Health concepts of municipal health councilors, and their relation to practice in the council

Abstract

Institutionalized participation in health councils is fundamental for the consolidation of a new healthcare model. One of the bases of this change is the way in which health/illness is measured. Given that health councilors are key players in the Sistema Único de Saúde (SUS) (the Brazilian National Healthcare System), their concepts form the basis of decisions on health policies. This study seeks to understand the concept of health/illness among municipal health councilors in two municipal districts on the coast of Santa Catarina, and how these councilors relate it to the current healthcare model and their practice in the health councils. It adopts a qualitative approach, through focal groups and semi-structured interviews. The concepts of health/illness go beyond a merely biological view, and their determining factors include: living conditions, equilibrium, caring for the body and access to services. The health councilors criticize the healthcare model that currently exists, yet when describing their activities, their emphasis is on medical care, and procedures of medium to high complexity. They are unable to articulate the concept and the practice they experience in the health councils. We noted, therefore, a discrepancy between the changes required by SUS, which looks for a model of health promotion, and actual practices in the councils and those of the councilors who still place too high a value on the medical procedures, to the detriment of primary health care.