The Role of Sef-Help Organizations in the Community Health Governance: The Italian Case-study
FACULTY OF MEDICINE UNIVERSITY 'MAGNA GRAECIA' CATANZARO, ITALY
The paper will pursue the specific aim of analysing the role of citizens-users/patients/carers organizations in the community health governance arena in Italy both at national and regional levels using a theoretical approach based on the the active citizenship paradigm and a participatory research methodology involving the self-help organisations themselves as an alternative to the prevailing consumerist paradigm rooted in health economics.
The acknowledgement of this more active role the patient plays in the health care system as an essential partner for health production brings this approach to elaborate a new participatory-democratic concept of active citizenship, aimed to fill the "democratic deficit" of such system by democratizing the health services through increased public participation in the health policy-making arena. Within this framework, the role of citizens-users/patients/carers organizations thus becomes central in promoting new forms of collective civic participation enhancing citizens' political awareness and empowerment about their fundamental rights and the contribution they can offer to the decision-making process in the health policy arena.
By the above approach, the paper will try to describe the Italian citizens-users/patients/carers organizations in the health arena by their development, aims, activities, internal structure and resources and to analyse the role the different types of citizens-users/patients/carers organizations play in promoting and/or representing the interests of citizens within national and regional health policy arena according to the preliminary outcomes of an integrated qualitative-quantitative national research project funded by the Ministry of Health : the regional level will be considered as particularly relevant for this purpose of the project, given both the historical differences existing in Italy among the various regions and the more recent political process of decentralization (federalism).
Finally, the chance of establishing in Italy a network of independent Regional Observatories on Health Citizenship run by the universities in co-operation with citizens-users/patients/carers organizations themselves and co-ordinated with the Regional Health Authorities, aimed to monitor the quality and equity of health care services and advocating citizens' rights to access appropriate care will be considered from the perspective of enhancing the active citizenship paradigm.