SCALES AND TEMPORALITIES OF SUS REGIONALIZATION IN RIO DE JANEIRO

Authors

DOI:

https://doi.org/10.4215/rm2025.e24016

Keywords:

Universal Health System; scales; temporalities; regionalization

Abstract

This paper is part of a broader research program examining the territorial contexts of public policy implementation, taking into account the different temporalities and spatialities involved in the processes of policy formulation, formalization, and execution. The object of analysis is the regionalization of Brazil's Unified Health System (SUS — Sistema Único de Saúde) in the state of Rio de Janeiro, and the study adopts a qualitative approach based on bibliographic and documentary research. The methodology includes semi-structured interviews with health system officials at different levels, as well as the analysis of official documents, legislation, and specialized literature. The findings highlight the numerous challenges
faced in this process, such as persistent fragmentation and localism within the state. The study also revisits the political-territorial legacy of the state's formation to better understand the obstacles to stronger coordination among municipalities and between municipal and state governments. Unlike other political-territorial contexts, the state of Rio de Janeiro still experiences delays in developing a regionalized and cooperative health policy management system, resulting from disruptions in governance, competition over funding among municipalities and across government levels (municipal, state, and federal), as well as partisan political disputes.

Keywords: Brazilian Unified Health System; Scales; Temporalities; Regionalization

Author Biographies

  • Juliana Nunes Rodrigues, Universidade Federal Fluminense, Niterói (RJ), Brasil

    PhD in Political Geography from the Université Jean Moulin Lyon. Professor in the Department of Geography of the Graduate Program in Geography at the Fluminense Federal University (UFF).  Coordinates the Research Center on Political-Territorial Pacts and Development (NUPACT-UFF).

  • Amanda Thereza Orozco Morais de Souza, Fluminense Federal University, Niteroi (RJ), Brazil
     PhD student in Geography at the Fluminense Federal University. She is a member of the Research Center on Political-Territorial Pacts and Development (NUPACT), within the Graduate Program in Geography at UFF. She conducts research in the areas of Political Geography and Urban Political Geography on the following topics: public policies; urban planning; governance; participation; territorial cooperation; federalism; federative coordination; and political spaces. She is currently participating in the project "Regionalization and Federative Cooperation: Regional Governance Structures of the Unified Health System (SUS) in the States of Bahia and Rio de Janeiro," where she is researching the regionalization process of the SUS in Rio de Janeiro. She is a member of the evaluation committee of the Journal Ensaios de Geografia, affiliated with the Graduate Program in Geography at UFF.

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Published

2025-07-28

Issue

Vol. 24 (2025)

Section

Artigos

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