"Measuring the health and fiscal outcomes of solid waste management operations by intergovernmental arrangements: The case of public consortia in Brazil".

This study estimates the health-related and public expenditure impacts of the solid waste services provided by public consortia in Brazilian Municipalities from the enactment of Public Consortia law (2005) to 2019. To conduct the analysis, we applied the econometric method of staggered difference-in-differences to publicly available datasets at the municipality level. The results show that the operation of solid waste services by public consortia had statistically significant effects in reducing hospitalizations caused by Schistosomiasis, Diarrhea/gastroenteritis (up to 5 years age) and other intestinal diseases. The results also indicate a positive impact on the reduction of environmental expenses in treated municipalities, supporting the idea that a Solid Waste Consortium can serve as a local coordinator and improve health and fiscal indicators simultaneously. The findings provide quantitative evidence that policymakers at the local and regional level can use to better understand the benefits of adhering to public consortia when preparing new investments and operation developments for this sector. This paper contributes to the literature of applied research in solid waste by shedding light on the underexplored theme of the intergovernmental cooperative arrangements, which can be instrumental in accelerating and enhancing the development of solid waste services.

Energy recovery from municipal solid waste of intermunicipal public consortia identified in São Paulo State.

The main reasons, which this research is based on, are evidenced by the need of technical, political, economic and socioenvironmental coordination for the municipal solid waste management in Brazil and in the State of São Paulo. Most of the counties do not have adequate size to promote the management of MSW, so it's necessary to perform a consortia to do it. Therefore, it was necessary to characterize the current State of Sao Paulo consortial arrangements considering the environment (including sanitation, waste, water resources, among others). The scale of waste generation and the total population involved in these consortia were also considered. The energy potential of municipal solid waste was evaluated considering two possible technologies: The burning of landfill biogas in engines and the incineration in plants with Rankine cycle. It was identified that the sum of consortia energy potential was 1,454,336 MWh y-1 (landfill biogas), and 2,715,925 MWh y-1 (incineration). It is intended that such results provide significant information and encourage interaction between the different agents involved in the intermunicipal arrangements. It is expected that the characterisation and calculation of energy potential will stimulate future studies about new consortia approaches that consider energy recovery in their projects.

Gestão interfederativa do SUS: a experiência gerencial do Consórcio Intermunicipal do Sertão do Araripe de Pernambuco / Inter-federal SUS management: the managerial experience of the Inter-municipal Consortium of Pernambuco's Sertão do Araripe / Gestión Interfederativa NHS: la experiencia de gestión del Consorcio Intermunicipal del Hinterland Araripe Pernambuco

O objetivo deste artigo foi analisar a experiência gerencial do Consórcio Intermunicipal de Saúde do Sertão do Araripe de Pernambuco (Cisape). Para isso, utilizou-se uma pesquisa qualitativa do tipo análise documental. Os documentos analisados foram relatórios produzidos por consultoria especializada, envolvida na implantação da gestão regionalizada e consorciada do Sistema Único de Saúde (SUS) em Pernambuco, no período de 2009 e 2010. Os resultados apontam que o Cisape adotou o modelo de gestão gerencialista, ou seja, orientado pela gestão pública pós-burocrática. A estrutura organizacional do Cisape foi definida como de direito público de natureza autárquica. A pesquisa identificou que em Pernambuco o Cisape se configurou como uma ferramenta importante para estimular a regionalização do SUS, porém com incipiente participação social.

El propósito de este artículo es analizar la experiencia de gestión del Consorcio Intermunicipal de Salud Hinterland Araripe Pernambucano (Cisape). Para ello, se utilizó una investigación cualitativa de tipo de documento de análisis. Los documentos fueron analizados los informes elaborados por consultores especializados, que participan en la aplicación de la gestión regionalizada y el consorcio del Sistema Único de Salud (SUS), en Pernambuco entre 2009 y 2010. Los resultados indican que la Cisape adoptó el modelo de gestión gerencial, es decir, impulsado por la gestión pública post-burocrático. La estructura organizativa de Cisape se definió como Ley Pública naturaleza autárquica. La investigación identificó que, en Pernambuco, la Cisape ha configurado como una herramienta importante para fomentar la regionalización del SUS, pero con la participación social incipiente.

The purpose of this article was to analyze the managerial experience of the Inter-municipal Consortium of Health of Pernambuco’s Sertão do Araripe (Cisape). To do it, we used a qualitative research of document analysis. The documents analyzed were reports produced by specialist consultants, involved in the implementation of regionalized and consortium management of the Unified Health System (SUS) in Pernambuco from 2009 to 2010. The results indicate that Cisape adopted the model of managerial management, ie, driven by the post-bureaucratic public management. The organizational structure of Cisape was defined as Public Law of autarchic nature. The research identified that, in Pernambuco, Cisape has been set as an important tool to encourage SUS’ regionalization, but with incipient social participation.