Healthcare in Brazil: The Subnational Dimension

November 12, 2010 - 4:00 pm

Jorge Antonio Alves, Brown University

Mauricio Font, Bildner Center for Western Hemisphere Studies

State-level healthcare frameworks—the set of institutions that govern the formulation and implementation of healthcare policies and manage the intergovernmental relations between states and municipalities—vary greatly within Brazil’s national health system. Despite the emphasis on municipalization and grassroots mobilization in much of the recent research on healthcare reform in Brazil, it is the level of coordination employed by state-level health offices that plays the crucial role in shaping the effectiveness of subnational healthcare institutions. Why do some states coordinate municipal action while others don’t? The incentives generated by patterns of political competition facing state-level political elites—in particular the level of competition and degree of party-system polarization—can explain for these different choices in institutional design in the Brazilian states of Bahia, Minas Gerais and São Paulo.

Jorge AlvesJorge Alves is a sixth year Ph.D. candidate at Brown University from Salvador, Brazil. His primary field is comparative politics. Jorge’s main research interests include political economy of development, state capacity construction, federalism and intergovernmental relations focusing on Brazil and Latin America. His current research is supported by the National Science Foundation.