The Citizen Participation in the health area: a qualitative study about the reality of Chile

Abstract

The subject of Citizen Participation is, definitely, a field of interest for public policies. It is understood that citizen participation (Diego Escobar) is a necessity of the citizens’ gaining power to exert an active role, in opposition to a passive one where they receive policies and governmental measures. When considering citizens’ participation, ideas tend to be centered solely on the political scope: on a democratic, representative system of all political tendencies; on political parties; on strong social organizations which can allege participation in certain governmental decisions, etc. Nevertheless, participation without being connected to a specific area is ethereal. For this reason, the present study aims at observing participation as it is developed, it stops, is reformulated and generates power in the area of health.
Citizens’ participation as a problem was expressed by ex-president Lagos through his Presidential Instructive on Citizens’ Participation, in the year 2000. In such Instructive, Lagos emphasizes the importance of citizens’ participation for the good operation of the democratic system. It also asserts that, in this level, a government which opens up to participation and an active civil society are required. Thus, the Ministry of Health and, especially, the Servicio de Salud Metropolitano Sur (South Metropolitan Health Service, SSMS for its abbreviation in Spanish) considered, for this year, three focal points to work on the subject of citizens’ participation: the strengthening of the networks between Health Centers and the community which they serve; the creation of participative Public Accounts; and the strengthening of the Bureaus of Information, Claims and Suggestions. The present study aims at assessing the type of existing participation in two different institutional areas at SSMS: on the one hand, hospital-related participation and, on the other hand, such participation connected with primary attention, located in the Family Health Centers of low socio-economic level communities. The investigation methodology was qualitative; person/s in charge of the area of participation and community representatives were interviewed. The results show that the proposed participation from the government is still insufficient, among other reasons, because the government does not assure all the instances for its development, and because their civil employees “have not been trained to grant participation.”