Community of Practitioners on Accountability and Social Action in Health
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Universidade Federal do Rio Grande do Sul

Context

The department of sociology has been involved in research and training since 1990. The main focus of this training is a graduate program with a track on ‘society, participation and public policy’. The department developed this program because of the participation experiences that have taken place in Porto Alegre, the region where the university is located.
The department has  a focus on studying the National Health Council, the State Health Council of Rio Grande do Sul, at least five municipal council of health (mostly Porto Alegre), a hospital council, a health unity (out patient) council, and other participatory mechanisms. They have also studied other experiences, such as participatory budget and participatory mechanisms in other social policy areas. 
Website
www.ufrgs.br/ppgs
Area of Work
Brazil
Contact Person
Soraya Cortes

Approaches to implementing Community monitoring/ accountability

The department focuses on research around citizens’ participation from a sociological perspective. They use different theories and approaches to identify what kind of stakeholder participates (civil society, governmental etc) and later classify them according to their role, interests or to what sector they represent. There is also some work around substantive participation, which can be seen as a more effective way of representing citizens’ interests and of presenting their views in the public arena.
By studying the different realities, the department can map and analyze participatory processes and build-up typologies that help to classify and qualify the variation that exist within ‘participation’: focusing on types of involvement in decision making processes, distinct agency attitudes or ways of involving users –as well as degrees of participation.

Results and Lessons

  • In federal states like Brazil, it is important to verify the nature of the relationships that exist between national, state and local administrative levels and the health system. This is because power can be distributed in different tiers of the government or throughout sectors in centralized or decentralized fashions. This helps to identify what aspects of policy are easier to decentralize than others.
  • The degree and the way in which individuals and representatives participate in decision-making processes are determined by political action of interest groups. Key or powerful stakeholders influence the process, and other organizations cannot support or influence the process as effectively.
  • Health authorities from federal, state and municipal level exercise multiple roles. Stakeholders and actors that represent the state are also powerful when it comes to implementing decisions in a participatory way. The way the health authorities view participation is directly related to how the participatory processes develop, and their personal careers qualify them as professionals and as members of policy communities trying to influence governmental decision-making processes. Municipal health authorities directly responsible for the co-ordination of the municipal health councils could have a strong influence over the way the forum would work.
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