalities recognized by the Pan American Health Organization as leaders in the fight against the pandemic. This initial sample was whittled down based on factors such as geographic distribution, management model and access to public health system managers to collect information.
Despite the different epidemiological, social and political contexts of the municipalities studied, the authors identified common patterns of behavior among managers, especially at the beginning of the pandemic in Brazil, in March 2020. This period was even more challenging due to the lack of adequate national response planning, which caused insecurity among teams and delays in measures to curb the spread of the disease.
Municipal health managers also had to deal with shortages of qualified human resources, overworked teams and scarce supplies and equipment. These limitations underline the importance of multisector and continuous steps to ensure the public health system’s resilience. “These initiatives ought to be promoted, coordinated and encouraged by the federal and state governments, with the full participation of all the stakeholders involved,” say researchers Renato Tasca, Mariana Carrera, Ana Maria Malik, Laura Schiesari, Alessandro Bigoni, Adriano Massuda and Cinthia Costa.
On the other hand, the authors emphasize that shared management, through partnerships with universities and coordination with state health secretariats, helped to organize responses to the pandemic at regional level. Municipal governments whose health centers are managed by non-governmental organizations proved to be more agile than those that directly administer medical services.
This article was first published on the “Impacto” blog on June 24, 2022.