RESUMO Introdução - O acesso à assistência odontológica pública é um dos principais problemas na área de saúde bucal. Nesta tese, se discute se os cuidados em saúde bucal são sentidos como necessidade por lideranças de movimentos populares de saúde e como estas lidam com o tema, aborda-se o potencial do capital social como referência teórica para analisar essa questão e apresenta-se um quadro da assistência odontológica na cidade de São Paulo. Objetivo - Analisar as representações sociais sobre saúde bucal e controle social entre lideranças da União de Movimentos Populares de Saúde de São Paulo (UMPS). Método - Pesquisa qualitativa, com orientação analítico-descritiva, mediante realização de grupos focais com lideranças da União de Movimentos Populares de Saúde de São Paulo (UMPS). Para a organização e apresentação dos dados, foi utilizado o procedimento metodológico do Discurso do Sujeito Coletivo (DSC). Além disso, fez-se revisão bibliográfica sobre capital social em periódicos brasileiros e utilizaram-se dados secundários para compor o quadro da assistência odontológica na capital paulista. Resultados O processo saúde-doença foi reconhecido como socialmente determinado. Em relação ao entendimento de saúde bucal como necessidade, houve antagonismo. A associação de saúde bucal à saúde geral foi apontada como razão de necessidade. A não identificação da saúde bucal como prioridade foi atribuída à população, aos fatores econômicos, aos governos e à falta de vinculação entre saúde bucal e saúde geral. O princípio da universalização na saúde bucal gerou discursos contraditórios, com forte presença da ideia de que a assistência odontológica deve ser dirigida para as crianças, com a presença de cirurgiões-dentistas nas escolas. As lideranças apontam que a assistência odontológica pública é insuficiente para garantir o acesso; não é resolutiva; tem problemas de infra-estrutura; e dispõe de profissionais que não atendem às exigências da comunidade. A organização da população é condição necessária para a implantação e manutenção de serviços assistenciais, por parte do Estado. Há um forte componente do conceito de saúde enquanto direito de cidadania, e de que a luta política e social é um vetor para a organização de redes assistenciais. Em relação à especificidade da saúde bucal no controle social, emergiram falas contraditórias. Os estudos realizados no Brasil corroboram a ambigüidade conceitual, dificuldade de operacionalização e aferição do conceito de capital social. Sobre a assistência odontológica na cidade de São Paulo registra-se, entre 2000 e 2009, um crescimento expressivo no número de beneficiários de planos odontológicos, que se elevou de cerca de 660 mil para aproximadamente 1,97 milhão, com a cobertura se expandindo de 6,3por cento para 17,9por cento da população paulistana. Por outro lado, é precário o acesso aos serviços públicos. Os indicadores Cobertura de Primeira Consulta Odontológica Programática e Cobertura Populacional Potencial registraram 3,8por cento e 8,2por cento em 2009. Conclusão As representações sociais das lideranças indicam sua visão de mundo e de sua inserção social, destacando-se a condição subalterna com que conseguem influenciar, em algum grau, o processo de decisões sobre as políticas públicas de interesse para a saúde. O capital social não se configura como referencial teórico suficientemente potente para a compreensão das contradições relacionadas à saúde bucal na cidade. Os serviços públicos odontológicos cobrem menos de 10por cento da população, expande-se a cobertura dos planos odontológicos (18por cento ) e se reproduz a transformação dos cuidados odontológicos em mercadorias, acessíveis apenas aos que podem comprá-la no mercado em saúde / ABSTRACT Introduction - Access to public dental care is a major problem in the field of oral health. In this thesis, it is discussed whether the oral health care is considered as a need for popular health movement leadership and how they deal with the topic, it is also discussed the potential of social capital as a theoretical reference for analyzing this issue and presents a picture of dental care in São Paulo. Objective - To analyze the social representations of oral health and social control among leadership of the Union of Popular Movements of Health of São Paulo (UMPS). Method - Qualitative research analytical-descriptive-oriented, by conducting focus groups with leadership of the Union of Popular Movements of Health of São Paulo (UMPS). For the organization and presentation of data, we used the methodological procedure of the Collective Subject Discourse (CSD). In addition, we reviewed the literature on social capital in Brazilian periodicals and secondary data was used to compose the picture of dental care in the state capital. Results - The health-disease process was recognized as socially determined. In relation to the understanding of oral health as a necessity, there