Most of the Latin American countries have ratified the international instruments that recognize the importance of the participation on the implementation of public policies (as the UN Committee on Economic, Social and Cultural Rights’ General Comment no. 14, the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), the United Nations Declaration on the Rights of Indigenous Peoples, among others). Interesting legal frameworks for the implementation of participatory mechanisms, such as participatory budgets, local committees for the administration of health services, and agreed development plans have developed in the region. This shows that there is a legal and political commitment to guarantee participation in some policy making processes.

At the same time, groups of citizens are protesting and asking for their right to participate in the policy making processes. In some situations, the Government has defended the decisions arguing that these were product of participatory processes. In other situations, participation has been directly denied using national interests as an argument. Such situations have been occurring repeatedly in places where residents have opposed, or continue opposing, the extraction of natural resources as they consider that this may threaten their livelihood. In many cases, clashes occur between people in rural areas, indigenous people, who are often among the poorest sectors of society, and the Government.

These kind of situations show that even if a formal commitment expressed in legal frameworks exists, participation is not always easy to implement, and not all societies are used to open spaces for a broader participation. The monitoring of participatory processes requires the development of a more critical view to the way participation is understood and set up. This presentation aims, through the analysis of a case in Colombia and in Peru to raise some questions regarding the risk of adopting participatory mechanisms as a recipe, part of a check list, without taking into account the context in which the process is occurring, that is without analyzing qualitative elements of the process that go beyond the existence of a formal mechanism for participation.

Camila Gianella Malca  is a Psychologist with a Master Degree in International Health. She is a PhD candidate at the Bergen University- Psychology Faculty and fellow at CMI. Her PhD aims to analyze the consequences of health rights litigation on access and quality of Health Care in Colombia.  This research includes an analysis of the mechanisms for health policy making in Colombia.