OBJECTIVE: To analyze the influences of the institutions in the operation of the Local Health councils.
METHODS: qualitative, descriptive and exploratory study.
METHODS: 02 Primary Health Care services of a municipality in the inland of the state of São Paulo, Brazil.
METHODS: twenty-four members of the Local Health Councils and 4 key informants.
METHODS: Supported by the theoretical methodological framework of Institutional Analysis. Data were produced through 28 semi-structured interviews, observation and participation in the activities of the councils and recording in the research diary. Data were organized and analyzed by the process of transcription, transposition and reconstitution.
RESULTS: The institutions act in the territories represented by social actors who occupy positions and functions within the Primary Health Care services, evidencing the perpetuation of hierarchization with valorization of the speeches of professionals and managers to the detriment of patients and predominance of bureaucratized meetings. The social actors reproduce the ideals of the collective to which they belong in these spaces.
CONCLUSIONS: The health management teams do not recognize the different forces that act in the health territory, however, these forces interfere in the activities performed and in health care. The groups act both in formal spaces through official representatives who meet and discuss issues in collegiate meetings and in informal spaces, and constitute forces in dispute in the health territory.

BACKGROUND: Living with cerebral palsy has consequences such as social interaction. Assistive technologies used for improving independence only focuses on biological and physiological variables. The main objective in this review is to synthesize the evidence on interventions with assistive technologies, including feedback systems, with the aim of discovering outcomes of social participation in children with cerebral palsy.
METHODS: There were 5 databases from rehabilitation which showed 683 articles in which only 9 were included.
RESULTS: The studies assessed social participation with several instruments. The majority suggested positive effects in activities such as: walking, writing, playing, and social interaction. There were tools such as electronic pencils, switches, and exoskeletons present.
CONCLUSIONS: Due to the poor quality of the methodologies of these studies, the search does not establish solid conclusions. However, the evidence suggests that assistive technologies with feedback have a positive impact on aspects of social participation.

Health strategies, programs and activities have historically been the result of institutional practices with a limited participatory component. Traditionally, institutional action is mainly determined by the criteria of the political actors and, in the best of cases, by the criteria of healthcare professionals. New forms of governance for health equity advocate for the inclusion of the community in the design of strategies, programmes and activities in health. For this reason, a growing concern in the field of participation in health is the measurement of the participatory quality of new designs of institutional practices. This article aims to develop an operational proposal to design, measure or describe the scope in participatory terms of the health planning processes. The proposal elaborates six dimensions for the measurement and assessment of participatory process: inclusivity, information flow, deliberative quality, decision making, institutional commitment and community empowerment.

The subjectivity of a multitude of dimensions that affect health requires systemic approaches, study designs that integrate population health data and the narratives of the population, as well as specific methodological approaches that allow the capture of evidence from social and community processes. The use of participatory methodologies in urban health diagnoses is key to capturing the different perspectives and knowledge of the local context, contributing to a more complete analysis of reality. This methodological note presents the development of the participatory process carried out as part of the Bilbao health diagnosis; the identification of participating agents and selection criteria, the invitation to participate and the dynamics developed. Sharing experiences that have incorporated participatory processes is necessary to foster its methodological development, and thus, to promote it practice.

To explore the perspectives of the decision makers and community members in primary health care (PHC) around the conceptualization of social participation (PS).
An exploratory cross-sectional study with qualitative methodology.
Health Centers of the Metropolitan Region (RM), Santiago, Chile.
Eight informants from the management level (group 1), 13 from execution level in PHC (group 2), 28 community members and four community agents of health (group 3).
Interviews and discussion groups were conducted, which were recorded and transcribed. The organization and analysis of the data was done with Atlas.ti 8.1. The narratives were systematized using a thematic analysis. All the documents were codified, and we hold periodic meetings to review the existing codes, as well as discussing the inclusion of new codes.
Group 1 refers to a more theoretical conception of PS. Group 2 expresses more concrete and operative dimensions. Group 3 indicates that PS is embodied in particular personal experiences. Groups 1 and 3 have more than one notion of social participation in health.
An institutional conception of participation prevails transversally, rooted since the 1990s. At the community level, the narratives take the form of collective practices lived around the improvement of the quality of community life mediated by the level of execution.

