{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:20:28Z","timestamp":1771546828672,"version":"3.50.1"},"reference-count":42,"publisher":"FapUNIFESP (SciELO)","issue":"12","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cad. Sa\u00fade P\u00fablica"],"abstract":"<jats:p>Resumo: A atua\u00e7\u00e3o dos representantes sociais exerce grande influ\u00eancia sobre o desempenho dos conselhos de sa\u00fade e a qualidade da gest\u00e3o participativa no Sistema \u00danico de Sa\u00fade. Este artigo objetivou analisar os mecanismos de representa\u00e7\u00e3o e as formas de representatividade no \u00e2mbito de conselhos de sa\u00fade em munic\u00edpios de diferentes portes populacionais. Trata-se de um estudo de casos m\u00faltiplos realizado em Vit\u00f3ria da Conquista, Guanambi e Urandi, na Bahia, Brasil. Os dados e informa\u00e7\u00f5es foram obtidos por meio da an\u00e1lise de documentos, observa\u00e7\u00e3o de reuni\u00f5es plen\u00e1rias e entrevistas com 30 conselheiros de sa\u00fade. Para a an\u00e1lise dos dados, utilizou-se uma matriz te\u00f3rica estruturada em cinco dimens\u00f5es: processo de escolha dos representantes; rela\u00e7\u00e3o entre representantes e representados; tipos de interesse representados; crit\u00e9rios para defini\u00e7\u00e3o de posicionamentos; e pr\u00e1tica participativa. Os resultados demonstraram o predom\u00ednio de crit\u00e9rios n\u00e3o eleitorais para a escolha dos representantes. A rela\u00e7\u00e3o entre representantes e representados \u00e9 marcada pelo isolamento do representante e reduzida presta\u00e7\u00e3o de contas. Predominou a consci\u00eancia individual na defini\u00e7\u00e3o de posicionamentos por parte dos conselheiros. A representa\u00e7\u00e3o nos conselhos de sa\u00fade tamb\u00e9m se mostrou influenciada pelo porte populacional dos munic\u00edpios. No munic\u00edpio de menor popula\u00e7\u00e3o, evidenciou-se consistentes fragilidades para o exerc\u00edcio da representa\u00e7\u00e3o. Os resultados demonstraram insufici\u00eancias do processo representativo. Ressalta-se a necessidade de aproxima\u00e7\u00e3o entre representantes e representados e a import\u00e2ncia da valoriza\u00e7\u00e3o do conhecimento experiencial como elemento capaz de conceder legitimidade \u00e0 representa\u00e7\u00e3o.<\/jats:p>","DOI":"10.1590\/0102-311xpt115524","type":"journal-article","created":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T10:56:59Z","timestamp":1738925819000},"source":"Crossref","is-referenced-by-count":3,"title":["Representa\u00e7\u00e3o e representatividade nos conselhos de sa\u00fade: entre a formaliza\u00e7\u00e3o e a legitimidade participativa"],"prefix":"10.1590","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9699-3825","authenticated-orcid":false,"given":"Edna Moreira","family":"Barros","sequence":"first","affiliation":[{"name":"Universidade Federal da Bahia,  Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4155-9612","authenticated-orcid":false,"given":"Jos\u00e9","family":"Patr\u00edcio Bispo-J\u00fanior","sequence":"additional","affiliation":[{"name":"Universidade Federal da Bahia,  Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6992-4928","authenticated-orcid":false,"given":"Luzia C\u00e9lia Batista","family":"Soares","sequence":"additional","affiliation":[{"name":"Universidade Federal da Bahia,  Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5761-2660","authenticated-orcid":false,"given":"Mauro","family":"Serapioni","sequence":"additional","affiliation":[{"name":"Universidade Federal da Bahia,  Brazil; Universidade de Coimbra,  Portugal"}]}],"member":"530","published-online":{"date-parts":[[2024]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"4829","DOI":"10.1590\/1413-812320141912.02292013","article-title":"Os desafios da participa\u00e7\u00e3o e da cidadania nos sistemas de sa\u00fade","volume":"19","author":"Serapioni M","year":"2014","journal-title":"Ci\u00eanc Sa\u00fade Colet"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1444","DOI":"10.1111\/hex.13483","article-title":"Representation in participatory health care decision-making reflections on an application-oriented model","volume":"25","author":"Holetzek T","year":"2022","journal-title":"Health Expect"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1590\/1413-81232014192.10542012","article-title":"Participa\u00e7\u00e3o