[Knowledge, opinions and experience from applying health participation policy in Colombia]

Analysing knowledge and opinions regarding policies related to social participation in health and how user, community leader and health personnel participation mechanisms are used in Colombia.

An exploratory and descriptive study was carried out between 1999 and 2001 in the towns of Tuluá and Palmira in Colombia using a combination of research methods. A sample of 1,497 health care users were formally surveyed, a focus-group-based qualitative study was made of 210 users and 40 community leaders and 36 semi-structured individual interviews were conducted with health personnel. SPSS was used for a descriptive analysis of survey data and Ethnograph for narrative content analysis of qualitative data.

The user survey results revealed a lack of knowledge regarding norms and mechanisms for social participation in health, as well as limited use. Limited knowledge and scepticism regarding its effectiveness was also reflected in the users, leaders and health personnel qualitative study results. Public sector personnel, however, displayed better knowledge and referred to greater implementation of participation mechanisms. Lack of both resources and a culture of participation were amongst the difficulties faced in implementing it.

The results indicated scarce knowledge and little use of social participation in health mechanisms (market-based ones predominating). Much greater investment in information and training the population and health system personnel is required as a first step towards promoting real social participation for social control of the health system.