was antagonism. The association among oral health to general health was cited as reason of need. The failure on prioritizing oral health was most appointed to the population, economic factors, governments and the lack of linkage among oral health and general health. The principle of universalization in oral health has generated contradictory discourses, with a strong presence of the idea that dental care should be directed toward children, with the presence of dentists in schools. The leadership points out that public dental care are insufficient to ensure access, it is not resolving, it has problems of infrastructure, and have professionals who do not meet the requirements of the community. The organization of the population is a prerequisite for the deployment and maintenance of healthcare services by the state. There is a strong component about the concept of health as a right of citizenship, and that the political and social struggle is a vector for the organization of health care networks. In relation to the specific oral health in social control, contradictory statements emerged. Studies conducted in Brazil reinforce the conceptual ambiguity, difficulty in operationalizing and measuring the concept of social capital. Dental care in São Paulo enroll between 2000 and 2009, significant growth in the number of dental plan, which amounted to about 660,000 to about 1.97 million, with coverage expanding from 6.3per cent to 17.9per cent of the population in Sao Paulo. On the other hand, the access to public services is poor. The indicators Coverage of First Outpatient Dental Program and Population Potential Coverage recorded 3.8per cent and 8.2per cent in 2009. Conclusion Leaderships social representation indicate their global vision and their social integration, emphasizing the subordinate status that can influence, to some degree, the decision process on public policies related to health. Social capital is not configured as a theoretical powerful enough to understand the contradictions related to oral health in the city. Public dental services cover less than 10per cent of the population expands the coverage of dental plans (18per cent) and reproduces the changing of dental care in goods, accessible only to those who can buy it on the health market

Esta pesquisa, de natureza qualitativa e caráter teórico-prático, alicerça-se nas técnicas de observação, entrevista (com base em história oral), análise de documentos e no referencial bibliográfico. O interacionismo simbólico reflete a postura teórica adotada, de valorização do ponto de vista do sujeito. Trabalha-se com as categorias: sustentabilidade, paisagem, patrimônio e comunidade. Seu desenvolvimento define-se na qualificação da paisagem cultural e do turismo sustentável. Tem-se como objeto de pesquisa as representações da comunidade local da vila ferroviária de Paranapiacaba com relação às transformações ocorridas relativas à patrimonialização e à menor influência da atividade ferroviária - e o envolvimento com o turismo na localidade. Em uma abordagem multidisciplinar, utilizam-se conceitos de diversas ciências - Geografia, Sociologia, Antropologia, Psicologia Social -, além de subsídios de estudos sobre Turismo. Como resultados, verificou-se que a comunidade participa da atividade turística desenvolvida em Paranapiacaba, entretanto, essa participação, atualmente, é marginal: dá-se, sobretudo, no nível operacional, não no patamar das decisões quanto aos rumos do setor. Em termos teóricos, propõe-se a aproximação do conceito de paisagem cultural aos estudos do turismo, no contexto da sustentabilidade socioambiental. / This theoretical-practical qualitative research was developed based on several techniques, such as observation, interviews (oral history), and documental analysis. The symbolic interactionism reflects the theoretical approach adopted in valuing the research subjects´ point of view. Categories analyzed were: sustainability, landscape, heritage and community. Its development was defined in the context of cultural landscape and sustainable tourism. The main focus of this thesis was on the representations of the local community of Paranapiacaba, a railway village, in relation to the transformations that have occurred, mainly related to the heritage and the declining influence of railroad activity, and their role in the tourism activity. In a multidisciplinary approach, concepts of several sciences - Geography, Sociology, Anthropology, Social Psychology were used, as well as studies in the tourism and leisure field. As a result, it was found that the local community participates in the activity, however, their participation is, mainly, at the operational level, not at the strategic decision-making level. In theoretical terms, this study suggests approaching the concept of cultural landscape in tourism studies, related to the context of social-environmental sustainability.

