Direito regulatório comportamental: nudges e novas abordagens na busca por eficácia de políticas públicas de saúde em Sergipe

Abstract

This master’s thesis investigates a public health governance problem that emerges in the gap between the formal provision of public health services and the population’s effective adherence to preventive policies, with an emphasis on vaccination within Brazil’s Unified Health System (Sistema Único de Saúde—SUS) in Sergipe, using Aracaju as a case study. The research problem is formulated as follows: how can a nudge-based choice architecture be designed to reduce decisional and administrative frictions and increase adherence to public vaccination policies, without claiming empirical measurement of impact, and under parameters of legal legitimacy guided by proportionality, transparency, data protection, and the dignity of the human person? The dissertation advances the hypothesis that instruments of Behavioral Regulatory Law (Direito Regulatório Comportamental) can operate as a complementary layer to conventional legal tools by lowering action costs and foreseeable barriers (such as inertia, forgetting, low salience, and difficulty navigating services), provided they are subject to a regime of public justifiability capable of preventing opacity, indirect discrimination, undue nudges, and the conversion of simplification into obstacles (sludge). The overall objective is to develop, in a predominantly theoretical framework, a proposal for a behaviorally informed intervention that is legally controllable and administratively feasible for the context of Sergipe; as specific objectives, the dissertation seeks to (i) systematize conceptual foundations regarding bounded rationality, choice architecture, and nudges; (ii) characterize the crisis of adherence to immunization policies as a regulatory problem of implementation and behavior; and (iii) propose design parameters and legitimacy-control standards for light-touch interventions in public health. Methodologically, the study consists of bibliographic and documentary research with international scope, combined with a critical review of the literature on behavioral science applied to public policy, a legal-normative analysis of the relevant constitutional-administrative framework for health, and a discussion of governance and ethical criteria; official data and indicators are used contextually and descriptively, without causal inference. As results, the dissertation delimits the adherence problem as a multifactor phenomenon associated with frictions and vaccine hesitancy, proposes a modular choice architecture for the case of Aracaju, and consolidates a set of methodological and constitutional-legal criteria for assessing, ensuring transparency and auditability, and protecting rights in the use of nudges, offering public policy recommendations formulated as conditional guidelines for responsible implementation.