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Challenges for the operation of councils for the rights of older people and their social consequences

Abstract

Objective

to understand the perceptions of councilors about the functioning of councils for the rights of older people in the state of Rio Grande do Norte.

Method

This is an analytical cross-sectional study with a quantitative approach carried out with municipal councilors for the rights of older people in the state of Rio Grande do Norte. 109 councilors participated, with a predominance of full members, female, from government representation and with a higher education level.

Results

Several challenges were identified for the performance and operation of the councils, among which stand out: isolated actions, low participation of government members and representation of civil society, little time for discussion in meetings and the need for valid instruments to monitor the actions of the councils. Low technical knowledge of the councilors and aversion to divergences and political positions were also evidenced.

Conclusion

it is essential to ensure intersectoral policies, greater independence from the executive and, above all, greater training of councilors and democratic political strengthening so that they can not only promote, but exercise a socio-political protagonism based on a collective construction and social representation.

Keywords
Aging; Public policy; Rights of Older People; Social Participation; Right to health

Resumo

Objetivo

compreender as percepções dos conselheiros acerca do funcionamento dos conselhos dos direitos da pessoa idosa no estado do Rio Grande do Norte.

Método

Trata-se de um estudo de natureza transversal analítica com abordagem quantitativa realizado com os conselheiros municipais dos direitos da pessoa idosa do estado do Rio Grande do Norte. Participaram 109 conselheiros, havendo predominância de membros titulares, do sexo feminino, de representação governamental e com nível de escolaridade superior.

Resultados

Foram apontados diversos desafios para atuação e funcionamento dos conselhos, dentre os quais destacam-se: ações isoladas, baixa participação de membros governamentais e representação da sociedade civil, pouco tempo de discussão nas reuniões e necessidade de instrumentos válidos para monitorar as ações dos conselhos. Evidenciaram-se também baixo conhecimento técnico dos conselheiros e aversão às divergências e posicionamentos políticos.

Conclusão

é imprescindível assegurar políticas intersetoriais, maior independência perante o executivo e, prioritariamente, maior capacitação dos conselheiros e fortalecimento político democrático para que possam não só promover, mas exercer um protagonismo sociopolítico a partir de uma construção coletiva e representatividade social.

Palavras-Chave:
Envelhecimento; Políticas públicas; Direitos dos Idosos; Participação Social; Direito à Saúde

INTRODUCTION

There is a growing demand for new forms of social organizations due to global aging. It is essential to rethink aging as an essentially social phenomenon and not reduce it to merely chronological and biomedical aspects. In order to meet the demands for representativeness and social participation of older people in Brazil, Law 8842, of January 4, 199411 Brasil. Lei n.º 8.842, de 4 de janeiro de 1994. Dispõe sobre a Política Nacional do Idoso, cria o Conselho Nacional do Idoso e dá outras providências [Internet]. 1994 [acesso em 20 abr. 2021]. Disponível em: https://www.planalto.gov.br/ccivil_03/leis/l8842.htm
https://www.planalto.gov.br/ccivil_03/le...
, created the National Council for the Rights of the Older Person (CNDI), which consists of a joint body, with an advisory and deliberative character.

The CNDI represents the maximum sphere of participation and social control in the promotion, protection and defense of the rights of older people. The council is committed to formulating, monitoring, inspecting and evaluating social protection policies for this population group. However, the councils for the rights of older people are still fragile, timid and hostage to the actions of managers of the executive branch, since they depend on them for their establishment, from creation to administrative and financial functioning22 Giacomin KC, Couto EC. O caráter simbólico dos direitos referentes à velhice na Constituição Federal e no Estatuto do Idoso. Rev Kairós. 2013;16(3):141-60. https://doi.org/10.23925/2176-901X.2013v16i2p141-160
https://doi.org/10.23925/2176-901X.2013v...
.

