This paper presents an analysis of the changes occurred in the health field, specifically regarding the decentralizing actions taken during the 80's. It examines how the decentralization politics has provoked changes in the organization and practices of health services, specially in Cabo Frio. The study is based on two main analysis: the urbanization process and its impacts on the social and economic life of the district. On the other hand, it also analyses the decentralizing policies practiced during 80's and 90's acting as a source of institutional changes that caused a growth in the districts. The conclusions are based on the virtuality of the micro process, that means, the powerful dynamics of the relationships established within the district, and its relation with the laws on a macro-structural level.
social politics; health politics; decentralization; municipal management