Social organization and control of tuberculosis: the experience of a Brazilian town

OBJECTIVE: this study was aimed at analyzing the participation of a committee formed by representatives of the community in tuberculosis control based on a participatory management model. METHOD: this is a Case Study involving a tuberculosis committee with data collected through semi-structured interviews conducted with nine individuals. The data, organized through the Association of Ideas Map technique, were analyzed based on the Social Constructionism perspective. RESULTS: the participation of the Tuberculosis Committee studied was shown to be effective and associated with aspects articulated according to the measures taken by the social parties involved in the committee, culminating with assistances inserted into certain parts of the town's co-management. CONCLUSION: it was concluded that the reality of this case study shows that relationships among civil society can guide the management model in the search for effective processes of tuberculosis control

Resoluções do Conselho de Saúde: instrumento de controle social ou documento burocrático? Resolutions of the Health Council: instrument of social control or bureaucratic document?

O presente estudo, de caráter documental, analisa as resoluções registradas em atas de reuniões de um Conselho de Saúde, de forma a caracterizar o controle social em saúde realizado por esta instância. A maioria das resoluções referiam-se à aprovação de programas e projetos, oriundos da Secretaria da Saúde, referentes à reforma, aquisição de material e equipamento para unidades de saúde, qualificação de serviços já existentes ou criação de novos serviços. O estudo sugere que a prática deste conselho parece ser burocratizada, sem que seja visualizada nenhuma proposição de políticas de saúde pelo conselho. A forma como as resoluções vêm sendo formalizadas não caracteriza seu encaminhamento, muito menos a visibilidade das ações para a população em geral. No caso estudado, sinaliza-se que o mero funcionamento regular deste conselho não garante que exista efetivo controle social.<br>The present study has a documentary character and analyzes the resolutions registered in minutes of meetings of a Health Council, as a form to characterize the social control in health carried through for this instance. The majority of the resolutions were referred to the approval of Programs and Projects, arising from the Secretariat of Health, regarding the reform, material and equipment acquisition for units of health, the qualification of existing services or the creation of new services. The study suggests that the practical one of this council seems to be bureaucratic, without any proposal of politics of health for the council is visualized. The way the resolutions have being legalized does not characterize its guiding not even the visibility of the actions for the population in general. In the studied case, it is signaled that the mere regular functioning of this council does not guarantee that exist effective social control

A participação nos conselhos de saúde e sua interface com a cultura política The participation in health councils and its interface with politics culture

O objetivo deste estudo é analisar as práticas de participação presentes no Conselho Municipal de Saúde de uma capital do Nordeste brasileiro e sua relação com a cultura política local. Partiu-se do seguinte pressuposto teórico: as práticas de participação exercidas nos conselhos de saúde inauguram uma nova institucionalidade, que inclui novos sujeitos sociais - os usuários - na esfera pública. O processo de democratização da sociedade brasileira amplia essa esfera e dá visibilidade para o confronto entre uma cultura política tradicional e outra democrática. Tratase de uma pesquisa qualitativa com as seguintes técnicas de coleta de dados: análise documental, observação participante e entrevista semiestruturada. Nas evidências surgidas, identificou-se a predominância da cultura política tradicional como um dos condicionantes das práticas de participação no conselho, expressa no autoritarismo e cooptação nas relações entre os gestores municipais e os representantes da sociedade civil. A maioria dos conselheiros reconhece o frágil poder deliberativo e fiscalizador do conselho. Apesar de se constatar as fragilidades dos conselhos de saúde, reconhece-se sua importância na democratização da relação entre Estado e sociedade civil e na luta para efetivação do direito à saúde.<br>The objective of this paper is to analyse the participation of current health councils in a city in the north-eastern of Brazil and its relationship with local political culture. The following theoretical presumption served as starting point: The practices adopted by health councils initiate a new institution that involves new social actors - the users - in the public sphere. The process of democratisation in the Brazilian society expands this sphere and leads to a confrontation of traditional and democratic political cultures. This is a qualitative research with the following data collection methods: documentary analysis, participant observation and semi-structured interviews. Within the evidence emerged, the dominance of traditional political culture resulted as one of the conditioning elements of participation practices in the Council, expressed in the authoritarianism and cooptation involving municipal managers and representatives of civil society. The majority of counsellors recognises the fragile power of the Council in terms of deliberative and fiscal issues. Despite confirming the frailties of the health councils, it is obvious that their importance in the democratisation of the relationship between State and civil society in the fight for the implementation of the right to health care