However, in 2019, decree no. 9.89333 Brasil. Decreto n.º 9.893, de 27 de junho de 2019. Dispõe sobre o Conselho Nacional dos Direitos da Pessoa Idosa. Diário Oficial da União [Internet]. 2019 jun. 27 [acesso em 20 mar. 2021] seção 1(123):27. Disponível em: https://pesquisa.in.gov.br/imprensa/jsp/visualiza/index.jsp?data=28/06/2019&jornal=515&pagina=27&totalArquivos=291
https://pesquisa.in.gov.br/imprensa/jsp/...
was sanctioned, which aimed to demobilize and centralize the actions of the CNDI. Articulation between government entities and civil society was restricted, the number of councilors, meetings was reduced and its members were submitted to the federal government, solely to the Ministry of Women, Family and Human Rights, hindering the execution of intersectoral policies. Although partially revoked by Decree no. 10,643 of 202144 Brasil. Decreto n.º 10.643, de 3 de março de 2021. Altera o Decreto nº 9.893, de 27 de junho de 2019, que dispõe sobre o Conselho Nacional dos Direitos da Pessoa Idosa. Diário Oficial da União [Internet]. 2021 mar. [acesso em 26 mar. 2021];seção 1:4. Disponível em: https://www.in.gov.br/en/web/dou/-/decreto-n-10.643-de-3-de-marco-de-2021-306390419
https://www.in.gov.br/en/web/dou/-/decre...
, it made clear the purposes of neoliberalism in the face of institutions that seek to strengthen participation and social control.

This neoliberal rationality operates through subjectivation processes guided by discourses saturated with individualist and mercantilist messages whose normativity underlies a specific rationale for governing the life of the population55 Rougemont FR. Medicina anti-aging no Brasil: controvérsias e a noção de pessoa no processo de envelhecimento. Rev Antropol USP. 2019;62(2):403-31. https://doi.org/10.11606/2179-0892.ra.2019.161077
https://doi.org/10.11606/2179-0892.ra.20...
. Neoliberal capitalist society distances itself from older people, judging them as impotent and unproductive beings and, on the other hand, establishes standards of being and living associated with the moralization of physical attributes. A moral filter refractory to old age itself is encouraged based on the exaltation of the signs of youth, characterized by expressive physical valences, readiness to work and productivity. On the contrary, the older one appears, the less social capital one has55 Rougemont FR. Medicina anti-aging no Brasil: controvérsias e a noção de pessoa no processo de envelhecimento. Rev Antropol USP. 2019;62(2):403-31. https://doi.org/10.11606/2179-0892.ra.2019.161077
https://doi.org/10.11606/2179-0892.ra.20...

6 World Health Organization. Global report on ageism [Internet]. Geneva: World Health Organization; 2021. [Acesso em 20 fev. 2023]. Disponível em: https://www.who.int/publications/i/item/9789240016866
https://www.who.int/publications/i/item/...

7 Duarte AM. Democracia em crise: biopolítica e governamento neoliberal de populações. Educ Filos. 2019;33(68):527-62. https://doi.org/10.14393/REVEDFIL.v33n68a2019-51961
https://doi.org/10.14393/REVEDFIL.v33n68...
-88 Bossio D, McCosker A, Schleser M, Davis H, Randjelovic I. Not that old person: older people’s responses to ageism revealed through digital storytelling. J Sociol. 2023;59(1):232-50. https://doi.org/10.1177/14407833211040111
https://doi.org/10.1177/1440783321104011...
. Still in the flourishing of the 21st century, while society enhances longevity, it denies older people their value and social importance99 Silva MF, Silva DSM, Bacurau AGM, Francisco PMSB, Assumpção D, Neri AL, et al. Ageism against older adults in the context of the COVID-19 pandemic: an integrative review. Rev Saude Publica 2021;55:4. https://doi.org/10.11606/s1518-8787.2021055003082
https://doi.org/10.11606/s1518-8787.2021...
.

In view of the exposed challenges and the need for greater visibility and strengthening of social control of public policies for dignified aging, this study aimed to understand the perceptions of councilors about the functioning of councils for the rights of older people in the state of Rio Grande do Norte.

METHOD

This is a cross-sectional study of an analytical nature with a quantitative approach. The study was carried out in the state of Rio Grande do Norte (RN), which has a little over 3.5 million inhabitants1010 Instituto Brasileiro de Geografia e Estatística. Cidades e Estados [Internet]. 2020 [acesso em 3 mar. 2021]. Disponível em: https://www.ibge.gov.br/cidades-e-estados/rn.html
https://www.ibge.gov.br/cidades-e-estado...
of which approximately 500,000 are older people, according to IBGE projections for the year 20221111 Instituto Brasileiro de Geografia e Estatística. Projeções da População do Brasil e Unidades da Federação por sexo e idade: 2010-2060: Tábuas de Mortalidade 2010/2060. 2018 [acesso em 2 ago. 2020]. Disponível em: https://www.ibge.gov.br/estatisticas/sociais/populacao/9109-projecao-da-populacao.html?edicao=21830&t=resultados
https://www.ibge.gov.br/estatisticas/soc...
and accompanying demographic characteristics. the global trend regarding the significant increase in the older population. It is associated with a substantial increase in life expectancy of almost 140% in the last 40 years, from 55.5 years in 1980 to 76.4 years in 20191111 Instituto Brasileiro de Geografia e Estatística. Projeções da População do Brasil e Unidades da Federação por sexo e idade: 2010-2060: Tábuas de Mortalidade 2010/2060. 2018 [acesso em 2 ago. 2020]. Disponível em: https://www.ibge.gov.br/estatisticas/sociais/populacao/9109-projecao-da-populacao.html?edicao=21830&t=resultados
https://www.ibge.gov.br/estatisticas/soc...
, being considered the second largest magnitude among the Brazilian states in this period.

