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Intermunicipal Health Consortiums and the Brazilian Public Health System

Municipalities (or counties) in the interior of Brazil have encountered difficulties in implementing the public health system as regulated by the 1988 National Constitution. The lack of human and financial resources, accessible technology, and adequate physical infrastructure, plus the remote location of public health facilities, constitute the most common obstacles that have led municipal managers to seek administrative alternatives. Intermunicipal Health Consortiums have been formed within that framework and present an innovative approach to the administration of the Brazilian public health system. This study describes the current status of the Health Consortiums and their distribution and organization in different regions of the country. This administrative strategy has been used mainly in small municipalities, especially in States from the Southeast and South. The strategy involves different interests and forms of implementation.

Local Health Systems; Health Policy; Public Sector


Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Rua Leopoldo Bulhões, 1480 , 21041-210 Rio de Janeiro RJ Brazil, Tel.:+55 21 2598-2511, Fax: +55 21 2598-2737 / +55 21 2598-2514 - Rio de Janeiro - RJ - Brazil
E-mail: cadernos@ensp.fiocruz.br