Resumo

PUERTA SILVA, Claudia  e  AGUDELO CALLE, Alejandro. MODALITIES OF INTERACTION IN THE HEALTH SUBSIDIZED REGIME IN MEDELLIN: PARTICIPATION AND SOCIAL STRATEGIES. Hacia promoc. Salud [online]. 2012, vol.17, n.1, pp.13-28. ISSN 0121-7577.

Objectives: To identify the ideas and actions of participation of users and staff of the subsidized insurance health system in Medellin. Materials and Methods: exploratory research using gathering and analysis of information qualitative techniques between October 2009 and March 2010 in five health care institutions in Medellin. Semi-structured interviews were applied to 40 users and 15 employees from the subsidized health care system about their understanding of participation and their strategies to engage and get involved in the health system were identified. A participatory workshop with 15 administrative and welfare staff was conducted to explore their role in the promotion of health participation. Results: participation was differentiated from other forms of interaction with the system, called here social health strategies. Institutional participation actions are sometimes inefficient according to respondents, who prefer to activate known and effective social health strategies that do not require specialized knowledge or a political mobilization. It was identified that participation and social strategies in health are mostly activated after dramatic situations. Conclusions: the participation has been defined institutionally and other modalities of interaction and engagement have been unknown by the system. It is necessary to recognize that, in general, the mechanisms and institutional participation spaces are not working properly, and instead social health strategies are effective. Identification of this phenomenon can promote the consolidation of a citizenship health education and the improvement of the institutional mechanisms to ensure health rights and co-responsibility.

Palavras-chave : Social participation; health education; health services; health policy; qualitative research; Colombia.

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