The challenges of popular participation in the public health care

The challenges of popular participation in the Public Health Care

 The democratization process in Brazil began in the 70s and gathered  the civil society to fight for their rights. The 1988 constitution is a landmark in this course. It stablishes the universalization of several social rights such as the right to health. It creates the Public Health Care (PHC) and it defines the decentralization guidelines and the community participation. These guidelines are laws which hold health councils and conferences in the city, state and nation, as places for participation and social control instruments of the state actions. The health councils are the permanent, deliberative and equal functional divisions – 50% are represented by PHC customers. The PHC proposition as a health universal public system is a project still under construction. However, the participation depends on different factors such as the local politics culture. In Brazil the relation state–society has been permeated by politics culture emphasized by authoritanism, assistencialism, and favor. Together with the process of democratization there come elements of a democratic politics culture – driven by autonomy, equality, sympathy and social justice values, which begin to live with the traditional politics culture. Aim: to analize the participation practices present at the Health Municipal Council of a Brazilian Northeast capital and its relation with the local politics culture. The techniques used to colect data were: the documental analisys, the participative observation and the semi-structured interview. The councils are more than deliberative, they are public spaces where the population can bring their claims. The authoritarism and cooptation between the public power and the civil society representatives were also present, although there has been some resistence to such practices which indicates the effort to transform in order to increase the popular participation.