[Social participation in health: a case study in Brazil].
OBJECTIVE
To study the complex relationships between government power and health care utilization in Brazil, through the analysis of local initiatives of social participation fostered by decentralization of health services.


METHODS
A qualitative study was carried out among the local executive groups (LEG), particularly the one located in the peripheral area of Rio de Janeiro, known as AP.3.1. Group activities were followed during 1986. Data were collected by means of open interviews to community leaders, health service managers and university faculty. One of the main information sources was the LEG proceedings book.


RESULTS
Data analysis disclosed the dynamics of the relationship between social mobilization and healthcare responses, underscoring the limits and potential of governmental initiatives regarding the inclusion of social groups as active interlocutors and actors in the definition of demands, as well as the limits of institutionalization of popular participation in settings socially and politically deprived.


CONCLUSIONS
Contraposition between health policymakers and healthcare users is evidenced by the implementation of social participation strategies that do not take into account the organizational figures of social groups.
Abrantes-Pêgo
R
R
Centro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México. mpego@insp3.insp.mx
D001938:Brazil; D016022:Case-Control Studies; D018166:Health Care Reform; D006296:Health Services / Q000706:statistics & numerical data; D006298:Health Services Administration; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D010358:Patient Participation / Q000379:methods; D012926:Social Control, Formal