Para repensar as práticas dos conselhos de saúde

Abstract

This study analyzed the practices of health councils face the challenges to social participation with a focus on power, with reference to the qualitative theoretical and methodological approach. Data from this study were produced in seven councils in the city of Vitória, Espírito Santo, through the use of three techniques: 1. Desk review of the minutes and internal regulations of the councils; 2. Systematic observation of the plenary of the councils, the 9th Municipal Health Conference and the election process for directors; 3. Individual interview in depth with health counselors and other community members. Data analysis was carried out globally, based on the assumptions of the thematic content analysis that guided the relations between the theoretical references of the study and the emerging units of the material produced, as well as the relations between the emerging units and objectives research, which emerged three main areas of analysis discussed in this study: the power relations in health councils; the power of manifestation in the health councils and limits the power of demonstrations in the health councils. It was found that power is a provisional and creative force from the power relations existing in the practices of these boards, which could be observed, especially in the local councils of the capital, manifesting itself in various ways, such as independence of board members ; co-management; democratization of information; establishment of participatory networks; representative legitimacy; diverse movements and entities being represented; feeling of belonging to SUS; political maturity of the actors; development of a participatory culture; collective motivation; publicizing the actions of councils; emphasis on continuing education, as well as in continuing education aimed at directors and also resistance movements against the assemblages of power, among others. There was also many challenges permeating daily life of these boards, among them, the authoritarian and traditional forms of management; the difficulties of institutional and organizational design of the councils; the incipient transparency and publicity of the actions of these spaces; misinformation of the actors involved in the participatory process, among others, that need to be overcome, otherwise, may lead to the delegitimization of these institutional mechanisms for participation.