Healthcare Networks in Metropolitan Areas - The Case of the Health System in Brazil

The health care system in Brazil is an example of the complexity and often fragmentation in health policy implementation. The notion of healthcare networks proposes that the health system must be organized through coordinated points to provide continuous and integrated care, based on cooperation between managers, providers, and users. In Brazil in 2010, the Ministry of Health enacted an ordinance defining the healthcare network as a management model to be pursued by the national health policy in order to address most of the difficulties of fragmentation. This paper proposes to discuss the cases of Healthcare Networks in Brazilian metropolitan regions, characterizing its implementation process as well as identifying management problems in various cases. This study is grounded on data provided by agencies responsible for health management in the federal and state levels, as well as the current literature on healthcare networks. Results include the analysis of metropolitan networks implemented within their different stages, challenges and advances.