Data collection was carried out between the months of September and November 2019 with the municipal councilors present in the training on the Social Control of the Rights of the Older Person, offered in five pole municipalities of the state by the State Council for the Rights of the Older Person of Rio Grande do Norte (CEDEPI/RN). CEDEPI/RN was created by State Law no. 6,254, of January 10, 19921212 Rio Grande do Norte. Lei Estadual nº 6.254, de 10 de janeiro de 1992. Dispõe sobre a criação do Conselho Estadual de Defesa da Pessoa Idosa. Diário Oficial [Internet]. 1992 nov 11 [acesso em 20 mar. 2019]. Disponível em: https://leisestaduais.com.br/rn/lei-ordinaria-n-6254-1992-rio-grande-do-norte-dispoe-sobre-a-criacao-do-conselho-estadual-de-defesa-da-pessoa-idosa?q=Lei%20Estadual%20n%C2%BA%206.254,%20de%2010%20de%20janeiro%20de%201992
https://leisestaduais.com.br/rn/lei-ordi...
and became deliberative, and not just advisory, through the approval of Decree no. 29,737, of June 1, 20201313 Rio Grande do Norte. Decreto nº 29.737, de 1º de junho de 2020. Aprova o Regimento Interno do Conselho Estadual dos Direitos da Pessoa Idosa (CEDEPI) e dá outras providências. Diário Oficial do Rio Grande do Norte [Internet]. 2020 jun 06 [acesso em 20 mar. 2021]. Disponível em: http://diariooficial.rn.gov.br/dei/dorn3/docview.aspx?id_jor=00000001&data=20200602&id_doc=684988
http://diariooficial.rn.gov.br/dei/dorn3...
.

According to CEDEPI records, there were a total of 75 municipalities with Municipal Councils for Older People (CMPIs) implemented (44.9% of the state), with only 33 of them active1414 Conselho Nacional de Direitos da Pessoa Idosa (Br). Painel de Informações sobre Conselhos e Fundos [Internet]. 2019 [acesso em 15 mar 2019]. Disponível em: https://www.gov.br/participamaisbrasil/painel-de-informacoes
https://www.gov.br/participamaisbrasil/p...
. Among the 172 participants in the training events, it was observed that some were not councilors (36.5%) and there was a greater participation of those from the municipalities of the metropolitan region (36.0%), with a lower participation of the municipalities from regions farther from the capital. The sample was given by convenience, with a size defined by the number of responding participants, considering as inclusion factors: being a municipal councilor and being present in the regional trainings that took place in five municipalities of RN: Natal, Mossoró, Pau dos Ferros, Santa Cruz and Caicó and was considered an exclusion factor: the presence of psychomotor and/or visual disorders that hinder the ability to write and/or read.

A structured questionnaire based on research carried out by the Applied Economic Research Study1515 Instituto de Pesquisa Econômica Aplicada (Br). O Conselho Nacional dos Direitos do Idoso na Visão de seus Conselheiros: Relatório de Pesquisa Projeto Conselhos Nacionais: perfil e atuação dos conselheiros. Brasília, DF: IPEA; 2012. (IPEA) was used for data collection, in addition to other research that discussed the main challenges for constituting councils on the rights of older people1616 Araujo CM, Bitener P. The Great Municipal Council of São Paulo for the Elderly: Challenges to Influence the Public Policy Process. Rev Kairós. 2016;19:73-102.,1717 Debert GG, Oliveira GD. Os dilemas da democracia nos Conselhos de Idosos. In: Alcântara AO, Camarano AA, Giacomin KC. Política Nacional do Idoso: velhas e novas questões. Rio de Janeiro: IPEA; 2016.. The questionnaire was developed by authors with expertise in aging during a meeting to discuss and define, by consensus, the indicators related to the construct of interest. This questionnaire was structured by 18 closed questions and one open question, divided into three axes: a) characterization of the councilors; b) performance of councilors and c) operation of councils for the rights of older people in the municipalities of RN. The purpose of the open question was to collect information about some peculiarity of the council to which the respondent belongs, considering one of the three axes mentioned or even a consideration about the questionnaire itself.

