THE JUDICIALIZATION OF HEALTH IN THE DAILY LIVES OF MUNICIPAL HEALTH MANAGERS

Abstract

This study aimed to analyze the impact of health judicialization on the daily work of municipal managers from the 11th Regional Health Office of the State of Ceará, Brazil. Health judicialization, understood as the use of the Judiciary to ensure access to healthcare services and medicines, is a growing phenomenon in Brazil and has been imposing administrative and financial challenges, especially on small municipalities with limited resources and infrastructure. This is an exploratory, qualitative study conducted from February to March 2019, involving 15 municipal health secretaries who had been in office for at least one year and had experienced legal actions against the Unified Health System (SUS) during their administration. Data collection was carried out through semi-structured interviews, and the analysis was based on the narrative analysis technique, supported by NVivo 10 software. Results showed that all managers had dealt with judicial cases, with common measures including the creation of specific sectors or committees to monitor such demands. The main difficulties reported were SUS underfunding, lack of clarity in the division of responsibilities among federal, state, and municipal levels, insufficient dialogue with the Public Prosecutor’s Office, and the need to finance high-cost procedures or those unavailable in the region. It was observed that judicialization directly disrupts prior planning, dismantling collective programs and actions, and significantly impacts the municipal budget by reallocating resources originally intended for collective public policies. It is concluded that strengthening institutional dialogue between the Executive and the Judiciary, investing in technical team training, and adopting preventive strategies are essential to reduce the number of judicial demands and their effects on public health management.