SUPPORT-SYSTEMS (67) Q3 Examples of civil society organisations and health policymaking (13)

30 May, 2022

Dear HIFA colleagues,

The CSOs are a heterogeneous group of organizations as the communities or the population groups whose scope of action will depend on the context they serve. In Latin America and the Caribbean, there are some experiences as a whole and from independent countries, such as Argentina, Brazil, Colombia, Chile, Ecuador, El Salvador, México, Panamá, Perú, and Venezuela, that highlight what civil society participation in health policy processes mean (Letter A-Inclusiveness examples).

Besides, considerations about a fluid "who" instead of a rigid definition: An Argentinean case study reviews the "networks theory" contributions that resize community participation in health from a complex perspective. The notion of networks assumes heterogeneity. The relationships, interactions, or links would give community networks that occur between them from the mediations established and organized around a «common good.» Under this view, the theoretical contributions of networks propose understanding community participation in health "as a complex and dynamic process in which a community actively supports mechanisms and practices for joint decision-making on the health-disease process itself." Therefore, community participation is described by the authors through three aspects understood as axes or indicators in health: the generation of spaces for community meetings and exchange on shared problems and concerns, a clear and concrete circulation of information, and the possibility for the participants to influence joint decision-making. This article could be found in Scielo (which has a translator tool for English), although you can reach the following article that describes what is defined as "dialogic science-policy networks," or interactions between scientists and policy-makers. Regarding incorporating studies of civil society and primary healthcare that capture these activities, an Ecuatorian article portrays the country's response to COVID-19 without including the response of civil society groups. (Letter B Informal Groups).

Further, strategies to promote evidence use for health program improvement in LATAM. (Letter C-Evidence-informed policy-making).

Last, a few words about two interesting comments: a. "take corporations into account too" I am sending the Uruguay case, a good example of how strong political support and actively engaged local civil society and financial and technical support are important factors in overcoming industry's legal threats to defend strong public health regulations. (Letter D-Corporation Accountability). Furthermore, "We can immediately see potential problems with evidence provided by civil society" CSO will have its priorities, mission, and agenda." I have attached a paper from a heterogeneous research team who used a qualitative approach to study mental health users' associations in Argentina; they concluded that the need for users to form alliances with other actors to gain ground, professional power struggles, and the historical disempowerment of 'patients' stand as obstacles for users' autonomous participation. (Letter E - CSO Accountability).

Letter A - Inclusiveness examples:

1. Ouriques Martins SC, Lavados P, Leite Secchi, et al. Fighting Against Stroke in Latin America: A Joint Effort of Medical Professional Societies and Governments. Front Neurol. 2021; 12: 743732. Published online 2021 Oct 1. doi: 10.3389/fneur.2021.743732

2. Hassell TA, Hutton MT, Barnett DB. Civil society promoting government accountability for health equity in the Caribbean: The Healthy Caribbean Coalition. Rev Panam Salud Publica. 2020;44:e79.

3. Corluka A, Hyder AA, Winch PJ, Segura E. Exploring health researchers' perceptions of policy-making in Argentina: a qualitative study. Health Policy Plan. 2014 Sep; 29(Suppl 2): ii40�ii49. Published onlinne 2014 Sep 11. doi: 10.1093/heapol/czu071

4. Martinez MG, Kohler JC. Civil society participation in the health system: the case of Brazil's Health Councils. Global Health. 2016; 12: 64. Published online 2016 Oct 26. doi: 10.1186/s12992-016-0197-1

5. Barredo D, Molina P, Medranda N, Rodríguez V. Health Transparency and Communication on the Government Websites of Ibero-American Countries: The Cases of Chile, Colombia, Ecuador, and Spain. Int J Environ Res Public Health. 2021 Jun; 18(12): 6222. doi: 10.3390/ijerph18126222

6. León M, Jiménez M, Vidal N, Bermúdez K, De Vos P. The Role of Social Movements in Strengthening Health Systems: The Experience of the National Health Forum in El Salvador (2009–2018). Int J Health Serv. 2020 Apr; 50(2): 218�233. doi: ;10.1177/0020731420905262

7. López-Bolaños L, Campos-Rivera M, Villanueva-Borbolla MA. Commitment and community participation towards health: knowledge creation from the systematization of social experiences. Salud Publica Mex 2018;60:192-201.doi:10.2114918460

8. Huicho L, Huayanay-Espinoza CA, Herrera-Perez E, et al. Examining national and district-level trends in neonatal health in Peru through an equity lens: a success story driven by political will and societal advocacy. BMC Public Health. 2016; 16(Suppl 2): 796. doi: 10.1186/s12889-016-3405-2

9. Salazar X, Nuñez-Curto A, Castillo R, et al. How Peru introduced a plan for comprehensive HIV prevention and care for transwomen. J Int AIDS Soc. 2016; 19 (3Suppl 2): 20790. doi: 10.7448/IAS.19.3.20790

10. Eid M, Nahon-Serfaty I. Risk, Activism, and Empowerment: Women's Breast Cancer in Venezuela. Int J Civ Engagem Soc Change. January-March 2015; 2(1): 43�64. doi: 10.4018/IJCESC.20150101004

Letter B -Informal Groups

1. Bang, C, Stolkiner, A. Aportes para pensar la participación comunitaria en salud/ salud mental desde una perspectiva de redes. Revista Ciencia, Docencia y Tecnología, 24 (46):2013; 123-143.

