Monitoring internal audit recommendations as a driver of transformation in the Brazilian Unified Health System (SUS)

Abstract

In Brazil, the Brazilian Unified Health System (SUS) is essential to ensure universal access to health care, although it faces challenges arising from limited resources and growing demands. In this context, audits play a strategic role by assessing resource allocation, strengthening institutional accountability, and promoting integrity in public management. These initiatives are aligned with the Sustainable Development Goals (SDGs), especially SDG 16, which focuses on building effective, accountable, and transparent institutions. This article analyzes how audit recommendations can contribute to the operational efficiency of the SUS and to a more responsible public administration, considering the experience of the National Audit Department of the SUS (DenaSUS). The research is based on experience reports from managers and technical staff who participated in the design and implementation, beginning in 2023, of the project for monitoring audit recommendations. The results indicate that systematic monitoring, agreed upon through Action Plans with audited managers, strengthened institutional governance, increased transparency, improved management effectiveness, and encouraged organizational changes aimed at expanding users’ access to health services.