This function exhibited an intermediate performance for the Region, with a median of 0.49. Most countries performed at the same level, except for a few that deviated from intermediate, as shown in the following graph:
Similar to Function 2, the indicators for this function performed at an intermediate level, although the indicator for strengthening social participation in health was somewhat higher.
The least amount of variation was observed in the indicator with the highest performance (strengthening social participation in health), and the greatest variation was observed in indicator 3 (support to the sub-national levels).
The primary factors determining this function’s performance are:
• Approximately 84% of the countries have formal agencies that receive public feedback on health issues, and 57% have citizen forums on health. However, less than one-third of the countries ensure responses to the feedback.
• Half of the countries have an independent Public Defense office with the legal power to protect the public’s interest in matters of health.
• Nearly 62% of the countries publicize a national report on health status at least every two years, although only 24% distribute these results through the media. Only a few countries have formal channels for receiving public opinion on these results.
• There are no formal procedures or channels for receiving or answering citizen opinions concerning matters of health.
• Approximately 65% of the countries have solicited the public’s opinion on health and can mention examples of citizen contribution to the definition of national health objectives.
• Weaknesses were acknowledged in the development of strategies to inform the population about their health rights. Only 32% of the countries took specific actions to this end.
• Personnel trained in promoting community participation in health programs are available, although weaknesses exist in leadership, teamwork, and conflict-resolution.
• Although the development of good community participation practices is encouraged, roughly 49% of the countries spread such practices to other countries, and 70% have access to resources for promoting citizen participation.
• Mechanisms exist in most countries for promoting social participation in health at the local and intermediate levels. These mechanisms include meetings, forums, workshops, and other activities to foster participation in health-related matters.
• In general, the capacity to promote social participation in health was not evaluated.
• With respect to support for sub-national entities, the main weaknesses were in the evaluation of efforts to promote participation, the design of mechanisms for receiving and responding to citizen opinions, the development of systems to inform the public about health status, and conflict-resolution mechanisms.