title: [Strengths and challenges of citizens' participation in local health councils: the cases of Italy, England, and Brazil].
abstract: This paper focuses on three models for citizens' participation in health (Italy, Great Britain, and Brazil). After discussing the strengths and weakness of the three experiences, the study presents a comparative analysis, highlighting convergences and variations in relation to the main characteristics of social participation in the health sector: (a) organization and composition of health councils; (b) functions played by citizens' representatives (decision-making, advisory, or social control or oversight); and (c) approaches to community participation. The paper then focuses on two critical points emerging from the analysis of experiences with community participation: the issue of representativeness and the difficulty experienced by representatives of health services users in influencing the decision-making by system managers.
authors.affiliation: Centro de Ciências da Saúde, Universidade Estadual do Ceará, Fortaleza, Brasil. mauro_serapioni@yahoo.es
authors.forename: Mauro
authors.initials: M
authors.lastname: Serapioni
authors.forename: Oriol
authors.initials: O
authors.lastname: Romaní
mesh_terms: D026683:Advisory Committees; D001938:Brazil; D003153:Community Health Services / Q000592:standards; D003256:Community Participation / Q000379:methods*; D003657:Decision Making; D004739:England; D018166:Health Care Reform; D006286:Health Planning Councils; D006801:Humans; D007558:Italy; D009313:National Health Programs; D012933:Social Identification