Background:

Studies on social participation point out some limitations in participatory architecture. For this reason, the World Health Organization designed a model with key components for bringing civil society and governments closer together.

Objectives:

This study aimed to identify the aspects that influence participation based on the components proposed by the World Health Organization.

Methodology:

This case study used a qualitative and cross-sectional approach. Data were collected through document analysis, non-participant observation, and semi-structured interviews in 2020 and 2021 with the municipal health council members of an inland city in the state of São Paulo, Brazil.

Results:

Weaknesses were observed in the council’s institutional structure, such as excessive bureaucracy, lack of user representativeness, and council members’ insecurity regarding the municipality’s health-related economic-financial issues.

Conclusion:

There is a need to strengthen the culture of participation in this municipal health council, disseminate the activities developed, and reformulate the technical-bureaucratic dynamics that predominate in this environment.

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