RESUMO Introdução - O acesso à assistência odontológica pública é um dos principais problemas na área de saúde bucal. Nesta tese, se discute se os cuidados em saúde bucal são sentidos como necessidade por lideranças de movimentos populares de saúde e como estas lidam com o tema, aborda-se o potencial do capital social como referência teórica para analisar essa questão e apresenta-se um quadro da assistência odontológica na cidade de São Paulo. Objetivo - Analisar as representações sociais sobre saúde bucal e controle social entre lideranças da União de Movimentos Populares de Saúde de São Paulo (UMPS). Método - Pesquisa qualitativa, com orientação analítico-descritiva, mediante realização de grupos focais com lideranças da União de Movimentos Populares de Saúde de São Paulo (UMPS). Para a organização e apresentação dos dados, foi utilizado o procedimento metodológico do Discurso do Sujeito Coletivo (DSC). Além disso, fez-se revisão bibliográfica sobre capital social em periódicos brasileiros e utilizaram-se dados secundários para compor o quadro da assistência odontológica na capital paulista. Resultados O processo saúde-doença foi reconhecido como socialmente determinado. Em relação ao entendimento de saúde bucal como necessidade, houve antagonismo. A associação de saúde bucal à saúde geral foi apontada como razão de necessidade. A não identificação da saúde bucal como prioridade foi atribuída à população, aos fatores econômicos, aos governos e à falta de vinculação entre saúde bucal e saúde geral. O princípio da universalização na saúde bucal gerou discursos contraditórios, com forte presença da ideia de que a assistência odontológica deve ser dirigida para as crianças, com a presença de cirurgiões-dentistas nas escolas. As lideranças apontam que a assistência odontológica pública é insuficiente para garantir o acesso; não é resolutiva; tem problemas de infra-estrutura; e dispõe de profissionais que não atendem às exigências da comunidade. A organização da população é condição necessária para a implantação e manutenção de serviços assistenciais, por parte do Estado. Há um forte componente do conceito de saúde enquanto direito de cidadania, e de que a luta política e social é um vetor para a organização de redes assistenciais. Em relação à especificidade da saúde bucal no controle social, emergiram falas contraditórias. Os estudos realizados no Brasil corroboram a ambigüidade conceitual, dificuldade de operacionalização e aferição do conceito de capital social. Sobre a assistência odontológica na cidade de São Paulo registra-se, entre 2000 e 2009, um crescimento expressivo no número de beneficiários de planos odontológicos, que se elevou de cerca de 660 mil para aproximadamente 1,97 milhão, com a cobertura se expandindo de 6,3por cento para 17,9por cento da população paulistana. Por outro lado, é precário o acesso aos serviços públicos. Os indicadores Cobertura de Primeira Consulta Odontológica Programática e Cobertura Populacional Potencial registraram 3,8por cento e 8,2por cento em 2009. Conclusão As representações sociais das lideranças indicam sua visão de mundo e de sua inserção social, destacando-se a condição subalterna com que conseguem influenciar, em algum grau, o processo de decisões sobre as políticas públicas de interesse para a saúde. O capital social não se configura como referencial teórico suficientemente potente para a compreensão das contradições relacionadas à saúde bucal na cidade. Os serviços públicos odontológicos cobrem menos de 10por cento da população, expande-se a cobertura dos planos odontológicos (18por cento ) e se reproduz a transformação dos cuidados odontológicos em mercadorias, acessíveis apenas aos que podem comprá-la no mercado em saúde / ABSTRACT Introduction - Access to public dental care is a major problem in the field of oral health. In this thesis, it is discussed whether the oral health care is considered as a need for popular health movement leadership and how they deal with the topic, it is also discussed the potential of social capital as a theoretical reference for analyzing this issue and presents a picture of dental care in São Paulo. Objective - To analyze the social representations of oral health and social control among leadership of the Union of Popular Movements of Health of São Paulo (UMPS). Method - Qualitative research analytical-descriptive-oriented, by conducting focus groups with leadership of the Union of Popular Movements of Health of São Paulo (UMPS). For the organization and presentation of data, we used the methodological procedure of the Collective Subject Discourse (CSD). In addition, we reviewed the literature on social capital in Brazilian periodicals and secondary data was used to compose the picture of dental care in the state capital. Results - The health-disease process was recognized as socially determined. In relation to the understanding of oral health as a necessity, there was antagonism. The association among oral health to general health was cited as reason of need. The failure on prioritizing oral health was most appointed to the population, economic factors, governments and the lack of linkage among oral health and general health. The principle of universalization in oral health has generated contradictory discourses, with a strong presence of the idea that dental care should be directed toward children, with the presence of dentists in schools. The leadership points out that public dental care are insufficient to ensure access, it is not resolving, it has problems of infrastructure, and have professionals who do not meet the requirements of the community. The organization of the population is a prerequisite for the deployment and maintenance of healthcare services by the state. There is a strong component about the concept of health as a