PARTICIPATORY GOVERNANCE INTERFACES: OBSTACLES AND POTENTIAL IN THE INTEGRATION BETWEEN THE MUNICIPAL HEALTH COUNCIL AND SOCIETY IN THE SUS

Abstract

This article analyzes the challenges and opportunities facing the integration between the Municipal Health Council (CMS) and society within the Unified Health System (SUS). Although CMSs are legal mechanisms for social oversight of public health policies, their effectiveness depends on the quality of social participation and dialogue among the various stakeholders. Significant challenges are identified, such as insufficient education and training for council members, the concentration of power in the hands of administrators, the low representation of vulnerable groups, and difficulties in communicating and providing information transparency. These factors limit popular participation, weaken the councils' autonomy, and compromise the legitimacy of their decisions. On the other hand, a scenario of promising opportunities is observed, marked by continuing education programs, such as "Participa+," and the creation of Local Health Councils (CLS), which expand participation at levels closer to the community. The incorporation of digital technologies and innovative methodologies also emerges as a tool to expand access and transparency, overcoming geographic and informational barriers. Strengthening the CMS also involves working with external oversight bodies, which enhance their oversight and intervention capabilities. To advance effective integration between the councils and society, institutional political commitment, democratization of councilor election processes, ensuring diversity, and implementing accessible communication strategies are essential. The article concludes that qualified social participation is an essential vector for consolidating the SUS as a public, universal, and equitable system, promoting social justice and improving health policies. Therefore, the importance of ongoing public policies that promote training, representation, and popular engagement to strengthen participatory governance in the SUS is highlighted.