The Municipal Health Councilors participation: a solution that has changed into a problem?

Abstract

The Brazilian Constitution proposal of social control opened many perspectives towards a democratic practice in health area. The Brazilian Health System has the Municipal Health Council to execute the constitution principle of "community participation", which means to assure social control on actions and services in any municipality. This Council has the competence to exam and to approve the directions established by health policies to reach their objectives. It also formulates strategies and through them, it is possible to improve and suggest proper means to execute them or to correct directions. In Botucatu (Sao Paulo state) the Municipal Health Council was formed in 1992 and this study aimed to analyze the participation of its members. A qualitative approach was adopted. Results showed that half of the principal members, a third part of the substitutes and also visitors attended the meetings, they brought claims or suggestions from the social groups they represent and had good evaluation about the effect over all the members, but not always they got adequate answers. Some of the problems were: decision-making outside the Council, the difficult integration among different health services, the poor organization of the meetings like long duration, lack of objectiveness in the questions, etc. and meetings only to approve decisions already taken by federal or state government. To listen to the councilors allowed to understand the problems faced and to perceive their proposals for advancement of the democratic process which is a challenge for life.