The District Permanent Chamber of Health Mediation in the Brazilian Federal District: an analysis of performance from the perspective of political-institutional actors

Abstract

Objective: to describe the process of creation of the Permanent District Chamber of Mediation in Health (Camedis, in Portuguese) from the perspective of institutional actors; to understand the articulations for the realization of the right to health and the ways in which actors have tried to overcome institutional failures and barriers to access Brazilian Unified Health System (SUS, in Portuguese) Methods: a semistructured script was used to conduct interviews with key actors, and content analysis was conducted according to thematic categories. Results: analysis revealed that while interviewees thought the chamber was successful, it had limited success in reducing the judicialization of health care. Weaknesses identified included lack of regulation, structure, staffing, and adequate materials, resulting in a lack of monitoring of agreements reached and political-institutional support for stakeholders. The greatest strength was the high percentage of agreements and articulation between the actors involved. Conclusion: considering the successful potential of the Chamber, its redesign is recommended, with investment in human resources, its own infrastructure suitable for permanent operation, the establishment of clear commitments between participants in the fulfillment and monitoring of requirements, eligibility criteria and processes of management, greater transparency, resolution and expansion of the service so that the Chamber can be for all.

Received: 03/30/22 | Accepted: 06/06/22