ADVANCES AND SETBACKS IN THE MANAGEMENT AND FINANCING OF THE SUS: A SCOPE REVIEW

Abstract

This paper addresses the management and financing of the Unified Health System (SUS) in Brazil, focusing on the advances and challenges faced in the area of public health policies. The choice of the topic is based on the importance of understanding how these aspects influence equitable and universal. The main objective was to analyze, through a scoping review, the changes that have occurred in the management and financing of the SUS, highlighting the main obstaclesand their consequences. The theoretical basis of the study brings together authors who discuss topics such as federalism in health, the historical underfunding of the system, the transformations in care models, and the management strategies adopted in the Brazilian context. The methodology followed the PICo (Population, Intervention and Context) approach, with searches carried out in the LILACS and SciELO databases, considering publications between 2018 and 2026. After applying the inclusion and exclusion criteria, 43 relevant articles were selected for analysis. The findings indicate that administrative decentralization, new rules for financial transfers and the fragility of information systems have generated inequalities in the implementation of health policies. In addition, fiscal criteria measures and the growing interaction with the private sector have called into question the sustainability of the SUS. In summary, the conclusion is that the consolidation of a universal and quality public health system depends on the review of the federative pact, the strengthening of social control mechanisms and the guarantee stable and sufficient financial resources.