The Management of Health in Brazil's Capital

Introduction: democratic health management in the Federal District is challenged by the absence of municipalities and administrative centralization. Objective: to analyze the implementation of democratic health management in the Federal District through the Health Councils. Method: retrospective documentary research examining federal and district regulations since 1990. Results: the consolidation of the Federal District Health Council (CSDF) was proved. Regional Health Councils show weaknesses, being absent in 62% of the Administrative Regions, with deliberations approved by the superintendent. The structuring of the Health Superintendencies, disconnected from the Regional Administrations, and the absence of binding mechanisms for public participation indicate centralized decision-making in the district government, contrary to the decentralization and social control principles established in the SUS. The creation of a parallel management committee, without coordination with the Councils, reinforces this centralization. Conclusion: it is necessary to strengthen the Regional Health Councils by amending the CSDF resolution to allow their decisions to be approved directly by the SESDF.