Theoretical reflections on governance in health regions/Reflexoes teoricas sobre governanca nas regioes de saude

This article analyzes governance in health regions, through the contributions of two studies: one on a governance model and the other on duties in the management of public policies networks. The former conducted a meta-analysis of 137 case studies in the literature on collaborative governance aimed at preparing an explanatory and analytical model. Authors identified critical variables that will influence the results: a previous history of conflict or cooperation, incentives for participation, power imbalances, leadership and institutional design. They also identified key factors: face-to-face dialogue, trust building and development of commitment and shared vision. The latter study examined networks of public policies in the analytic tradition and the perspective of governance, incorporating concepts from the field of political science, economics and interorganizational relations, in order to support the management of public policies networks. The study identified network management as equivalent to a strategic game involving functions: network activation, framework of relations, intermediation, facilitation and consensus building and mediation and arbitration. The combination of the two reflections provides a conceptual reference for better understanding of governance in health regions. Key words Management, Public policy, Governance Este artigo analisa a governanca nas regioes de saude, atraves das contribuicoes de dois estudos: um sobre modelo de governanca e outro sobre funcoes na gestao de redes de politicas publicas. O primeiro realizou meta-analise de 137 estudos de caso na literatura sobre governanca colaborativa visando elaborar um modelo explicativo e analitico. Os autores identificam variaveis criticas que irao influenciar os resultados: Historia previa de conflito ou cooperacao, incentivos para participacao, desequilibrios de poder, lideranca e desenho institucional. Tambem identificaram fatores cruciais: dialogo face-a-face, construcao de confianca e desenvolvimento de compromisso e visao compartilhada. O segundo examinou redes de politicas publicas na tradicao analitica e na perspectiva da governanca, incorporando conceitos do campo da ciencia politica, economia e relacoes interorganizacionais, com o objetivo de apoiar a gestao delas. O estudo identifica a gestao da rede como equivalente a um jogo estrategico envolvendo as funcoes: ativacao da rede, enquadramento das relacoes, intermediacao, facilitacao e criacao de consenso e mediacao e arbi