Participação social em saúde: estudo sobre as motivações e a influência dos recursos para o envolvimento comunitário.

Abstract

This study aimed to analyze the factors that influence the population's involvement in health issues based on institutionalized and non-institutionalized participation mechanisms. This is a multiple case study with overlapping levels of analysis and a qualitative approach carried out in three municipalities of different population sizes in the state of Bahia: Vitória da Conquista, Guanambi and Urandi. The study aimed to analyze institutionalized and non-institutionalized mechanisms of participation in health. In each municipality, the municipal health council and community participation bodies and initiatives were investigated. Data were obtained through 46 interviews with key informants, document analysis and participant observation. The theoretical-methodological framework was based on an analytical matrix adapted from the chain of participation model by Simmons and Birchall. The results were presented through two scientific articles. The first article aimed to analyze how the availability of resources influences the engagement of communities in non-institutionalized participatory practices in health in Brazil. The results demonstrated that the availability of resources has a great influence on people's participation in community participation spaces. The resources of time, money, skills and trust influenced the capacity to participate, and the scarcity of these resources acted as a limiting factor for community involvement. It was identified that gender issues restrict women's time for social activities and limit participation. The creation of strategies by participants to overcome resource limitations and a willingness to participate even in the face of scarcity of resources were also identified. The second article aimed to analyze the motivations for involvement in institutionalized and non-institutionalized spaces for participation in health. The results were structured into two dimensions: individual motivations and collective motivations. In individual motivations, the influence of internal benefits such as the search for knowledge, personal fulfillment, empowerment and self-confidence was observed. The external benefits identified were the possibility of personal and professional advancement and the resolution of personal and family problems. Collective motivations showed greater capacity to influence individuals to act. Citizens share common goals with the guarantee of the right to health and citizenship values. The importance of the influence of family members and community leaders as motivating agents is highlighted. A sense of community was expressed by participants who seek to bring benefits to the communities through participation. The need to understand the necessary resources and motivations for social participation in health is emphasized in order to reduce barriers and enhance participant engagement. The need to recognize and encourage community participation initiatives is also highlighted.