[Social participation in health. An experience in Simojovel, Chiapas]

One of the basic foundations for the operation of health programs is the social participation of the population in actions going from planning to evaluation, promotion and control of actions related with their own health. In the work, we present the results of a preliminary and partial evaluation of an ongoing autopromoting health project in the communities of Lázaro Cárdenas and Las Limas, in the Municipality of Simojovel, Chiapas, México. The basic goal of this work is to identify factors derived from the relations of localities with the State and, on the other hand, from socioeconomic conditions of the populations, which favor or hinder the development of social participation in their own health projects. This is a comparative study, type before and after, within and between localities, intended to measure the effect of a health program with community participation in two communities having divergent relations with the State. For this, we carried out a socioeconomic and prevalent morbidity survey before and after the implementation of social participation in health actions. We also characterized social participation in health actions and identified the type of State intervention in the localities through governmental programs and institutions. The results convey the notion that the health program contributes to enhance hygienic sanitary conditions of the population and decrease the frequency of such ailments as diarrhea and parasitic diseases; social participation is more active in Lázaro Cárdenas than in Las Limas. State interventions in the communities are given through social programs and institutions in a mandatory way, with no opportunity for community participation in decision-making. The conclusion is that the demographic organization of the community and autopromotion favor the participation in health actions, while the presence of the State through political repression and actions delivered through social programs promote dependence and paternalism, hindering the ample social participation in actions for health.