Abstract
This study examined the creation and implementation of local health councils in the municipality of Anchieta, state of Espírito Santo, Brasil. The goal was to identify the factors that supported or limited their effective participation in the context of the local Unified Health System. Using a qualitative approach, 13 interviews were carried out among the council members. Content analysis was used to show three categories worked on in this text: To be or not to be a health counselor? That is the question!; Non-belonging and non-participation; and local health Councils: links, means, and mediations. It was concluded that counselors face major difficulties that end up distorting the desired paths of social participation in the scope of the National Health System. Therefore, it is essential that there is political will, support for effective participation, and education programs for the citizenship of the actors involved in these forums so that they can exercise their roles to the fullest extent.
Unified Health System; social participation; health councils