social e sa\u00fade no Brasil revis\u00e3o sistem\u00e1tica sobre o tema","volume":"19","author":"Paiva FS","year":"2014","journal-title":"Ci\u00eanc Sa\u00fade Colet"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1080\/13698230.2020.1808761","article-title":"The representative system","volume":"26","author":"Rey F","year":"2023","journal-title":"Crit Rev Int Soc Political Philos"},{"key":"ref5","series-title":"Voice, agency, empowerment - handbook on social participation for universal health coverage","year":"2021"},{"key":"ref6","series-title":"The concept of representation","author":"Pitkin H","year":"1972"},{"issue":"1","key":"ref7","first-page":"63","article-title":"Interpreta\u00e7\u00f5es contempor\u00e2neas da representa\u00e7\u00e3o","author":"Loureiro MR","year":"2009","journal-title":"Revista Brasileira de Ci\u00eancia Pol\u00edtica"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1080\/00344893.2012.712547","article-title":"Non-electoral political representation expanding discursive domains","volume":"48","author":"Maia RC","year":"2012","journal-title":"Representation"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.socscimed.2015.04.019","article-title":"Inclusive public participation in health policy, practice and theoretical contributions to promote the involvement of marginalised groups in healthcare","volume":"135","author":"De Freitas C","year":"2015","journal-title":"Soc Sci Med"},{"key":"ref10","first-page":"636","article-title":"Enabling the participation of marginalized populations case studies from a health service organization in Ontario, Canada","volume":"32","author":"Montesanti SR","year":"2017","journal-title":"Health Promot Int"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1111\/j.1369-7625.2009.00563.x","article-title":"Social participation in health in Brazil and England","volume":"12","author":"Barnes M","year":"2009","journal-title":"Health Expect"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1007\/s11673-018-9861-x","article-title":"Representative claims in healthcare identifying the variety in patient representation","volume":"15","year":"2018","journal-title":"J Bioeth Inq"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1111\/1468-0009.12060","article-title":"What are the key ingredients for effective public involvement in health care improvement and policy decisions A randomized trial process evaluation","volume":"92","author":"Boivin A","year":"2014","journal-title":"Milbank Q"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1111\/j.1369-7625.2007.00472.x","article-title":"Health consumer and patients' organizations in Europe towards a comparative analysis","volume":"11","author":"Baggott R","year":"2008","journal-title":"Health Expect"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1111\/hex.12665","article-title":"Consumer input into health care time for a new active and comprehensive model of consumer involvement","volume":"21","author":"Hall AE","year":"2018","journal-title":"Health Expect"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1590\/1413-81232020261.08872019","article-title":"Conselhos e confer\u00eancias de sa\u00fade no Brasil uma revis\u00e3o integrativa","volume":"26","author":"Silva BT","year":"2021","journal-title":"Ci\u00eanc Sa\u00fade Colet"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"03061","DOI":"10.7189\/jogh.11.03061","article-title":"Community participation lessons and challenges of the 30 years of health councils in Brazil","volume":"11","author":"Bispo J\u00fanior JP","year":"2021","journal-title":"J Glob Health"},{"key":"ref18","first-page":"884","article-title":"Desafios da participa\u00e7\u00e3o social nos conselhos de sa\u00fade","volume":"23","author":"Dur\u00e1n PRF","year":"2014","journal-title":"Sa\u00fade Soc"},{"key":"ref19","article-title":"Resolu\u00e7\u00e3o n\u00ba 453, de 10 de maio de 2012. Aprova diretrizes para institui\u00e7\u00e3o, reformula\u00e7\u00e3o, reestrutura\u00e7\u00e3o e funcionamento dos Conselhos de Sa\u00fade.","year":"2012","journal-title":"Di\u00e1rio Oficial da Uni\u00e3o"},{"key":"ref20","article-title":"Participa\u00e7\u00e3o social um olhar sobre a representatividade nos conselhos de sa\u00fade no Brasil, a partir da Resolu\u00e7\u00e3o 453\/2012","volume":"31","author":"Silva RD","year":"2021","journal-title":"Physis (Rio J.)"