Institutional support as a strategy for improving health management: The case of COSEMS-CONASEMS supporters

Abstract

This study aims to analyze the performance of institutional supporters within the COSEMSCONASEMS Support Strategy in the Unified Health System (SUS), considering their profile, context of operation, and the adequacy of their actions to meet local managers’ needs, as well as to discuss the challenges related to the sustainability and institutionalization of the strategy. The adopted methodology is based on an empirical and multifaceted approach, combining different data collection instruments: i) a monitoring report of activities; ii) a profile survey of the 234 active supporters, conducted through an online questionnaire; and iii) a perception survey of managers, consisting of questionnaires and semi-structured interviews. The data were analyzed using descriptive statistics. The results show a qualified profile of the supporters, with 87% holding postgraduate degrees and 42% having experience as health secretaries. While managers’ perception of the support is positive, challenges such as variability in workload and in the number of regions supported and regional inequalities in the Regional Inter-Management Commissions remain. The study also highlights the importance of monitoring and the sustainability of the Support Strategy, which requires continuous funding and long-term political commitment to strengthen municipal management within SUS.