Participatory Health Councils and Good Governance: Healthy Democracy in Brazil?

Posted: 27 Aug 2014

See all articles by Jillian C. Kohler

Jillian C. Kohler

Leslie Dan Faculty of Pharmacy, University of Toronto

Martha Martinez

University of Toronto - Leslie Dan Faculty of Pharmacy

Date Written: 2014

Abstract

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

Suggested Citation

Kohler, Jillian C. and Martinez, Martha, Participatory Health Councils and Good Governance: Healthy Democracy in Brazil? (2014). APSA 2014 Annual Meeting Paper, Available at SSRN: https://ssrn.com/abstract=2454940

Jillian C. Kohler (Contact Author)

Leslie Dan Faculty of Pharmacy, University of Toronto ( email )

144 College St.
Toronto, Ontario M5S 3M2
Canada

Martha Martinez

University of Toronto - Leslie Dan Faculty of Pharmacy ( email )

144 College St.
Toronto, Ontario M5S 3M2
Canada

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