},{"issue":"100","key":"ref21","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1590\/0102-083118\/100","article-title":"Resgatar a participa\u00e7\u00e3o democracia participativa e representa\u00e7\u00e3o pol\u00edtica no debate contempor\u00e2neo","author":"Miguel LF","year":"2017","journal-title":"Lua Nova"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.1590\/1413-81232014196.08062013","article-title":"Os limites da a\u00e7\u00e3o coletiva nos Conselhos Municipais de 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da Macrorregi\u00e3o Sudoeste."},{"key":"ref28","series-title":"Sistema de Acompanhamento dos Conselhos de Sa\u00fade - SIACS."},{"key":"ref29","series-title":"An\u00e1lise de dados qualitativos","author":"Gibbs G","year":"2009"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1590\/0102-311X00086214","article-title":"Legitimidade da representa\u00e7\u00e3o em inst\u00e2ncias de participa\u00e7\u00e3o social o caso do Conselho Estadual de Sa\u00fade da Bahia, Brasil","volume":"31","author":"Bispo J\u00fanior JP","year":"2015","journal-title":"Cad Sa\u00fade P\u00fablica"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1057\/palgrave.cpt.9300234","article-title":"The representative claim","volume":"5","author":"Saward M","year":"2006","journal-title":"Contemporary Political Theory"},{"key":"ref32","article-title":"Avalia\u00e7\u00e3o de desempenho dos conselhos de sa\u00fade em munic\u00edpios de pequeno e m\u00e9dio porte","volume":"30","author":"Santos EP","year":"2021","journal-title":"Sa\u00fade Soc"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1590\/1413-81232015215.00352016","article-title":"Rela\u00e7\u00f5es entre representa\u00e7\u00e3o e participa\u00e7\u00e3o no Conselho Municipal de Sa\u00fade do Rio de Janeiro segmento dos usu\u00e1rios, 2013-2014","volume":"21","author":"Rezende RB","year":"2016","journal-title":"Ci\u00eanc Sa\u00fade Colet"},{"key":"ref34","article-title":"Posicionamento dos representantes dos usu\u00e1rios no Conselho Estadual de Sa\u00fade da Bahia diante do agravamento do subfinanciamento do SUS em 2016-2018","volume":"30","author":"Morais AS","year":"2021","journal-title":"Sa\u00fade Soc"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1111\/j.1369-7625.2009.00567.x","article-title":"Patient participation in collective healthcare decision making the Dutch model","volume":"13","year":"2010","journal-title":"Health Expect"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"1971","DOI":"10.1590\/1413-81232018236.06682018","article-title":"Gest\u00e3o da educa\u00e7\u00e3o e do trabalho em sa\u00fade no SUS trinta anos de avan\u00e7os e desafios","volume":"23","author":"Machado MH","year":"2018","journal-title":"Ci\u00eanc Sa\u00fade Colet"},{"issue":"spe","key":"ref37","first-page":"94","article-title":"Gest\u00e3o do trabalho na aten\u00e7\u00e3o b\u00e1sica em sa\u00fade uma an\u00e1lise a partir da perspectiva das equipes participantes do PMAQ-AB","volume":"38","author":"Seidl H","year":"2014","journal-title":"Sa\u00fade Debate"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1590\/1807-57622015.0941","article-title":"Cultura participativa um processo de constru\u00e7\u00e3o de cidadania no Brasil","volume":"21","author":"Ventura CAA","year":"2017","journal-title":"Interface (Botucatu)"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1590\/s0102-6992-202035010010","article-title":"A participa\u00e7\u00e3o nos sistemas de sa\u00fade de Brasil e Portugal potencialidades e desafios","volume":"35","author":"Kr\u00fcger TR","year":"2020","journal-title":"Sociedade e Estado"},{"key":"ref40","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1007\/s11673-018-9864-7","article-title":"Legislating patient representation: a comparison between Austrian and German regulations on self-help organizations as patient representatives.","volume":"15","author":"Rojatz D","year":"2018","journal-title":"J Bioeth Inq"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"2315","DOI":"10.1590\/S0102-311X2011001200004","article-title":"Avalia\u00e7\u00e3o das condi\u00e7\u00f5es de atua\u00e7\u00e3o de Conselhos Municipais de Sa\u00fade no Estado de Santa Catarina, Brasil","volume":"27","author":"Vieira M","year":"2011","journal-title":"Cad 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