Análise da dinâmica de participação e representatividade de um Conselho Municipal de Saúde em um município de grande porte de Minas Gerais

Abstract

The Municipal Health Councils (MHC) are important mechanisms guaranteed by the Organic Health Law (Law No. 8080/1990) that promote social control and popular participation in the management of local public health. However, the mere existence of the MHC does not guarantee popular representation and the efficiency of its functioning, with reports of challenges in the representative dynamics, work, functioning, and efficiency of the MHC. This study aims to analyze the representational dynamics in the MHC of a large city in the interior of Minas Gerais. Documental research was conducted, adopting qualitative analysis from a Foucauldian perspective and participant observation. Data sources consisted of restricted access documents (attendance lists and meeting calls) and unrestricted access documents (minutes, Internal Regulations (IR), and pertinent legislation), in addition to field diary records. The results found hindering elements for both the effective functioning of the MHC and its representative capacity of the population: irregular positions, underrepresented segments, low attendance of councilors, insertion of religious elements, gender and race inequality in representations, irregular document production, changes in agendas and meetings in disagreement with the regimental rite, lack of articulation between representatives and the represented bases, among others. It is concluded that, in addition to the existence of the MHC, a policy is also necessary to ensure structural conditions to strengthen the democratic function of the councils, such as mobility programs for low-income councilors, training, compliance with regimental procedures that allow participatory equality for all members, among others.