IEGM e Agenda 2030: a dimensão i-Saúde e evidências institucionais para o planejamento municipal em saúde nos municípios sergipanos

Abstract

Objective: To analyze how the items and results of the i-Saúde dimension of the Municipal Management Effectiveness Index (IEGM), articulated with the Sustainable Cities Development Index, Brazil (IDSC-BR), and the Municipal Health Plans (MHPs), can constitute institutional evidence useful for municipal health planning aligned with the targets of Sustainable Development Goal 3 (SDG 3) in the municipalities of Sergipe, from the perspective of public governance. Methodology: The research adopted a predominantly qualitative approach, complemented by descriptive quantitative treatment, and was designed as a single-case study with multiple units of analysis. Three sources of institutional evidence were articulated: IEGM/i-Saúde data and microdata for the 2017 to 2024 period; IDSC-BR indicators related to SDG 3 from the 2023 and 2024 editions; and five MHPs intentionally selected based on classification persistence, inclusion of the four typological profiles, territorial and demographic diversity, and documentary suitability. The MHPs were subjected to qualitative descriptive documentary analysis, guided by a protocol comprising five interpretive dimensions. Main Results: The i-Saúde dimension showed a predominance of intermediate classifications and, in 2024, a redistribution toward category B, with a reduction in the number of municipalities classified in category C. This result was interpreted cautiously in view of the methodological changes made to the instrument. The typological articulation between i-Saúde and IDSC-BR identified four relative profiles, defined according to state medians, and 23 municipalities with persistent classifications across the two analytical pairings. The analysis of the MHPs revealed an incipient incorporation of the 2030 Agenda, variations in the coherence among diagnoses, priorities, objectives, targets, indicators, and monitoring mechanisms, as well as the absence of an automatic correspondence between the documentary quality of the plans and the municipalities’ relative positions in the instruments. Vocabulary convergent with the 2030 Agenda was also identified, although without explicit textual linkage to this framework. Theoretical and Methodological Contributions: The research broadens the understanding of public governance informed by institutional evidence by articulating external oversight, monitoring of the 2030 Agenda, and sectoral health planning. Methodologically, it systematizes a typological procedure that can be replicated and adapted to other contexts, as well as a fivedimension analytical protocol for the documentary examination of MHPs. Relevance and Originality: The relevance of the study derives from the integration of instruments with distinct characteristics and purposes to support municipal health planning. Its originality lies in applying, to the health field in Sergipe, an articulation inspired by a precedent developed in the educational field and in proposing four relative profiles constructed from state medians. Social and Management Contributions: The research provides municipal managers, Municipal Health Councils, and the Sergipe State Court of Accounts (TCE/SE) with evidence and operational instruments, materialized in a Final Technical Report and a Practical Guide, to support the preparation and revision of MHPs, the incorporation of the 2030 Agenda and SDG 3, the measurability of targets, documentary traceability, and budgetary articulation. By fostering more coherent, transparent, and evidence-informed plans, the research has the potential to contribute to greater responsiveness and equity in municipal health planning.