The role of street-level bureaucracy in the implementation and (re)formulation of the health service’s Humanization Policy in Porto Alegre (RS)

This article analyzes the implementation of the National Humanization Policy in basic health units of Porto Alegre. For this, we analyzed interaction that emphasizes the process of mutual influence between the planning of public policy and characteristics of local implementation. Thus, this perspective is from the context of operations of street-level bureaucracies, emphasizing the role played by its discretion. The study was qualitative with the use of primary and secondary data. We examined implementers, given the lack of training in the policy framework, as well as perceptions on the lack of resources and low levels of support, which forged a peculiar understanding of the goals and strategies of public policy. They created a vision of what it would mean to humanize the service when adjusted to local preferences and needs.