right of citizenship, and that the political and social struggle is a vector for the organization of health care networks. In relation to the specific oral health in social control, contradictory statements emerged. Studies conducted in Brazil reinforce the conceptual ambiguity, difficulty in operationalizing and measuring the concept of social capital. Dental care in São Paulo enroll between 2000 and 2009, significant growth in the number of dental plan, which amounted to about 660,000 to about 1.97 million, with coverage expanding from 6.3per cent to 17.9per cent of the population in Sao Paulo. On the other hand, the access to public services is poor. The indicators Coverage of First Outpatient Dental Program and Population Potential Coverage recorded 3.8per cent and 8.2per cent in 2009. Conclusion Leaderships social representation indicate their global vision and their social integration, emphasizing the subordinate status that can influence, to some degree, the decision process on public policies related to health. Social capital is not configured as a theoretical powerful enough to understand the contradictions related to oral health in the city. Public dental services cover less than 10per cent of the population expands the coverage of dental plans (18per cent) and reproduces the changing of dental care in goods, accessible only to those who can buy it on the health market

Introdução A participação da comunidade, diretriz constitucional do Sistema Único de Saúde (SUS), foi concretizada pela criação de conselhos junto à estrutura de gestão pública em todo o país, integrando gestores, trabalhadores e usuários visando à construção coletiva das decisões, possibilitando maior envolvimento e desalienação na produção do cuidado em saúde e fazendo com que a práxis do cuidado em saúde se torne menos fragmentada e mais resolutiva. Objetivo O estudo identifica como se configuram a gestão do SUS em São Bernardo do Campo e a organização dos espaços institucionais de participação da comunidade, e suas implicações no cotidiano do processo de produção de cuidado, nos diversos níveis do sistema municipal de saúde. Método Trata-se de pesquisa qualitativa que abordou a gestão participativa em São Bernardo do Campo. Os dados utilizados resultam da observação de eventos relacionados ao tema e da análise de documentos produzidos no âmbito da gestão e do controle social. Para a análise foram utilizadas as seguintes categorias: a) acesso e uso dos espaços de controle social; b) diálogos construídos entre os atores; e, c) estratégias inovadoras para mobilização da comunidade. Resultados Diversas iniciativas de participação foram identificadas como promotoras da gestão democrática, além do Conselho Municipal de Saúde, destacando-se: a) Conselhos Gestores Locais, presentes nas unidades assistenciais; b) plenárias de Orçamento Participativo, definindo prioridades para alocação de recursos; c) Encontro Popular de Saúde, contribuindo na mobilização; d) Audiências Públicas de prestação de contas e debates de projetos, favorecendo a transparência e publicidade das ações; e, e) Conferências de Saúde, avaliando e apontando as diretrizes. A produção de políticas e ações de saúde no município apresentou diversos momentos de elaboração, sendo a maioria resultante de deliberação coletiva. Quatro dimensões podem ser identificadas nesse processo: 1) Política ações governamentais e intersetoriais e captação de recursos financeiros; 2) Gestão monitoramento e construção de estratégias para enfrentamento das questões sanitárias; 3) Assistência inserida no cotidiano da atenção à saúde, principalmente consultas e procedimentos; 4) Controle popular envolve mobilização das comunidades e reivindicação por melhorias nos serviços. Discussão O exercício do controle social amplia a capacidade da sociedade civil fiscalizar o poder público, com maior acesso às informações, mas não chega a interferir de forma significativa no planejamento da política, somente em sua homologação. Desta maneira, os processos de trabalho não se transformam no sentido de tornarem-se democráticos de fato / Introduction Community participation, a constitutional guidelines of Brazils National Health System (SUS), was able due to the creation of councils in the structure of the public administration throughout the country, encompassing managers, workers and users; aiming at the collective construction of decisions, which enables greater involvement and a de-alienation in health care promotion, and making the praxis of health care be less fragmented and more efficient. Objective This paper identifies how the management of SUS in São Bernardo do Campo is structured, how institutional spaces for community participation in that city are organized, and what are their implications for the day-to-day health care promotion process in several levels of the municipal health system. Method It refers to a qualitative research that addressed the participatory management in the city of São Bernardo do Campo. The data used result from the observation of events related to the theme and from the examination of documents produced in the management and social control areas. To make an analysis the following categories were used: a) access and use of social control spaces; b) dialogs constructed between actors; and c) innovative strategies for mobilizing communities. Results Several participation initiatives were identified as promoters of democratic management, besides the Municipal Health Council, highlighting: a) Local Managing Councils, present in the assistance units; b) plenary sessions on participative budgets, where priorities for the allocation of resources are defined; c) Popular Health Meeting that contributes to the mobilization; d) Public hearings for accountability and debates on projects, favoring