The questionnaires for situational analysis of the RN councils were given to the councilors at the beginning of the training and a report was made on their application and on the research objectives, as well as clarified that the data will not be personified and, therefore, the link was not discriminated from the councilors to their respective. The collection took place at the end of the meeting. For analysis, we performed the simple sum of the marked items, but in question 3.3 we added the inverse score, that is, for priority “1” (highest priority) we attributed 3 points and for priority “3” (lowest priority among those scored) we attributed 1 point.

We consider the challenges for the functioning of the CMPIs as a dependent variable in view of the following independent variables: a) characterization of the councilors of the municipalities; b) performance and c) operation of CMPIs. We also used, as a method of analysis, the Foucauldian precepts of Biopower, which consist of an immaterial power anchored in bodies and their acts and which aspires to ensure discipline through the regulation of life and normalization of customs1818 Foucault M. Microfísica do poder. 11. ed. São Paulo: Paz e Terra; 2021..

The study was approved by the Ethics Committee of the University Hospital Onofre Lopes (CEP/HUOL) of the UFRN under opinion number 5.224.483.

RESULTS AND DISCUSSION

109 municipal councilors from RN were interviewed. In Table 1, the results referring to the axis of the interviewees' characterization questionnaire are compiled.

Table 1
Characterization of the interviewees. Natal, RN, 2022.

There was a predominance of women regarding the occupation of councilors for the rights of older people. Similar characteristics were found in the study by IPEA1515 Instituto de Pesquisa Econômica Aplicada (Br). O Conselho Nacional dos Direitos do Idoso na Visão de seus Conselheiros: Relatório de Pesquisa Projeto Conselhos Nacionais: perfil e atuação dos conselheiros. Brasília, DF: IPEA; 2012. (2012), in which 12 full councilors and six alternates of the CNDI participated, of which 75% were female.

The predominance of women can be explained by their historical role in the field of social care policies and their low socio-political protagonism. They are ahead in a context of low social capital, as in Brazil there is still a tradition of improvising equipment structures regarding the care of older people, in addition to the low investment in the qualification of teams and representatives1919 Estevam EA, Francisco PMSB, Silva RA. Privatização da velhice: sofrimento, adoecimento e violência na relação entre cuidadores e idosos. Saude Soc. 2021;30(3):e200928. https://doi.org/10.1590/S0104-12902021200928
https://doi.org/10.1590/S0104-1290202120...
. However, in the National Congress, where power relations have a wide magnitude, women occupy approximately 15% of the vacancies. Brazil remains one of the countries with the worst female political empowerment index, occupying the 156th position in a list of 190 countries2020 Montesanti B. Mulheres são 15% do novo Congresso, mas índice ainda é baixo. UOL [Internet]. 2018 out 08 [acesso em 20 abr. 2021]. Disponível em: https://noticias.uol.com.br/politica/eleicoes/2018/noticias/2018/10/08/mulheres-sao-15-do-novocongresso-mas-indice-ainda-e-baixo.htm
https://noticias.uol.com.br/politica/ele...
.

The results regarding the characterization of the interviewees show that the level of education, 62.4% have at least completed higher education, of the councilors is well above the national proportion, which is only 17.4% of the population with higher education2121 Instituto Brasileiro de Geografia e Estatística. Desigualdades sociais por cor ou raça no Brasil [Internet]. Rio de Janeiro: IBGE; 2019 [acesso em 20 mar. 2021]. Disponível em: https://biblioteca.ibge.gov.br/index.php/biblioteca-catalogo?view=detalhes&id=2101681
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, while the racial issues reproduce the Brazilian social distribution, which in 2018 consisted of 43.1% whites, 9.3% blacks and 46.5% browns2222 Instituto Brasileiro de Geografia e Estatística. Educação 2019. Rio de Janeiro: IBGE; 2020 [acesso em 8 mar. 2021]. Disponível em: https://biblioteca.ibge.gov.br/index.php/biblioteca-catalogo?view=detalhes&id=2101736
https://biblioteca.ibge.gov.br/index.php...
. Most of the councilors represented the public authorities, were holders and were between 31 and 60 years old. This representation was also verified in a study carried out by IPEA1515 Instituto de Pesquisa Econômica Aplicada (Br). O Conselho Nacional dos Direitos do Idoso na Visão de seus Conselheiros: Relatório de Pesquisa Projeto Conselhos Nacionais: perfil e atuação dos conselheiros. Brasília, DF: IPEA; 2012., in which 69% of the CNDI councilors were aged between 41 and 60 years.

