Democratization of the management of national health care system (SUS) in the municipality of Santo André, São Paulo, through the consolidation of the councils of popular participation

The question of social participation in the context of public health in Brazil gained area of rhetoric and practice over the last two or three decades and suffered influence of some important factors of the political situation, for example, the movement of the health reform (1970s) and the process of democratization of the country with the promulgation of citizen Constitution (1980s). With the growth of that movement has become almost impossible, for the continuity of the treatment of health issues of the Brazilian population, to ignore the collective interests. The Councils called of social or popular participation may be understood, indeed, as mechanisms of representation, in which act citizens elected by the Community to represent it, investing them in this way, power to decide on its place in health issues. Therefore, the Municipality of Santo André has initiated a democratic process of implantation of 100% Councils of health care units during 2007 and continues to guarantee educational activities, developed to the citizens interested to participate on those councils, organized by the School of Health and Popular Participation. The methodology in this qualitative research is a case study, of the elections process of the municipal councils of health units. The results show that in Santo André (SP) the management of the SUS is carried out by tree hierarchically public councils: Municipal Conference of Health; Municipal Council of Health; Administrative Councils of Health Units. After the reformulation of the election process the municipality could improve those spaces of participation and representation of the society through 552 advisors of health elected, with 889 votes. The public power have been stimulating and providing the implantation of the councils, which have the finality to define the priorities for action of public health units and allows the social effective participation.