Networks and hierarchies: a study on managerial setups towards healthcare equity

Abstract

This article begins with a narrative of the recent process of normalization developed by the Brazilian federal government, as part of a wider project — the State reform, influenced by concepts developed by the World Bank and the World Health Organization. It makes a few critical considerations centered on hierarchy as a theoretical category that organizes aspects such as public administration, government capability, health services, and regionalization, which are central to the institutionalization of the healthcare field. Finally, it presents, as a potential alternative construction, the interorganizational networks approach, considering the difficulties of its adoption in a social and political context marked by an authoritarian and centralist culture.