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This article analyzes the state of social participation in health in the Region of the Americas, framing it within the regional context and commitments assumed by the Member States of the Pan American Health Organization. It aims to provide regional input to the discussion of a resolution on social participation for universal health coverage, health, and well-being at the 77th World Health Assembly in 2024. In the Americas, social participation has evolved from a utilitarian approach to a fundamental aspect of health system governance, enshrined within legal frameworks and recognized as a citizen’s right. Regional resolutions emphasize inclusive policies and intersectoral action to tackle health inequities, meanwhile the World Health Organization handbook on social participation underscores the need for inclusive governance mechanisms and addressing power imbalances. Informed by Member States’ recommendations and scientific literature, the article emphasizes the importance of addressing power imbalances, strengthening legal frameworks, and enhancing capacities of governments and populations. It stresses adapting social participation mechanisms to diverse cultural contexts and ensuring meaningful community involvement in decision-making. Finally, the article advocates for a comprehensive approach to social participation grounded in principles of equity, democracy, and human rights; and fundamentally as an essential component of the primary health care approach. It calls for integrating social participation into health system governance, policy dialogues, capacity- building, and evaluation to ensure effective participatory processes.

Abstract: The HIV/AIDS epidemic remains a persistent and real issue, especially in key populations such as men who have sex with men (MSM), travestis and transgender persons. Projects for expanding rapid HIV testing are strategic initiatives aimed at the earliest possible identification of individuals’ serological status and thus early treatment, screening of sex partners, and upscaling of preventive actions to interrupt the transmission chain. This study thus maps, describes, and systematizes the projects for expanding rapid HIV testing implemented from 2004 to 2021 in Brazil, highlighting the on-going contribution of civil society organizations and discussing the interoperability and cooperation resulting from public governance processes. We selected 67 documents for analysis, including 30 scientific publications retrieved from electronic databases and 37 documents produced by government institutions and nongovernmental organizations (NGOs). Find Out (Fique Sabendo), I Want to Get Tested (Quero Fazer), The Time is Now (A Hora É Agora), Live Better Knowing (Viva Melhor Sabendo), and Live Better Knowing Young (Viva Melhor Sabendo Jovem) were the projects mapped. Results show that the projects have used strategies adapted to the key population, such as mobile testing units, peer education, and innovative community engagement approaches. Such actions were enabled by effective cooperation and interoperability between participating stakeholders, especially NGOs.

Objective: To describe the aspects with the greatest impact on the satisfaction of patients treated in a multidisciplinary unit specialising in immune-mediated inflammatory diseases (IMIDs) and to identify areas for improvement in the care model., Methods: Cross-sectional descriptive study using a satisfaction survey structured in three blocks: sociodemographic variables, functional aspects of the unit and satisfaction with the professionals. Immediate satisfaction was measured on aspects related to the care received, the physical structure and the likelihood of recommending the unit., Results: A total of 168 patients completed the surveys, the mean score of overall satisfaction with the unit was 4.75 (SD:0.4). The regression model showed the relationship between overall satisfaction and unit signage (OR:3.558, p=0.045, 95% CI: 1.027-12.33), coordination between professionals (OR:9.043, p=0.000, 95% CI: 2.79-29.28) and participation in decision making (OR: 44.836, p=0.000, 95% CI: 5.49-365.97). In terms of immediate satisfaction, the overall Net Promoter Score (NPS) was 87 (excellent). The mean score for coordination with Primary Care was 4.54 (SD:0.8) and they scored waiting time to be seen with 4.49 (SD:0.8), so they have been considered an area for improvement The mean score for coordination with Primary Care was 4.54 (SD:0.8) and they scored waiting time to be seen with 4.49 (SD:0.8), so both were considered areas for improvement., Conclusions: Coordination between intra-centre professionals and patient participation in decision-making explain the excellent level of patient satisfaction. The monitoring of satisfaction has made it possible to implement immediate improvement actions., (Copyright © 2024 FECA. Publicado por Elsevier España, S.L.U. All rights reserved.)

This article analyses some of the emerging problems in the field of social studies at the juncture of the domains of health and science. Building on critical perspectives, namely those hailing from social history, postcolonial studies and collaborative research, it argues for the need to ground investigation on concrete historical forms of social suffering. This implies a multi-scale approach which considers: 1) individual suffering and illness experienced in social interactions; 2) the institutionalised expert translations of suffering into disease; and 3) the political rationales, developed by both local and global stakeholders, which assist in the creation of social environments of health and illness. While illustrations of the theoretical proposals derive mostly from the particular field of mental health, it is argued that their implications may apply to a wider range of themes dealing with health and science issues.

The objective of this article is to describe how governance and political will have influenced the implementation of the HEARTS Initiative for the prevention and control of hypertension in the Peruvian health system.The governance process is described and a secondary data analysis compares baseline levels at the start of HEARTS phase 1 with observed levels after the first six months of follow-up in 34 health facilities.HEARTS implementation was planned and organized at the national level through the Directorate of Noncommunicable Diseases, with political support from senior management of the Ministry of Health and technical support from the Pan American Health Organization. Governance was structured at three levels: national, regional, and local; implementation was supported by key actors from academia, scientific societies, regional health directorates, and integrated networks.Results after the initial months of follow-up showed an increase in the coverage and control of hypertension in most of the participating facilities. Analysis of the key factors related to political will and governance in the implementation of the HEARTS Initiative for the prevention and control of hypertension showed that the functions of senior management-in terms of aligning public policies and prioritizing noncommunicable diseases, in close and permanent coordination between policymakers and the Minister of Health-had a positive effect on the implementation of the HEARTS Initiative in Peru.