Participatory Health Councils and Good Governance: Healthy Democracy in Brazil?
Posted: 27 Aug 2014
Date Written: 2014
Pursuant to Article 196 of Brazil’s 1988 Constitution, universal access to health services and basic medicines is constitutional right. In 1990, Participatory Health Councils (PHCs) were implemented at the national, state and municipal levels to ensure transparency and accountability in the health system and to introduce social control. PHCs are advisory bodies that engage civil society groups, government representatives, and health professionals in the monitoring and development of health policies at the municipal, state and national levels of government. Despite the seemingly positive and comprehensive reach of PHCs, their real impact is inconclusive.
We conducted a methodological triangulation of a literature review between the years 2000-2013 in English and Portuguese, 21 semi-structured interviews with health council members, and a qualitative analysis of PHC data from the Sistema de Acompanhamento dos Conselhos de Saude (SIACS) database to developed an exploratory study of PHCs’ limitations and contributions. We utilized the United Nations Economic and Social Commission for Asia and the Pacific’s (UNESCAP) good governance framework, (participatory, consensus oriented, accountable, transparent, responsive, effective and efficient, equitable and inclusive, follows the rule of law) to analyse PHCs’ strengths and shortcomings. We found the PHCs’ real impact on improving health policies is limited.
Keywords: Health Policy, Brazil, Good Governance, Participatory Health Councils
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