Mapping the emergence of the National Health Care Policy for Indigenous People in Brazil

Abstract

This article is a case study about the construction of the National Health Care Policy for Indigenous Peoples (PNASPI), in which causal processes are reconstituted and descriptive inferences concerning the entry of indigenous health into the government agenda as a public policy of the Brazilian State are made. The theoretical-analytical models that supported this article are the Multiple Streams Framework, by John W. Kingdon, and the Punctuated Equilibrium Theory, developed by James L. True, Bryan D. Jones, and Frank R. Baumgartner. The research that gave rise to it was undertaken through documental, bibliographical, and interviews analysis. The results of this article are the description of the process by which the health of indigenous people became a public policy, the identification of institutions and actors involved, the construction of the image of the differentiated health policy for indigenous people, as well as the political conditions, the historical context, and the prevailing national “climate”. It is concluded that the constitution of the PNASPI results from the effective participation of indigenous people in health councils and conferences and in different forms of demand mobilization. In addition, institutional changes have been both in the sense of making concrete the proposal for a differentiated policy for indigenous people and, in the opposite sense, of promoting the integration of people into the rest of Brazilian society, ignoring Brazilian multiculturalism.