Social mobilization and citizen participation in health councils

Abstract

This study aimed to analyze social mobilization efforts and the role of representative entities in fostering participation in health councils across municipalities of different population sizes. It is a qualitative multiple-case study conducted in three municipalities in the state of Bahia, Brazil. Data were collected through document analysis and interviews with 30 health council members. A theoretical framework was developed based on the participation chain and decision-making domains models. Social mobilization was examined across three dimensions: micro, representing the individual perspective; meso, reflecting the role of community organizations; and macro, encompassing the dynamics of health councils. The results revealed low levels of community mobilization. At the individual level, limited interest in participation was observed. The meso dimension highlighted the weakening of traditional interest-based organizations, such as labor unions, alongside the growing prominence of recognition-based movements, such as the Black movement. The dynamics of the health councils demonstrated weak mobilization both internally and externally. The limited interest in community engagement was associated with an individualistic culture and a diminished sense of collective responsibility. The study concludes by underscoring the need to promote civic culture and strengthen community organizations.