NÍVEIS DE AUTORIDADE - CENTRAL REGIONAL E LOCAL - NOS PROGRAMAS DE SAÚDE PÚBLICA NO BRASIL

Abstract

HEAL TH ADMINISTRA TION should comprise, in Brazil: I . At the federal levei:
a) general planning;
b) endemic control;
c) estabJi.shment of !policies;
d) supplemental financiai aid;
e) administration of local services when convenient to and required
by state government;
f) social security medical services.

2. At the state level:
a) planning out state level;
b) financiai aid;
c) medicai and hospital services, directly to the public or indirectly
through financiai aid to private and charity hospital;
d) administration o f local health agencies.
Local governments are not socially, politically and economically fit, in
Brazil, to direct local health agencies. In 1958, local governments took 6%
o f general taxes, where as in the U .S.A., they took 16% . The state governments
in Brazi!, at the same period, took 41% compared to 15% in the U.S.A.
and federal government took 53% and 69% in both countries in the same order.
Municipal government in Brazil can undertake the following activities :
1) fiscalization o f health conditions o f housing;
2) food contrai.

They could also participate in maternal and child health programs and in
chronic disease control. Under experimental conditions and agreement with
state government, munidpal governments could direct local health agencies, provided they could finance 50% of expenses.