[The interactions between the national, regional and intra-regional levels in public health programmes]

Defined and recognised as a relevant level for steering health policy, the regional level is also a strategically important level for integrating national orientations and local projects. Management models are identified based on an analysis of national plans and about twenty regional programmes. If normative reference irrevocably shapes the representation of programme implementation, then the experience of regional health programmes based on the establishment of partnerships and skills sharing has played an important training role function and has influenced the methods used at the national level. There is a need to find a balance between the drafting of plans and the awareness of local characteristics, and to build new relationships between these levels and clarify their roles.