transparency and actions publicity; and e) Health Conferences to evaluate and indicate the guidelines. The production of policies and health actions in the city presented several elaboration moments, most of them result from collective deliberation. Four dimensions can be identified in this process: 1) Policyinter-sectorial and governmental actions as well as fund raising; 2) Management Monitoring and construction of strategies for facing problems related to health issues; 3) Assistance inserted into the day-to-day health care, especially with regard to consultations and procedures; 4) Popular control It involves mobilization of communities and claims for better services. Discussion Social control increases civil society capacity to monitor the actions of public power, since it has greater access to information. But it does not significantly interfere in the policy planning, except for its homologation. In this manner, work processes do not become democratic

O propósito desta tese foi analisar como os Conselhos Deliberativos e Fiscalizadores das Autarquias Hospitalares Regionais do Município de São Paulo exerceram suas funções de controle da gestão desses entes públicos e deliberaram sobre as políticas de saúde de sua competência em sua área de abrangência. Buscou-se, ainda, analisar o papel que os membros desses Conselhos de Saúde desempenharam; a influência exercida pelos gestores desses serviços de saúde, bem como os fatores limitantes à sua atuação e desempenho. Realizou-se pesquisa qualitativa de estudo de caso com triangulação de fontes. Foram entrevistados os superintendentes das Autarquias analisadas e os presidentes dos respectivos Conselhos, através de roteiro de entrevistas semi-estruturadas. Foi feita, ainda, a análise de documentos oficiais, incluindo as atas das reuniões desses Conselhos do período de julho de 2002 a dezembro de 2004; legislação municipal correlata; portarias do executivo municipal e documentos oficiais, entregues para vistas desses fóruns de participação comunitária. Esses Conselhos, tripartites e paritários, se reuniram mensalmente. Contaram com a participação dos membros dos segmentos usuários e servidores, porém os representantes do governo estiveram ausentes nos três conselhos, evidenciando sua falta de motivação e uma barreira à participação por conflito de interesses inerentes à suas funções na administração pública. Foi evidenciado que houve fiscalização das ações do executivo, apesar da falta de preparo técnico e da dificuldade de compreender a linguagem da burocracia do setor público pública. Tiveram acesso às informações contábeis, financeiras e assistenciais dessas Autarquias, demonstrando o respeito dos gestores pelo controle social. Deliberaramse questões pontuais da gestão, mas não políticas de saúde. A capacidade de influenciar as decisões do superintendente foi maior quando, para esse executivo, a participação social representou um grande valor. Observou-se, também, o amadurecimento desses fóruns com o exercício de suas funções e o investimento em sua capacitação que foi objeto de preocupação, principalmente de seus presidentes. Concluiu-se que, apesar dos fatores limitantes a seu desempenho, representam uma instância institucional de participação e controle que contribuiu para o acesso da sociedade organizada às instâncias de gestão, aproximando Estado e cidadãos e superando os limites da democracia representativa. / The purpose of this thesis was to analyze how the Deliberative and Supervisory Councils of Regional Hospital Autarchies in the city of Sao Paulo played their role of controlling management of these public institutions and resolved about their health policies within the Council coverage area. Moreover, it aimed to consider the role played by the health council members; the influence exerted by managers of these healthcare services, as well as the factors restricting their function and performance. A qualitative case study was conducted with triangulation of sources. The superintendents of the Autarchies studied and the presidents of the respective Councils were questioned by means of semi-structured interviews. Official document analysis was conducted including the minutes of Councils´ meetings from July 2002 to December 2004; related municipal legislation; decrees of the municipal executive branch and official documents submitted to consideration of these community participation forums. These tripartite and paritary Councils held monthly meetings, with the participation of users and employees; however, the government representatives did not often take part in the three councils, demonstrating possible lack of motivation and/or an obstacle to participate due to conflict of interests inherent to their public administration functions. It was shown that the executive branch actions had been supervised despite lack of technical preparation and difficulty to understand the language of public sector bureaucracy. The members had access to accountancy, financial and healthcare information of these Autarchies, which demonstrates respect of managers for social control. They deliberated punctual management issues but not health policies. The capacity to influence the uperintendent\'s decisions was greater when social participation represented a real value for this executive professional. Furthermore, these forums are more mature in playing their roles and investing in capacity-building processes, which are a concern, particularly to their presidents. It was concluded that despite the factors limiting their performance, the Councils represent an institutional forum of participation and control that contributes to access of the organized society to management agencies, thus placing the State and citizens closer to each other and overcoming the limits of representative democracy.