Souza and Machado2323 Souza MS, Machado CV. Governança, intersetorialidade e participação social na política pública: o Conselho Nacional dos Direitos da Pessoa Idosa. Cienc Saude Colet. 2018;23(10):3189-3200. https://doi.org/10.1590/1413-812320182310.14112018
https://doi.org/10.1590/1413-81232018231...
(2018), consider important the participation of older people in instances of promoting the rights of older people. This is because a greater representation of the main stakeholders in the councils would make it possible to single out and give life to local demands, aiming at the development of their own political guidelines. The lack of this authentic diagnosis of the local reality, in turn, can limit participatory management and the socio-political role of the older person, making municipalities mere executors of federal policies. Other authors, however, defend the technical capacity and educational level as the main assumptions of the board of councilors representing civil society for the greater possibility of exercising an active role in decision-making2424 Almeida C, Tatagiba L. Os conselhos gestores sob o crivo da política: balanços e perspectivas. Serv. Soc. Soc. 2012;(109):68-92. https://doi.org/10.1590/S0101-66282012000100005
https://doi.org/10.1590/S0101-6628201200...
.

One cannot accept the idea of incommensurability, focusing only on one variable, in this case, age classification or technical capacity to occupy an essentially political position. It is believed that the ideal would be for councilors, in addition to having a high level of education, to be primarily older people. There is a caveat, as the composition of the councils by older people does not guarantee the legitimacy of local demands, as they may not represent and have not experienced the reality of communities with low social capital, which are the ones that most need public social assistance. For example, in the study carried out by IPEA1515 Instituto de Pesquisa Econômica Aplicada (Br). O Conselho Nacional dos Direitos do Idoso na Visão de seus Conselheiros: Relatório de Pesquisa Projeto Conselhos Nacionais: perfil e atuação dos conselheiros. Brasília, DF: IPEA; 2012., 94% of the councilors participating in the survey had a monthly income at least 44.7% higher than the national average and almost 50% had an income at least 189.5% higher than the national average.

To corroborate this context, the concept of habitus is brought up, which consists of a tendency to homogenize the forms of behavior and thoughts referring to people who occupy the same social spaces, being elitist, making it difficult to understand in relation to material needs and interests of less favored social groups2525 Arribas Macho JM. Genesis of a concept: The Pierre Bourdieu'habitus. Postface, on the work of Erwin Panofsky: Gothic architecture and scholasticism. Empiria. 2021(49):165-79. https://doi.org/10.5944/empiria.49.2021.29237
https://doi.org/10.5944/empiria.49.2021....
. Therefore, the CMPIs must materialize other strategies to represent the values and needs of the older people in the different performance scenarios beyond technical capacity, highlighting the development of valid instruments to evaluate and monitor decision-making by different social strata, including older people, this being an attribution of the CNDI according to Decree no. 4,227 of 20022626 Brasil. Decreto n.º 4.227, de 13 de maio de 2002. Cria o Conselho Nacional do Idoso - CNDI, e dá outras providências [Internet]. 2002 [acesso em 12 jul. 2021]. Disponível em: http://www.planalto.gov.br/ccivil_03/decreto/2002/d4227.htm
http://www.planalto.gov.br/ccivil_03/dec...
.

It should also be noted that eight councilors did not know their social representation on the councils and worse, a large part was averse to political stances, with a denial of response by more than 50%. It is reiterated that approximately 10% did not even know their political stances. This fact confronts the function of the councils, which inaugurate a pattern of political activity and consolidation of democracy and social representation of older people, with the purpose of allowing society to participate in defining priorities for the political agenda, as well as in formulating, in monitoring and controlling public policies2626 Brasil. Decreto n.º 4.227, de 13 de maio de 2002. Cria o Conselho Nacional do Idoso - CNDI, e dá outras providências [Internet]. 2002 [acesso em 12 jul. 2021]. Disponível em: http://www.planalto.gov.br/ccivil_03/decreto/2002/d4227.htm
http://www.planalto.gov.br/ccivil_03/dec...
. Indeed, political positioning itself is a democratic exercise.

