Introduction

Principles are legally or non-legally established rules and norms that guide society towards permissible or prohibitive actions. The Organic Health Law describes the doctrinal principles - universality, integrality, equality, equity - and organizational principles - decentralization, regionalization, hierarchization, and community participation - of the SUS. Described below are the main principles of this healthcare system.

The doctrinal principles relate to the common core of values and conceptions that serve as the basis for the SUS. The organizational principles are related to the way the system is organized and operationalized.

Below are some characteristics of the doctrinal and organizational principles of the SUS.

Figure 1: Doctrinal Principles of the SUS.

Source: Elaborated by the Author (2022).

Figure 2: Organizational Principles of the SUS.

Source: Elaborated by the Author (2022).

Classification of health actions and services

The General Programming of Health Actions and Services (PGASS), elaborated by the Ministry of Health, is responsible for planning, advising, and articulating health in the interfederative spheres.

The program determines the physical and financial amounts of the health services and actions to be developed, which include health care actions (Basic Care, Emergency and Urgent Care, Psychosocial Care, Specialized Outpatient Care, and Hospital Care), promotion, surveillance (health, epidemiological and environmental), and pharmaceutical assistance, among others.

The PGASS must be elaborated annually because it's a tool that allows the negotiation and elaboration of health actions, and also determines the resources available for its realization. PGASS is based on the following assumptions (Brazil, 2013, p. 5-6):

• PGASS covers the actions of health care (basic/primary care, urgent and emergency care, specialized outpatient care and hospital care), promotion, surveillance (health, epidemiological and environmental), and pharmaceutical assistance, included in RENASES (list of all public health actions and services of the SUS) and RENAME (National List of Medicines), to be carried out in the region.
• It has strict coherence with the Integrated Regional Planning instruments, the Health Plans and respective Health Programs, expressing commitments and responsibilities of each one, in the regional scope.
• RENASES and RENAME will guide the programmatic openings to be used in programming.
• Contribute to the organization and operationalization of the Care Network in the territories.
  
• The instrument of the General Programming of Health Actions will be unique, respecting the specificities of the methodological proposition of each component.
• The elaboration of the General Programming of Health Actions and Services will be triggered by the integrated regional planning, and its temporality will be linked to the municipal plans, with periodical updates and annual reviews.
• The elaboration of the General Programming of Health Actions and Services must occur in the health regions, as an attribution of the CIR (Regional Intermanagement Commissions), with the need to harmonize regional commitments and goals in the state level, in a process coordinated by the SESs (State Health Secretariats) and agreed upon in the CIB (Bipartite Intermanagement Commissions), contributing to the shaping and organization of the healthcare network. Thus, the programming process must be carried out simultaneously in all health regions of the UF (Federative Unit).
• The Ministry of Health will make available a web application for the elaboration of the General Programming of Health Actions and Services, allowing real time updates and the incorporation of actions and services included in RENASES and RENAME that were not included in previous versions.
• The General Programming of Health Actions and Services makes up Annex II of the Public Health Action Organizational Contract - COAP and will also be the base on which the regulation, control, evaluation, and audit devices for fulfillment of the contracted quantitative and qualitative goals will be established.
• Point out, at the regional level, the cost deficit and the need for investments.

Wrap Up

In this topic, you have understood the doctrinal and organizational principles of the SUS, which include universality, integrality, equity, equality, decentralization, regionalization, hierarchization, and community participation, as well as the General Programming of Health Actions and Services, which must be elaborated annually in order to determine the health actions and the financial resources destined to these actions. In the next topic, you will learn about care models and healthcare networks in the SUS. See you soon!