THE PARTICIPATION AND INFLUENCE OF SOCIETY IN THE DECISIONS of government officials, in public institutions in general and in those spheres directly related to their policies, are decisive factors in the State’s ability to fulfill its redistributive and social protection functions.

The participation of society in the public and governmental sphere is decisive and articulates social protection with the various macro-institutional governance mechanisms. As it becomes stronger over historical trajectories, its institutions favor the formation of the social capital necessary for sustainable development in a just society¹1 Putnam RD. Comunidade e Democracia: a experiência da Itália Moderna. Rio de Janeiro: Editora Fundação Getúlio Vargas; 1996.. Also, in terms of State regulatory policies, participatory bodies and collegiate bodies increase the dialogic and contradictory nature of decision-making processes, populate the decision-making arenas, and outline a type of responsive regulation²2 Ayres I, Braithwaite J. Responsive Regulation: Transcending the Deregulation Debate Oxford: Oxford University Press; 1992. [acesso em 2022 out 13]. Disponível em: http://johnbraithwaite.com/wp-content/uploads/2016/06/Responsive-Regulation-Transce.pdf.
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In Brazil and in the health sector, these foundations articulate social participation with a series of government bodies and inclusive institutions with the action of organizations focused on equity policies and with beneficiaries, public policy agents, and representatives of vulnerable groups.

In terms of ideas, social participation is understood in the redistributive sense and is oriented towards strengthening institutional mechanisms of social protection. It follows the known principles of justice and equity³3 Rawls JA. Theory of Justice. Cambridge: Harvard University Press; 1971.. This is the institutional framework that drove the successful participatory governance observed in negotiated and consensual democracies, which include, among others, the European experiences of the Welfare State⁴4 Lijphart A. Patterns of Democracy: government forms and performance in thirty-six countries. Yale: Yale Universit; 1999..

These arrangements aim to create channels of participation in the State Apparatus and, with that, to provide governments with greater porosity to society and in contrast to the force of action of economic corporations in the state decision-making structure. Social participation and increasingly dialogic governance mechanisms are, therefore, part of a political agenda for social inclusion.

The Public Ombudsman’s Offices are essential and innovative bodies in this institutional framework. They represent the gateway to individual and collective demands from citizens and beneficiaries of public policies. In the national health sector, there is an evident evolution in its integration into decision-making processes, which reflects its progressive institutionalization. The articles published in this issue reflect on the direct or intertwined connections between the Ombudsman of the Unified Health System (SUS) and decision-making processes on a sectoral scale. Integrated with the theme of governance and the participation of society, these articles provide analyses on these experiences and related topics in the national and international context.

The functioning of public ombudsmen in terms of work processes and the quality of the services provided becomes a critical factor for these institutions to take their place in regulatory and participatory systems.

In the first axis of articles in this issue, two studies discuss this topic in detail from the perspective of ‘Institutional Accreditation’ and the processes of building the path of quality of services. Quality implies permanent negotiation, as a normative guideline, and the incorporation of the technical culture of self-assessment and independent external assessment as an assessment process. The foundations and results of studies developed from the experience of their authors with the evaluation processes of the SUS Ombudsman are analyzed in depth and according to their theoretical references.

This issue, therefore, presents a set of articles, in different forms, and that address the axes defined to promote this reflection on the SUS Ombudsman and, in a broader sense, on the mechanisms of society’s participation in governmental decisions in policies public.

There is a first axis directly related to the SUS Ombudsman and to institutional accreditation processes that are underway through cooperation between the Ministry of Health and the National School of Public Health of the Oswaldo Cruz Foundation (TED 19/2017). This axis includes five studies that address the process of Institutional Accreditation of the SUS Ombudsman; the methodology developed for the accreditation of these ombudsmen; the analysis of young people’s demands presented to the SUS General Ombudsman; the experience of the SUS Ombudsman of the state government of Bahia; and the ombudsman with the Brazilian Network of Public Health Schools.

The second axis, with five publications, concerns social participation in the health sector. The articles involve studies with different approaches on the subject and include the decision-making process in the Municipal Health Council of Marabá (PA); popular participation and health surveillance; public participation in Portugal during the COVID-19 pandemic; participatory management in Primary Health Care; and an interview with the President of the National Health Council.

The third axis involves four articles that address the topic according to governance mechanisms, institutional structure of health systems, and sociological aspects related to equity policies. They include articles on governance mechanisms in an international comparative perspective; on governance mechanisms and the formation of state bureaucracies; a reflection on the look at differences and their repercussions for equity policies; and on participatory challenges in Chile’s health system in the context of social conflict and political change.

This issue closes with an important tribute to Antônio Ivo de Carvalho who, among so many great attributes that are the mark of his life story, was also one of the main Brazilian intellectuals to reflect on social participation in public health systems. Furthermore, he was a leader with great ability to formulate agendas and policy alternatives for the SUS. The authors have organized, after reading their work published in books and articles, a document containing exclusively selected excerpts from their writings. Only Antônio Ivo speaks through this compilation, which gives a small idea of the quality, complexity, and generosity of his thinking.

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