A capacidade institucional na gestão das compras públicas em saúde: uma análise dos municípios da 7ª Região de Saúde do Rio Grande do Norte

Abstract

With different local realities, many Brazilian municipalities have had difficulty managing their public policies and producing results. Many of them do not have the administrative and/or financial capacity to transform their resources into public policies efficiently and effectively, making their actions limited by their own lack of resources (Huerta; Montes, 2013; Rocha; Wittman, 2017). In the case of Health Policy, these disparities impact the institutional capacity of municipal governments, within the same Health Region, to provide quality services to the population. Institutional capacity is understood as the combination of two capacity components: administrative and political (Huerta, 2008). In view of this, public procurement has stood out as an important mechanism for implementing public policies, since it functions as a crosscutting instrument, capable of promoting regional development and innovation and, when carried out in a shared manner, enables the creation of partnerships and the institutional strengthening of federated entities. In view of this, the starting question was: how is the institutional capacity of the municipalities of the 7th Health Region of Rio Grande do Norte characterized in the management of public procurement? In this sense, the present study has the general objective of understanding the institutional capacity of the municipalities of the 7th Health Region of Rio Grande do Norte in the management of public procurement in health, in the period from 2020 to 2023, and as specific objectives a) to understand the profile of the managers and employees of the purchasing area of the selected municipalities; b) to diagnose the technical-bureaucratic processes developed by the municipalities in the public procurement cycle; c) to understand the scenario of municipal investment in health based on the existing institutional capacity; and d) to investigate the interaction between civil society and local public authorities in the management of public procurement based on the perception of managers and employees. To this end, the methodological basis was based on the analysis model proposed by Huerta and Montes (2013) and adopted a qualitative and quantitative approach, using bibliographic and documentary research procedures, using a multiple case study as the research method (Chmiliar, 2010). The research technique adopted was conducting interviews, with semi-structured scripts, with municipal managers (secretary responsible for public purchases) and public employees responsible for the purchasing area. The results indicated that the municipalities of Parnamirim, São Gonçalo do Amarante and Extremoz have institutional capacity, since they achieved adequate results for most of the attributes related to administrative and political capacities in the management of public health purchases, unlike the municipality of Macaíba. These results indicated that the presence of institutional capacity in the management of public purchases in the municipalities of the 7th health region of Rio Grande do Norte can favor cooperation in local governments in the formalization of an institutional arrangement, such as an intermunicipal consortium, for carrying out collective purchases, since the municipalities presented different potentialities, but which together favor the achievement of the ideal scenario of institutional capacity in the management of purchases for health.