Revista de Salud Pública
Print version ISSN 0124-0064
PUERTA-SILVA, Claudia and VH DOVER, Robert. Developing an interlocution model for the health system based on studying the Colombian Guajira. Rev. salud pública [online]. 2007, vol.9, n.3, pp. 353-368. ISSN 0124-0064.
Objectives This article shows the development of an interlocution model regarding the health system's local performance in La Guajira from 2005 to 2007. It was aimed at producing conditions for social participation and improving the system's performance according to local conditions, needs and expectations. Methods Such model was developed by using ethnographic techniques during the investigation's first and second phases and participative techniques during its third phase. The methodology sought to collect information leading to choosing intervention strategies for improving user-participation ability and capacity and creating spaces of trust for interlocution between the actors and negotiating action for improving the system. Intervention-strategies were based on system and user ethnography, including printed pedagogical material and three modules in the form of participative workshops. The model was tested in four localities in the Guajira, leading to working tables for health being created, encouraging participation by users and institutional decision-makers. Results It was noted that users could participate as informed citizens and critical consumers, strengthening their interlocution abilities, broadening their knowledge, producing vocabulary and meaning shared with the institutional actors and using local mechanisms and social participation networks. Conclusion Effective strategies must be found for motivating greater participation by institutions, especially health promoting entities and subsidised regime insurers.
Keywords : Consumer participation; social planning; social control informal; quality of health care; health systems.