title: Lessons from local engagement in Latin American health systems.
abstract: OBJECTIVE
  To examine the management of recent policies for stronger patient and public involvement in Latin American health systems, identifying common features and describing local practice examples of relevance to the UK.
  
  
  BACKGROUND
  Participation is a core principle of many contemporary policies for health system reform. In Latin America, as in the UK, it is frequently associated with innovations in primary care services and their organizational developments. This shared interest in alternative models of local engagement offers new opportunities for collaborative research and policy development.
  
  
  METHODS
  Commissioned by UK policy makers, a 4-year research programme was designed to promote exchanges with international counterparts focusing on how modern reform policies are being implemented. The selected countries possessed comparable principles and timeframes for their reforms. A series of individual country case studies were undertaken. Data were drawn from literature and documentary reviews; semi-structured interviews with national policy makers and expert advisers; and with management representatives at local exemplar sites. The aggregate data were subjected to thematic analysis applying a model for sustainable development.
  
  
  RESULTS
  Six common factors were identified in Latin American policies for stronger patient and public involvement. From these the most significant transferable learning for the UK relates to the position and status of professions and non-governmental agencies. Illustrative case exemplars were located in each of the eight countries studied.
authors.affiliation: Research and Policy Centre for the Study of Faith and Wellbeing in Communities University of Winchester, West Hill Winchester Hampshire SO22 4NR, UK. geoffrey.meads@winchester.ac.uk
authors.forename: Geoffrey D
authors.initials: GD
authors.lastname: Meads
authors.forename: Frances E
authors.initials: FE
authors.lastname: Griffiths
authors.forename: Sarah D
authors.initials: SD
authors.lastname: Goode
authors.forename: Michiyo
authors.initials: M
authors.lastname: Iwami
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration*; D006291:Health Policy; D006801:Humans; D007843:Latin America; D009313:National Health Programs / Q000458:organization & administration* / Q000639:trends; D006113:United Kingdom