Mecanismos de difusão de políticas sociais no Brasil: uma análise do Programa Saúde da Família

Abstract

In recent decades, the study of policy diffusion has received a great deal of attention, especially in the U.S. and in Europe. These studies have identified the role of internal (i.e., characteristics proper to the unit of analysis) and external (i.e., characteristics outside the unit of analysis) factors in explaining innovation of policy diffusion. Events of diffusion is also closely related to a time issue because the adoption often requires the simultaneous occurrence of factors in large intervals of time to take place. In this paper, we propose to explore the diffusion of social health policies in Brazil. This paper innovates by examining at the same time the role of internal and external factors using a nonconventional unit analysis to the field of study, namely local governments. To the analyses it is worth noting that the 1988 Brazilian Constitution recognizes municipalities as autonomous jurisdictions, giving them broad latitude over policymaking. What factors determine the spread of Programa Saúde da Família? To answer these question we adopt an event history analysis using data from over 5,560 municipalities over a period 1997-2010. The findings show that political competition and ideology drive the horizontal and vertical diffusion among municipalities. Surprisingly, municipal elections also drive policy emulation.

KEYWORDS:
policy diffusion; family health program; municipal governments; political competition; survival analysis