Participation is a process that requires the involvement of the policy makers, managers, technicians and staff of the institutions, and of citizens, as well as intersectoral and interdisciplinary action. To generate transformative changes, an infrastructure that encourages participation and planned action is required, and that recognises all the actors in the process. It takes time and commitment to ensure continuity through the joint production of actions, hence the importance of consolidating participatory projects that continue beyond political changes making public services sustainable. Training, the appropriate use of participation tools and a horizontal policy of delegated power are essential to ensure participation. Surveys, sociograms, flowcharts, health assets mapping, participatory budgets and participatory evaluation matrices are some of the tools that can be chosen, depending on the type of subjects addressed, the time and resources available, the characteristics of the participating population and territory, as well as determining the use that will be made of the information generated for the next phase. Participation tools are useful for citizens and professionals to analyze, understand, debate and decide collectively how to improve living conditions and environments. Over the past decade, social networks in the virtual environment have generated new trends in mass participation, which are self-managed by citizens.

Health means individual and collective well-being determined by factors that transcend the health services. If the health services want to address the collective dimension of health, a change of approach is required. Community health is theoretically included in legislation, training, coordination and planning with strategic frameworks that involve the coordination and participation of institutions, health services and citizenship. We present a discussion article in which five authors reflect on the situation, barriers, strengths and opportunities for action of the health services in relation to community health. Changes are needed in the actions of the health services in relation to community health and the way they approach it to address the health problems faced by the communities in the current socioeconomic situation. Given that health is an essential right, we will make a shift in action towards participation, equity, social orientation, intersectorality, comprehensive approach, social justice, and health in all policies, so that community health is taken into account in our health system.

OBJECTIVE: To determine the impact that intersectoral policies and social participation, implemented worldwide, have had on the modification of the social determinants for health and on the reduction of social health inequities.
METHODS: A scoping review of the literature published in the period 2005-2015 was performed. The literature search was conducted on PubMed and Scielo databases. Two researchers reviewed each document. Data were analysed according to the intersectoral action and social participation variables and according to the theoretical frameworks of the Social Determinants Model of the Commission on Social Determinants of Health (CSDH) and the theoretical constructs of Social Capital (SC) and Life Course (LC).
RESULTS: Out of 45 documents likely to be selected for final review, all of them based on title and abstract, 20 documents were eventually picked out and analysed; most them (n = 8) were conducted in all Latin America and Latin America\'s countries. Twelve documents reported intersectoral action associated with social participation in partnership with different institutions. Regarding theoretical frameworks, most of studies (n = 8) used CSDH and SC. In relation to health outcomes, the studies showed mainly: increased access to health and education, follow-up of pregnant women, increasing in prenatal examinations, reduction in malnutrition/child mortality, reduction in extreme poverty/hunger; reduction in epidemics/tuberculosis, control of alcohol/drug consumption, promotion of health/mental as well as basic sanitation improvements.
CONCLUSIONS: Intersectoral and social participation experiences studied yielded positive outcomes regarding health status and quality of life in the communities in which such experiences were implemented.

Based on the ideas of Paulo Freire, the methodological framework of Popular Education for Health (PEH) provides a more adaptable method for sex education, including societal participation as well as the social, historical and cultural dimensions of the population. The purpose of this work is to relate one such PEH experience in sex education, which took the form of a community project with a group of students from 10 to 28 years of age attending Itinerant Schools and with groups from the Landless Rural Workers Movement (MST) in the state of Parana, Brazil. This work provides knowledge of certain elements that may help in developing similar projects, not only for sex education but also education for other public health issues. PEH demonstrates a method of ensuring socially effective participation in the different dimensions of health-promotion strategies.

OBJECTIVE: To determine the health impact perceived by residents and social players involved in two urban regeneration interventions (a new fish market and the redevelopment of North/West Herrera) in Pasaia Bay (Gipuzkoa, Spain) that have been the subject of a health impact assessment (HIA).
METHODS: Qualitative methodology was used with theoretical and intentional sampling. Information was obtained through 18 personal interviews and five discussion groups and was analyzed in accordance with the sociological analysis model of discourse. The preliminary results were triangulated and contrasted among the team members and those taking part in the study.
RESULTS: Four interrelated areas of health impact were identified: urban quality, connectivity, social cohesion, and-to a lesser extent-employment. Specific aspects for improvement were indicated for each field, as well as the influence of the sociopolitical context and conceptions of health. Other significant findings were the impact of the process of carrying out the building work and the distinct perspectives due to the differing roles and social profiles of participants.
CONCLUSIONS: Knowledge of the perceptions and expectations of affected individuals through qualitative methods provides novel elements and interrelations that are needed to apply HIA as a tool for improving health and for citizen participation.