Valeria Santoro Lamelas
The article analyzes the arguments that professionals use to think of themselves and the target population as subjects of participation and its consequences of their inclusion as agents to negotiate health problems and propose their solutions. The study presented has been carried out as part of the development of a Projecte Demostratiu de l'Agència de Salut Public de Catalunya: the transversal plan for the education and promotion of health in infants and young in La Garrotxa, which began with the approval of Law 18/2009 on Public Health in Catalonia. For the compilation of the information we conducted 20 interviews with key informants between 2009 and 2012. As an analytical strategy we performed a thematic content analysis. The results show two essential elements from which the arguments about participation in the design of healthcare policies and actions are articulated: (a) the possession of scientific and expert knowledge as a source of knowledge in unquestionable health and (b) the construction of beneficiaries from their identification to age categories and the attribution of qualities that limit their power to dialogue and negotiate their needs and interventions in health. Finally, we debated about the need to relocate the various actors involved in health processes (professionals, beneficiary population, institutions) in a relational framework that allows for the confrontation of diverse healthcare perspectives to ensure the construction of a politically and socially conscious public health.