12 October 2011
Institutionalizing participation in Brazil and Thailand
Brazil and Thailand are two countries that have shown impressive improvements in health and reductions in health inequities over the past 20 years. They have also been at the forefront of increasing public participation in policy-making.
In Brazil, participatory approaches to decision-making relevant to health have been inspired by the social movements that drove the establishment of the universal health system as well as subsequent improvements in primary health care and social protection. The 1988 Brazilian constitution established health — including the right to participate in health governance — as a human right for all.This commitment provided the space for institutionalizing public participation at the municipal, state, and national levels. Participation through health councils at each of these levels (including municipal health councils in 5564 cities, where half the councillors represent health system users) is supplemented by regular national health conferences. Innovative models such as participatory budgeting have also been implemented in some jurisdictions.
In Thailand, civil society assemblies over the last decade have led to the institutionalization of the National Health Assembly, which has been held annually since 2008 as mandated by the new national Health act. Adapting the machinery used at the WHo World Health assembly, the national Health assembly brings together more than 1500 people from government agencies, academia, civil society, health professions, and the private sector to discuss key health issues and produce resolutions to guide policy-making. Policy impacts attributable to assembly resolutions have included protection of budgets for universal health coverage, endorsement of strategies for universal access to medicines, and establishment of national commissions on Health Impact Assessment and Trade and Health.
Further information can be found at http://en.nationalhealth.or.th/