In this way, the councilors seem to be unaware of the scope of their role, which is essentially political. Without a proper understanding of their role, councilors will hardly be able to become subjects of politics, instead of objects manipulated by neoliberal hegemonic powers, which naturalize and blame the health conditions of older people linked to the interests of capital77 Duarte AM. Democracia em crise: biopolítica e governamento neoliberal de populações. Educ Filos. 2019;33(68):527-62. https://doi.org/10.14393/REVEDFIL.v33n68a2019-51961
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,1616 Araujo CM, Bitener P. The Great Municipal Council of São Paulo for the Elderly: Challenges to Influence the Public Policy Process. Rev Kairós. 2016;19:73-102.,2727 Dowbor L. A era do capital improdutivo: a nova arquitetura do poder, sob dominação financeira, sequestro da democracia e destruição do planeta. São Paulo: Autonomia Literária; 2017.. Only in this way will it be possible to act to transform, as such a conquest can never exist if the concrete reality is hidden. This lack of preparation was also reflected in the completion of the questionnaire according to the paragraph referring to the limitations of the study. The need for training councilors was also highlighted in a study carried out by the National Front for Strengthening Councils for the Rights of the Older Person (FFC)2828 Frente Nacional de Fortalecimento de Direitos da Pessoa Idosa (Br). I diagnostico nacional dos conselhos de direitos da pessoa idosa. Belo Horizonte: FFC; 2020..

The absence of political positioning and the strangeness of the truths that constitute us sustain a social order disguised as technical objectivity in order to legitimize the hegemonic neoliberal biomedical model, which subsidizes the State's lack of responsibility2929 Haddad EGM. A ideologia da velhice. São Paulo: Cortez Editora; 2017.. Population aging becomes a burden to be carried from the perspective of neoliberal policies. The State is more concerned with managing older people in order to ensure a reduction in health costs than, in fact, with caring for them. The burden of the State, subverted to the care of an unproductive body marked by old age, conditions changes towards a “reprivatization” of old age, which values individual responsibility and blames negligent older people on their bodies, making them solely responsible for diseases or other conditions that may affect them1717 Debert GG, Oliveira GD. Os dilemas da democracia nos Conselhos de Idosos. In: Alcântara AO, Camarano AA, Giacomin KC. Política Nacional do Idoso: velhas e novas questões. Rio de Janeiro: IPEA; 2016.. Generalizing to old age what can be experienced by only a minority of old people and, even more, blaming them for the inability to follow a broad prescription of aging “without old age”, is one of the cruelest paradoxes of productivism.

The neoliberal capitalist imperative distances itself from older people, judging them as impotent and unproductive beings. The social dimensions and natural singularities of the older people are ignored as a perverse counterface of productivity and, moreover, as a pathological state to be treated and, if possible, prevented3030 Fernández Liria C, García Fernández O, Galindo Ferrández H. Escuela o barbarie: Entre el neoliberalismo salvaje y el delirio de la izquierda. Madrid: Akal; 2017.. The market, oblivious to social issues, is still a benchmark for all spheres of life. The principle of depoliticization and isolation is consolidated, tending to individualize what should be the object of collective analyzes and political struggles77 Duarte AM. Democracia em crise: biopolítica e governamento neoliberal de populações. Educ Filos. 2019;33(68):527-62. https://doi.org/10.14393/REVEDFIL.v33n68a2019-51961
https://doi.org/10.14393/REVEDFIL.v33n68...
. This approach seeks to deactivate any initiative that has a political or demanding character3030 Fernández Liria C, García Fernández O, Galindo Ferrández H. Escuela o barbarie: Entre el neoliberalismo salvaje y el delirio de la izquierda. Madrid: Akal; 2017..

However, political polarization has been experienced, further weakening debates that promote participation and social control as instruments of political empowerment3131 Mendonça RF, Domingues LB. Protestos contemporâneos e a crise da democracia. Rev Bras Cienc Polit. 2021;(37):e246424. https://doi.org/10.1590/0103-3352.2022.37.246424
https://doi.org/10.1590/0103-3352.2022.3...
. Otherwise, we are increasingly subjected to a neoliberal ideological institution and, therefore, responsible for everything that happens to us, ignoring the social determinants of health. It is necessary, in fact, to deepen democracy. “But in reality, we really need to rescue it from the caricature it has become”2727 Dowbor L. A era do capital improdutivo: a nova arquitetura do poder, sob dominação financeira, sequestro da democracia e destruição do planeta. São Paulo: Autonomia Literária; 2017. in order to give voice to the divergences, and not only meet the hegemonic neoliberal precepts that are far from the real values, needs and socio-political protagonism of the older person.