2. Lutz-Ley AN, Scott CA, Wilder M. Dialogic science-policy networks for water security governance in the arid Americas. Environmental Development. 2020. doi: 10.1016/j.envdev.2020.100568

3. Torres I, López-Cevallos D. In the name of COVID-19: legitimizing the exclusion of community participation in Ecuador's health policy: Special call: Health Promotion Perspectives on the COVID-19 Pandemic. Health Promot Int. 2021 Jan 20:daaa139. doi: 10.1093/heapro/daaa139

Letter C-Evidence-informed policy-making

1. Diez Roux AV, Slesinki SC, Alazraqui M, et al.A Novel International Partnership for Actionable Evidence on Urban Health in Latin America: LAC‐Urban Health and SALURBAL. Glob Chall. 2019 Apr; 3(4): 1800013. doi: 10.1002/gch2.201800013

2. García-Cerde R, Becerril-Montekio V, Langlois E, et al. Embedded implementation research in Latin American health systems. Rev Saude Publica. 2021; 55: 16. doi: 10.11606/s1518-8787.2021055003027

3. Becerril-Montekio V, Torres-Pereda P, García-Bello LA, Alcalde-Rabanal J. Embedding research into health services in Latin America and the Caribbean: experiences and challenges of the Technical Support Center. Rev Panam Salud Publica. 2021; 45: e41. doi: 10.26633/RPSP.2021.41

4. González AC, Jaramillo IC. Legal Knowledge as a Tool for Social Change: La Mesa por la Vida y la Salud de las Mujeres as an Expert on Colombian Abortion Law Health Hum Rights. 2017 Jun; 19(1): 109�118.

5. Zicker F, Cuervo LG, Salicrup LA. Promoting high-quality research into priority health needs in Latin America and the Caribbean. BMJ. 2018; 362: k2492. doi: 10.1136/bmj.k2492

6. Romero LI, Quental C. Research for better health: the Panamanian priority-setting experience and the need for a new process. Health Res Policy Syst. 2014; 12: 38. doi: 10.1186/1478-4505-12-38

7. Paz X, Espinosa-Marty C, Castillo-Laborde C, Gonzalez C. From instinct to evidence: the role of data in country decision-making in Chile. Glob Health Action. 2017; 10(Suppl 1): 1266176. doi: 10.3402/gha.v9.32611

8. Rodríguez L, Cofré C, Pizarro T, et al. Using evidence-informed policies to tackle overweight and obesity in Chile. Rev Panam Salud Publica. 2017; 41: e156. doi: 10.26633/RPSP.2017.156

9. Vélez M, Wilson MG, Abelson J, Lavis J, Paraje G.Understanding the Role of Values in Health Policy Decision-Making From the Perspective of Policy-Makers and Stakeholders: A Multiple-Case Embedded Study in Chile and Colombia. Int J Health Policy Manag. 2020 May; 9(5): 185�197. doi: 10.15171/ijhpm.2019.94

10. Evens E, Lanham M, Santi K, et al. Experiences of gender-based violence among female sex workers, men who have sex with men, and transgender women in Latin America and the Caribbean: a qualitative study to inform HIV programming. BMC Int Health Hum Rights. 2019; 19: 9. doi: 10.1186/s12914-019-0187-5

Letter D. Corporation Accountability

Crosbie E, Sosa P, Glantz SA. Defending strong tobacco packaging and labeling regulations in Uruguay: transnational tobacco control network versus Philip Morris International. Tob Control. 2018 Mar; 27(2): 185–194. doi: 10.1136/tobaccocontrol-2017-053690

Letter D. CSO Accountability

Ardila S, Agrest M, Fernández MA, et al. The mental health users' movement in Argentina from the perspective of Latin American. Collective Health Glob Public Health. 2019; 14(6-7): 1008�1019. doi: 10.1080/17441692.2018.1514063


María Eugenia.

HIFA profile: Maria Eugenia Aponte-Rueda is a Breast Surgeon and Ph.D. working at the Venezuelan Breast Cancer Research and Education Foundation. She is a member of the HIFA working group on SUPPORT-SYSTEMS - How can decision-making processes for health systems strengthening and universal health coverage be made more inclusive, responsive and accountable?

Email: fuveicam AT