title: [Social participation in health: user community leaders, managers and policy makers in Colombia. A qualitative view].
abstract: BACKGROUND
  Health sector reforms taking place in Colombia during the Nineties included policies to promote social participation in the health system, which is considered essential to its functioning. The aim of this article is to analyse the meaning and the significance of participation in health for the different social actors involved in implementing policies in Colombia.
  
  
  METHODS
  A qualitative, descriptive, exploratory study was carried out using focal groups (FG) and semi-structured individual interviews (I) of the different social actors: 210 users (FG), 40 community leaders (FG), 3 policy makers (E) and 36 healthcare professionals (E). A carried out analysis was content up of the contents. The study area corresponded to the municipalities of Tulua and Palmira in Colombia.
  
  
  RESULTS
  The concept of participation was interpreted differently depending on the actor studied: for users and leaders the concept referred to contributing ideas, presence in social spaces, solidarity and frequently, and use of the health services. Healthcare professionals considered the activities carried out by institutions together with the community as social participation, the use of services and affiliation to the health system. Policy markers considered participation to concern evaluation and control of the health services by the community, to improve its quality.
  
  
  CONCLUSIONS
  The different concepts of participation reveal dif ferences between the content of the policy and how it is understood and interpreted by the different social actors in their interaction with the health services. These different perspectives must be taken into account to develop a link between society and the health services.
authors.affiliation: GEMA--Universidad del Valle, Colombia. mariedel@andinet.com
authors.forename: María Eugenia
authors.initials: ME
authors.lastname: Delgado Gallego
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Vázquez Navarrete
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Zapata Bermúdez
authors.forename: Mariano
authors.initials: M
authors.lastname: Hernán García
mesh_terms: D000293:Adolescent; D000328:Adult; D003105:Colombia; D018672:Community Health Planning; D003256:Community Participation; D005260:Female; D017144:Focus Groups; D018166:Health Care Reform; D006284:Health Plan Implementation; D006291:Health Policy; D006298:Health Services Administration; D006801:Humans; D007407:Interviews as Topic; D007857:Leadership; D008297:Male; D008875:Middle Aged; D011787:Quality of Health Care