In the axis of the questionnaire referring to the performance of the councilors, an attempt was made to evaluate the composition of the council in terms of the number and forms of choices of the civil or public sectors represented, as well as the degree of articulation of the councils with the public power and civil society (details in Table 2).

Table 2
Performance of Municipal Councilors for the Rights of Older People. Natal, RN, 2022.

In general, there is satisfaction on the part of the councilors with regard to the action taken in the face of the issues raised, but there is less satisfaction with the way of choosing the councilors within the social entities, with a margin of non-satisfaction of 27% of the respondents, very similar to the IPEA study1515 Instituto de Pesquisa Econômica Aplicada (Br). O Conselho Nacional dos Direitos do Idoso na Visão de seus Conselheiros: Relatório de Pesquisa Projeto Conselhos Nacionais: perfil e atuação dos conselheiros. Brasília, DF: IPEA; 2012., which had 25% of non-satisfaction of the respondents.

In the axis referring to the functioning of the CMPIs, we list some aspects related to the satisfaction of the councilors, as well as the biggest obstacles, as shown in Tables 3 and 4, in general, we list the main initiatives to promote the effectiveness of the councils.

Differently from the performance axis, in the functioning of municipal councils there were some indicators in which satisfaction was not very predominant. In question 3.1 “Evaluate the influence of the Council's performance in relation to:” the results point to the maintenance of sectoral fragmentation in the structures of the councils' organizations, with a low satisfaction of the councilors in face of intersectoral policies, highlighting the productive, governmental and social sectors.

Intersectoriality is conceptualized as a fundamental strategy to face health problems related to social determinants. The proximity of isolated knowledge, without generating new articulations or prosperity of dialogues, is not able to promote synergistic and lasting solutions2323 Souza MS, Machado CV. Governança, intersetorialidade e participação social na política pública: o Conselho Nacional dos Direitos da Pessoa Idosa. Cienc Saude Colet. 2018;23(10):3189-3200. https://doi.org/10.1590/1413-812320182310.14112018
https://doi.org/10.1590/1413-81232018231...
. The councils end up reaffirming the fragility of intersectoral policies based on the low participation of civil society and government representatives in the meetings. The study carried out by the FFC also observed the need for a more aligned action between the councils themselves in the different governmental, federal, state and municipal levels2828 Frente Nacional de Fortalecimento de Direitos da Pessoa Idosa (Br). I diagnostico nacional dos conselhos de direitos da pessoa idosa. Belo Horizonte: FFC; 2020..

Other aspects were pointed out as obstacles to the functioning of the councils with regard to indicator 3.3, as shown below: “In your opinion, what are the main difficulties and obstacles faced by the council (check a maximum of 3 alternatives, listing from 1 to 3 in order of priority. Where 1 equals the main difficulty and 3 equals an important difficulty, but less priority in relation to the others)", of which we highlight: little time for discussion in meetings; lack of structure; low political priority by the executive; low qualification of civil councilors; low participation of government members in meetings or deliberations and the low representation of the older population. The last two indicators reaffirm the fragility of intersectoral policies while the indicator “low qualification of civil councilors”, endorses the previous discussion related to the characterization of the interviewees.

The short time for discussion may be related to the low divergence of opinions among the councilors. These issues bring to light a culture that tries to hide disagreements and seeks recognition through consensus. Other authors point out that the lack of plurality of ideas in decision-making is related to the low technical capacity of the body of civil society councilors, particularly with regard to knowledge of legislation and the functioning of the state machine2424 Almeida C, Tatagiba L. Os conselhos gestores sob o crivo da política: balanços e perspectivas. Serv. Soc. Soc. 2012;(109):68-92. https://doi.org/10.1590/S0101-66282012000100005
https://doi.org/10.1590/S0101-6628201200...
. Disagreements rarely appear and when they do, they tend to be seen as consequences of vested interests and even the annoyance of certain councilors1717 Debert GG, Oliveira GD. Os dilemas da democracia nos Conselhos de Idosos. In: Alcântara AO, Camarano AA, Giacomin KC. Política Nacional do Idoso: velhas e novas questões. Rio de Janeiro: IPEA; 2016..

