Discussing community participation in health: an approach from the Brazilian experience

Abstract

This article deals with the problem of community participation in the process of planning, management and decision-making in the Brazilian health system. It seeks to discuss the political process that gave rise to the formation of this model of participation in Brazilian health sector and to identify the reasons for possible weaknesses or constraints in the functioning participatory process.To that end, it makes a review on the literature to address the concept and approaches related to community participation, the advantages of adopting it, some obstacles to its implementation in health management and planning, as well as identifying three kinds of participation in health, according to different technical-political practices and rationalities. Special attention is given to Brazilian experiments in health participation, which culminated in the institutionalising of health councils. In this sense, emphasis is placed on the importance of the social process known as the "Health Reform Movement" and on the holding of the VIII National Health Conference in 1986. Finally, the study concludes that in countries with political, social and economic characteristics like Brazil, the task of incorporating community participation in the formulation and management of health policy depends on the creation of a new spirit of citizenship.