A Gestão Energética Descentralizada é uma forma de gestão dos recursos energéticos cujas primeiras publicações referentes ao tema datam dos anos 1980, no entanto, foi verificado um crescimento do desenvolvimento de estudos e aplicações do conceito na prática de forma substancial somente em tempos recentes (anos 2000). A Gestão Energética Descentralizada é tratada sob uma infinidade de termos e conceitos, e também pode ser aplicada com graus diferentes de descentralização como em vilas, quarteirões, bairros, distritos e estados. Tal conceito está fortemente atrelado ao combate das emissões de Gases de Efeito Estufa, busca pela inserção das fontes de energia renováveis nas matrizes, conservação de energia e eficiência energética, e pela associação entre planejamento urbano, ou das cidades, ao dos sistemas energéticos. Ainda, cabe destacar que nesse modelo de gestão descentralizado- a participação popular e o engajamento dos cidadãos nos processos decisórios e na busca por cidades sustentáveis veem sendo colocado, por muitos pesquisadores do tema, como requisitos indispensáveis ao seu adequado funcionamento. Esta dissertação tem como foco de pesquisa a Gestão Energética Descentralizada em âmbito municipal e seu desenvolvimento nas cidades do Brasil. Dessa forma, foi realizada uma revisão bibliográfica sobre o estado da arte do desenvolvimento da Gestão Energética Descentralizada Municipal no Brasil e no mundo, abarcando principalmente questões do planejamento e de políticas públicas como transparência e participação popular no desenvolvimento dos Planejamentos Energéticos Locais. O resultado da pesquisa mostra que existe Gestão de Energia Descentralizada Municipal no Brasil com desenvolvimento de Planejamentos Energéticos Municipais, os quais têm como principal instrumento incentivador o subprograma PROCEL-GEM, foco de estudo de caso também desenvolvido nessa pesquisa, que demonstrou que os planejamentos realizados dentro do subprograma estão restritos as unidades consumidoras de energia elétrica dos órgãos e serviços públicos, além disso, foram observados indícios de falta de transparência e participação popular nos processos de planejamento, assim como falta de recursos para a implementação dos projetos formulados em tais documentos. / Early publications on Decentralized Energy Management, which is a form of energy resources management, date back to the 1980s, however, a substantial increase in the development of such studies and applications of the concept was verified only in recent times (2000s). The Decentralized Energy Management is treated under a multitude of terms and concepts, and can also be applied with varying degrees of decentralization such as in villages, blocks, neighborhoods, districts and states. This concept is close linked to themes like Greenhouse Gases mitigation, integration of renewable energy sources in the energy matrix, energy conservation, energy efficiency and the relationship between urban planning and the energy system. It is noteworthy that in this management model decentralized the communitys participation and engagement in the decision making in the development of sustainable cities is being pointed out, by many researchers, as an indispensable requirement for the proper functioning of this kind of model. This dissertation focuses on Decentralized Energy Management at the municipal level and its development in the cities of Brazil. Thus, this work performs a state of art review on Decentralized Municipal Energy Management in Brazil as well as in the world, covering mainly planning and public policy issues such as transparency and community participation in the development of local Energy Planning. The results shows that there are Decentralized Municipal Energy Management projects in Brazil which develop Municipal Energy Planning, mostly supported by the PROCEL GEM-subprogram, that is also the case study of this research. Additionally, the results demonstrated that the planning made within this subprogram is restricted to the electricity consumption of public agencies or services. Moreover, were observed indications of a lack of transparency and community participation in the planning process as well as the lack of resources for the implementation of such projects.

