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<p>The decentralisation of healthcare systems is a vital concept that transcends national borders, promoting greater efficiency, effectiveness, and accessibility by delegating management and decision-making to local levels. Brazil’s Unified Health System (SUS), since its creation, has embraced decentralisation as a cornerstone for delivering healthcare services, establishing itself as a valuable reference for applying this model in other contexts. Thus, this article aims to identify learning elements through a scoping review of the main studies on SUS decentralisation, using the PRISMA protocol and analyzing them within the framework of “Health System Performance Assessment: A Framework for Policy Analysis.” The results indicate that, although SUS still faces several challenges, significant improvements have been observed in the population’s health outcomes. The analysis identified learning elements from the process, which were synthesized and proposed as refinements to the current understanding of health system decentralisation. The research also emphasizes the importance of considering the specific nuances of each national context when implementing decentralised health policies.</p>

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The decentralisation of the SUS as a source of learning for the decentralisation of other health systems

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月7日

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  • Daniela Pinheiro Botica,
  • Marco Antonio Catussi Paschoalotto

摘要

The decentralisation of healthcare systems is a vital concept that transcends national borders, promoting greater efficiency, effectiveness, and accessibility by delegating management and decision-making to local levels. Brazil’s Unified Health System (SUS), since its creation, has embraced decentralisation as a cornerstone for delivering healthcare services, establishing itself as a valuable reference for applying this model in other contexts. Thus, this article aims to identify learning elements through a scoping review of the main studies on SUS decentralisation, using the PRISMA protocol and analyzing them within the framework of “Health System Performance Assessment: A Framework for Policy Analysis.” The results indicate that, although SUS still faces several challenges, significant improvements have been observed in the population’s health outcomes. The analysis identified learning elements from the process, which were synthesized and proposed as refinements to the current understanding of health system decentralisation. The research also emphasizes the importance of considering the specific nuances of each national context when implementing decentralised health policies.