Effectiveness of community participation in Municipal Health Councils in Santa Catarina State, Brazil

This article presents a model for the evaluation of community participation in municipal (county) health systems. The theoretical basis for this evaluative study was the existing Brazilian legislation on community participation in drafting health strategies and overseeing health policy implementation. The indicators and measures were validated using the expert consensus technique. The proposed model has 26 indicators divided into five evaluative dimensions that reflect the legislation's adequacy for the structure, organization, representativeness, health planning participation, and autonomy of the Municipal Health Councils. Its applicability was tested in 24 municipalities in Santa Catarina State, Brazil. The data analysis indicated the best results for the dimension "planning system in the Unified National Health System" and the worst for "structure" and "autonomy". Only two municipalities showed good results for the final summary indicator. The study demonstrated the feasibility and adequacy of the proposed evaluation model.