Citizenship rights, participation, collective health

Are users of health services “consumers” or “citizens”? What does citizen participation really mean? Why are citizenship and participation so strictly bond? This essay attempts to answer these questions. An effective participation guarantees the rights’ respect. There are several important and creative participation experiences in the health services. Participation, though, is not always “citizens activism”. It is often ambiguous and useful to the aims of “management activism”. One has to think not only about ways for a participate services evaluation by citizens (Altieri, 2002a; Altieri, Giarelli and Maturo, 2004), but also about ways to evaluate participation, e.g. by asking these questions: who effectively participates? Who do they effectively represent? How often? How many and what decisions have been modified by participation? What improvements in services’ quality have been made? What experiments have been run to include and pay more attention to the weakest social categories? In one sentence, what is the efficacy of concrete experiences of participation? Rivista catalogata “A”, con referee anonimi.