Municipalization of health services according to oral health professionals in an upstate Sao Paulo municipality in Brazil

During the setting up of the National Health System (SUS), one of the main strategic vectors in the process of decentralization was the municipalization of the health services. However, few studies have addressed the perceptions of this process, particularly in the field of oral health, held by workers in this sector. This article highlights the opinions of dental professionals in the municipality of Itapira (Sao Paulo) on the significance of the municipalization of health. Data was collected through individual semi-structured interviews with a group of eight key informants, consisting of dentists and dental health assistants already working in the municipal health service before the introduction of SUS. Discourse analysis was undertaken using the collective subject discourse technique. As regards municipalization, it was found that respondents had difficulty conceptualizing it and identified it as favoring a better organized dental service in the SUS, involving such areas as the proximity with management levels which benefit, for example, the implementation and monitoring of programs and the acquisition of equipment and material. In addition, they recognized that municipalization: 1) boosted the qualification of primary care, 2) allowed for a gradual expansion of the resolvability of services and thereby contributed to meeting the more prevalent demands, and 3) created favorable conditions for overcoming the problem of excessive appreciation of mutilating procedures which had characterized the sector in the pre-SUS era. This study concluded that the respondents perceived the positive impact of municipalization in the organization of public dental services in the reality of their daily activity.