[Social participation in health: user community leaders, managers and policy makers in Colombia. A qualitative view].
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.
Delgado Gallego
María Eugenia
ME
GEMA--Universidad del Valle, Colombia. mariedel@andinet.com
Vázquez Navarrete
María Luisa
ML
Zapata Bermúdez
Yolanda
Y
Hernán García
Mariano
M
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