Background: Health promotion is significant for reducing health inequalities at local and global levels. The Swedish Government has developed a policy for sustainable global development in the pursuit of implementing Agenda's 2030 sustainability goals in the international arena. Svalorna Latinamerika works in Peru with implementing the global goals at local level. Aim: The purpose of the field study is to analyze how Svalorna Latinamerika works strategically with involving local citizens to participate in the development work at the local level. The work is based on the global sustainability goals (Agenda 2030). Methods: The study applied a qualitative method and deductive approach to test whether the theory could be applied in to achieve sustainable development goals. Community participation theory claims that participation (i) is a strategy within the health promotion work that aims to involve local residents in the developing work that affects their lives (ii) it creates trust and legitimacy for the development work (iii) it can strengthen people's self- esteem, knowledge and development of new skills and (iv) the level of participation can affect the sustainability and efficiency of social development. A targeted sampling technique was applied to select the interviewees while data collection was performed through semi- structured interviews. Furthermore, manifest content analysis was used to analyze the collected material. Result: Participation as a health promoting strategy was applied by the non-profit organization. The level of participation consisted of partnership, a collaboration with both top-down and bottom-up approach. The co-operation and involvement of local citizens in decision-making processes created trust and legitimacy and enabled the development program to meet local needs and conditions. It also resulted in increased participation in the program's capacity building activities. Conclusion: The involvement of local citizens in decision-making processes created the conditions for the citizen to strengthen the individual and the community empowerment. Keywords: Community participation, empowerment, global sustainability goals, health promotion, local community development

In February 2001 the Minister of Health, in announcing the Primary Health Care Strategy (King, 2001), identified Primary Health Organisations as the vehicles for planning, funding and coordinating primary health care services throughout New Zealand. The requirement that communities be involved in their planning and development was integral to this strategy implementation. Investigation of the Horowhenua Primary Health Organisation establishment process from the inception of planning to the formation of a Primary Health Organisation provided an excellent opportunity to analyse the determinants of genuine community participation. This case study extended over a nine-month period. Data collected from multiple sources provided the basis for investigating the complex notion of community participation and the attributes which are essential for sustainable community engagement. The Horowhenua Primary Health Organisation Steering Committee comprised community representatives, iwi and local health professionals. This group along with the two external stakeholder groups - namely the District Health Board Funding Division and the District Health Board Primary Health Care Reference Group – were central to the analysis. The events recorded and observations made throughout the planning period formed the basis of identifying essential determinants of community participation. These included knowledge of the community and its unique “ways of doing”, the dynamic interdependencies both within the Horowhenua community and with stakeholders external to the Horowhenua, changing power relationships, managing material resourcing and accessibility to essential information. These all influenced how this rural community engaged in Primary Health Organisation planning. One common theme which emerges in the literature is the synergy between community participation and community development. A community development approach is a commonly agreed way of engaging communities in health service planning which is genuine, inclusive, self-reliant, and self-determining. This research demonstrated that the New Zealand context, where implementation of the primary health care strategy must be nationally consistent and comply with prescriptive, central government-determined criteria - as well as involving communities in a meaningful way - requires an alternative approach. The thesis presents a way of addressing power discrepancies, promoting interdependencies between stakeholders and achieving inclusiveness in all decision-making where “expert” stakeholders and community bring to the partnership a set of attributes and knowledge which collectively informs the entire planning process.

This research examined intersectoral relationships and community participation in policy processes across the mental health and housing sectors. The focus was on the development of suitable housing options for people with a psychiatric disability. The study period covered five years of mental health system reform in South Australia (2000-2005). The research found a shortage of housing and support options for people with psychiatric disability and lack of significant strategic policy coordination or ongoing cross-sectoral programmes. The problems faced by people in gaining access to housing and disability support services and the ways in which families provide housing or support in the absence of public services are documented. This case study used qualitative research methods which were triangulated across four stages: 1) a thematic analysis of national and state policies in the health, housing and disability sectors; 2) participant observation of NGO activity, a thematic analysis of NGO documents, and interviews and focus groups with NGOs; 3) interviews and focus groups with consumer and carer representatives and a thematic analysis of the minutes from state-level groups; 4) interviews with professionals from the health, housing and disability sectors The housing situation for people with psychiatric disability was explained in terms of a number of key issues in the policy environment; „X The overarching neo-liberal policy context synonymous with a decline in public housing resources and increasing tension between NGOs service provider and advocacy roles. „X The political nature of the local mental health policy context and lack of political commitment to ongoing resources. Broad community stigma reflected in the media and government, affecting ongoing political commitment to mental health and housing and the introduction and progress of housing ¡¥projects¡¦. „X The slow development of peak NGO and consumer organisations and alliances in South Australia which affected access to policy networks and contributed to the dominance of professional interests within policy processes. „X The separation of health, housing and disability policy and networks within and across levels of government. This was associated with bilateral agreements (between Australian and state governments) tied to resources within departments, the programme objectives and the goals of bureaucrats. „X The separation of policy networks by sector was also connected to the dominance of bio-medical discourses and interventions and associated professional interests in the health policy sector. Medical discourses on health and disability and ¡¥consumerist¡¦ discourses on participation also led to social determinants of health such as housing being overlooked within policy processes. „X Governance reform at a state level contributed to organisational instability within departments, causing some problems for cross-sectoral initiatives and protocols. Kingdon¡¦s (2003) multiple streams analysis of policy helped to explain what missed or reached political agendas within each policy sector of the case study. Kingdon predicts that the unity of policy networks is important for the realization of policy solutions, and the lack of unity in policy sectors was an obstacle to policy agendas on housing for people with a psychiatric disability. However, the way in which problems were being represented (Bacchi 1999) was also important to understanding this policy environment. For example, a medical discourse on disability (Fulcher 1989) tied to the health sector led to a narrow focus on clinical mental health services. Similarly, neo-liberal discourse (Dean 1999) supported private housing solutions and resources or NGOs advocating ¡¥within sectors¡¦ for the types of services they already provided or wished to provide. The case study suggested strategies for ¡¥policy change¡¦ need to address a number of factors across service delivery, policy and political realms. Firstly, better recognition is warranted of the difficulty experienced by many people with psychiatric disability in achieving stable housing, and the need for indicators on housing access and stability for this group. Secondly, processes to address stigma (particularly that perpetuated in the media) will be instrumental for policy change and political commitment. Thirdly, ongoing cross sectoral advocacy and alliances require development at both a national and state level and support by a political culture which encourages advocacy. Developing processes for working across sectors such as policy learning forums involving both experts and community groups could counter problems arising from professional culture and territories that were documented in this study. Finally, the cross-sectoral development of policy, programmes and accountability mechanisms and the stability of policy networks will be important to ensuring stable housing for people with psychiatric disability.

Natural resource managers are facing increasing challenges as environmental degradation accelerates and the need to integrate a broad spectrum of community experiences into management decisions is increasingly recognised. To help meet these novel challenges, this study explores how professional researchers and communities can combine their skills and learn to work in partnerships to achieve shared management goals. Community-based research involves people as citizen scientists, whereby citizens actively participate in research on local issues. The inclusive nature of community-based research has the ability to produce auxiliary benefits uncommon in conventional research. These include the development of social capital and social learning as the practice of citizen science empowers communities with new skills, knowledge and social networks, thus building capacity within communities to take an effective role in natural resource management. Community-based research also has the potential to enrich the range of management options available by increasing the breadth of accessible knowledge. However, despite much rhetoric about democratising science, little is known about the practice, value and problems of involving citizens as collaborators in natural resource management research projects. This thesis presents the findings from a comparative survey of the attitudes to community-based research held by 'citizen' scientists, on the one hand, and 'expert' scientists and natural resource managers, on the other. It also draws upon a multi-site case study, set in a diverse urban-rural catchment, where an integrated research program was established for different natural resource management agencies to work with each other and community groups to develop research protocols so that community groups could participate in assessing the health of catchment areas. This involved scientists, natural resource managers and community education/extension officers working with established community groups to develop and trial modified scientific methods for the environmental monitoring of catchment and estuarine areas. This inter-agency/community project was continued as a case study site into the second and third years of research and was augmented in the second and third years by focusing on two of the initial community groups as second and third case study sites in their own right. Synthesis of both survey and case study analysis reveals that, despite resource and attitudinal barriers, community-based research can ensure access to local knowledge and increased relevance of research. In addition, many participants most valued the increased feeling of connection towards their local environment and community. I argue that citizen/expert collaboration is key to successful community-based research and best achieved in an atmosphere of mutual respect where all participants are seen as co-researchers. However, participatory intentions are unlikely to be acted upon without sufficient opportunity. Thus, the process of research must be re-defined from that associated with positivist science to include a greater range of participants and activities in an adaptive manner. This more inclusive and reflective approach seems most likely to ensure the quality and utility of research data, the knowledge sharing and social learning, and the enjoyable atmosphere that underpin successful citizen/expert interactions. Certainly, the ability to draw upon and create social capital is vital. The integration of these findings enabled the development of guidelines for effective collaboration between citizens and experts when addressing catchment management issues and undertaking participatory research.