Participation of citizens in health policy and health care organization has been recognized as cardinal since Alma Ata health care for all declaration. Yet, the width and breadth remain contested and implementation difficult. Movements to involving and empowering communities in decision making for health priorities and interventions varied from instrumentalizes community health worker approaches to bottom-up health policy planning. Especially in countries where professional health systems were weak these strategies received much attention and support, less so in professionally dominated health systems in Europe.
 Yet the shift from an individual care-oriented system towards a population based approach has opened opportunities to rethink health governance at local levels, and the voice of the population. Population-based health management implies the defining and addressing of health care needs of a specific population defined for instance by a geographic delineation. This allows decentralization of decision-making. However, especially in a highly professionalized health care system, such shifts are difficult. Implementation challenges relate to whom to involve, how to organize representation, and how to ensure equitable participation of different stakeholders. 
 In this working session, we aim to address the implementation challenge of how persons with care needs and informal care givers can take up and develop their role in governance of local health care planning. We will take a practice-based approach, exploring the role, organisation and effects of participation of citizens in the local care councils in the primary care zones in Flanders, Belgium. In part 1, persons with care needs and informal caregiver representatives in care councils will present their stories, implementation challenges and utility of instruments such as the participation toolbox. In part 2, session participants will assess tools and strategies for the challenges presented in a world café format. In part 3, the results of the café discussions will be presented to a panel of person and informal caregiver representatives, policy makers and researchers from different countries, to provide locally relevant and international perspectives on the problem and solutions. The session will be co-led by people with care needs, people from the implementation support organization VIVEL and by researchers from two higher education institutions. 
 Organisers: Josefien van Olmen (University of Antwerp), Christophe Wille (Artevelde University of Applied Sciences), Marlies De Clerck (VIVEL), Naomi De Bruyne (Coördinator Steunpunt Mantelzorg), Lieve Dossche, Annet Wauters (Vlaams Patiënten Platform), Lie Verryssen (VIVEL), Patricia De Vriendt (Vrije Universiteit Brussels, University of Applied Sciences)
 Procedures to ensure representation and inclusion: simultaneous translation in English and Dutch. 
 
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