Envolvimento comunitário na Estratégia de Saúde da Família: Dilemas entre institucionalização e efetiva participação

Abstract

This paper analyzes the performance of Local Health Councils as tools for social participation in the Family Health Strategy. It is a quali-quantitative research with triangulation method. The research took place in the city of Vitoria da Conquista, state of Bahia, Brazil. Data and information were gathered through the analysis of the agenda, followup forms, minutes of meetings of the council and semistructured interviews with key informants. The results show that the local health councils have limited performance, with a low frequency of meetings, commitments directed to the council itself and meetings on difficulties to access health care services. Low levels of social mobilization and community engagement are the main draw-backs for the good performance of these forums. Some problems stand out: counselors' representativeness, lack of motivation to perform voluntary tasks and feeling unprepared due to a poor graduation and training program. We conclude that institutionalization of local councils is not enough to promote community participation. It requires actions that can promote social mobilization and inform communities of the importance of group participation and engagement.