Briceño-León R. El contexto político de la participación comunitaria en América Latina. [Community participation and its political context in Latin America.] Cadernos de Saúde Pública [Public Health Notebooks] (Rio de Janeiro, Brazil) 1998; 14(2): 141-147.

Objectives: To review the different meanings of community participation in health, its relationship to endemic diseases, and changes in Latin American society that have led to transformations in the idea of participation.

Methodology: Analytical and interpretive.

Results: The author describes changes that have occurred in meanings of community participation, relating them to changes in society at large. The author begins by analyzing participation in the context of the Cold War, noting four modalities: participation as ideological manipulation, as cheap manual labor, as facilitator of medical action, and as subversive activity. The author then reviews participation in the context of the crisis of ideologies and notes two modalities: participation as grass-roots movements and popular advocacy. Finally, the author interprets participation in the context of structural adjustment programs, including changes in the state and privatization. The author proposes that participation serves as a mechanism for attaining greater democracy; participation, in this sense, would provide a means by which to criticize power structures, a feature of democratic organization, and a mechanism for transforming the health sector.

Conclusions: Participation should be seen as a means by which to transform the health sector and not as an end in itself.

Copyright 2007 University of New Mexico