Scope and Limitations of Municipal Health Councils: A Case Study

Abstract

This case study analyzed citizen participation at the Municipal Health Council (MHC) of Ribeirão Preto, in the state of São Paulo (Brazil), using a qualitative approach with a phenomenological basis and methodological triangulation: (i) analysis of the minutes of the meetings, (ii) passive observation, and (iii) semi‐structured interviews with councillors. The interviews were analyzed using content analysis and categorized according to three themes: (i) challenges and limitations of participation in the MHC, (ii) representativeness of the councillors, (iii) the Council and its influence on local health‐care policies. Problems with infrastructure and the organizational logistics of the MHC, as well as relational difficulties among members occupying varied roles and having different levels of knowledge about health, influenced the quality of the deliberative process. In contrast to studies that indicate poor participation by health‐care service users in spaces of dialogue around health‐care policies, this study found the users actively engaged and committed.