Cross-Border between Brazil-Uruguay: Power in Health Production by Municipal Management

Introduction: The objective of the study is to describe the power relations used by managers in health production in twin cities and how they operate to ensure health, considering the reality of crossborderation. Methods: This is an exploratory approach and a qualitative method, carried out on the border between Brazil and Uruguay. The participants were six municipal mayors. Data collection took place from October to November 2016. Results: By producing health in the border territory, managers have strategies and jurisdictions to enable local and, at the same time, international policy, which affects the daily, somewhat restricting local governance, involving binational decisions, such as complementarity in health services. The lack of recognition of national health systems and the interdependence of the need for health production in this binational space is a challenge for municipal management. Conclusion: Managers use political power to realize binational actions and ensure foreigners access to the Single Health System; Agreements signed outside the reality of the administration interfere with law enforcement at the border. Managers need representation in decision-making spaces at the state and national levels that order the demands arising from binational border committees, as well as enabling better local governance in health cooperation in Mercosur.