As for the aspects associated with the main initiatives to promote greater legitimacy and effectiveness of action in the councils, we highlight the need to develop an evaluation and monitoring through valid instruments, intersectoral actions and the construction of specific policies, which arise from the community reality (details in Table 4).

Table 3
Functioning of Municipal Councils for Older People. Natal, RN, 2022.
Table 4
Main initiatives to promote the effectiveness of the Councils on the Rights of Older People. Natal, RN, 2022.

Questions 4.1 “Are the goals and actions of the councils based on valid indicator systems?” and 4.2 “Are there mechanisms to monitor older people care activities?” are complementary, but they show a certain contradiction of the respondents regarding the understanding of a system of valid indicators, since in question 4.1, 77% of respondents associated the actions of the councils with systems of valid indicators and in item “4.2”, the respondents cited routine monitoring activities, such as: visits, communication, civil whistleblowing, labor gymnastics, home care program, among others, which do not characterize valid evaluation/monitoring instruments. This fact is ratified in sequence by question “4.3”, in which the use of valid instruments is pointed out as one of the most important initiatives to ensure the performance of the councils.

Also in question 4.3, the importance of improving the means of communication and mechanisms to encourage plural participation to promote intersectoriality was also highlighted. Another point highlighted in an intermediate way in question 3.3, but more evident in question 4.3 was the need for tax incentives and financial resources. Questions 4.5 “In your opinion, what would be the most important practice to guarantee the social protection of the older person?” and 4.6 “Do you think that the set of Brazilian laws and norms regarding older people are efficient?” bring a uneasiness of councilors regarding the inefficiency of laws to protect olde people. Public policies must be evaluated and readjusted periodically, since they need to follow the changes that occur in society over time, so that their guidelines become effective22 Giacomin KC, Couto EC. O caráter simbólico dos direitos referentes à velhice na Constituição Federal e no Estatuto do Idoso. Rev Kairós. 2013;16(3):141-60. https://doi.org/10.23925/2176-901X.2013v16i2p141-160
https://doi.org/10.23925/2176-901X.2013v...
. Moreover, in order to meet the health needs and expectations of each community and support its own political agendas, it is necessary to link the informational activity to the autonomy of the places in an ascending way, doing justice to the function of formulating public policies of the councilors so that they are not only mere executors of national policies.

Of the 109 participants, 19 (17.4%) answered the open questions, but there were no innovative facts to what had already been commented. Much praise, nine of which are objectives and related to the research initiative (47.4% of respondents), in addition to specific criticisms to make the questionnaire more succinct, to cover councils in the implementation phase, in addition to questions about what would be a valid indicator although we have been available for any queries. It was also commented on the importance of financial resources for the functioning of the councils and a criticism for having a question about the political position of the councilors, as there seems to be a paradox, since the councilors occupy a political position, but are afraid or uncomfortable to express their positions confidentially.

The study had limitations due to the mistaken understanding of the councilors for completing two questions: in question 3.3, where they were asked to list only three alternatives, listing from 1 to 3 in descending order of priority, from highest to lowest, 13 respondents did not respect the maximum amount and 30, instead of scoring, marked an “x”. Thus, in item 3.3 we scored 2 points for each marking of “x”, the forecast was 3 points for marking 1 (highest priority); 2 points for marking 2 (intermediate priority) and 1 point for marking 3 (lowest priority), however, all markings were considered, even if there were more than three as stated. In item 4.3, mistakes were also noticed in filling out the questionnaire, where 39 people marked more than one item despite the statement requesting only one initiative. Thus, all markings were taken into account, adding 1 point for each marking.

The way of allocating the sample by convenience in a training meeting is also a limitation for the representativeness of the data, however, the final size of the sample is considered relevant in view of the existence of just over 30 active councils. It was also not possible to analyze the participation of different municipalities, as this data was not collected to avoid a possible identification of respondents. Furthermore, it was not possible to establish parameters regarding the characterization, performance and functioning of the councils due to the lack of studies in this context.

FINAL REMARKS

Despite the reported support from the executive branch, it was observed that the structural weakness and the need for qualification and active participation of council members, especially people aged 60 or over and civil society, who had a lower proportion of participation, reflect in a perception that the effectiveness of the set of laws and legal bases is still far from the real needs and expectations of the older person. Thus, the need for efforts towards participatory management and a centrality that involves older people participant in the communities is evident. These mechanisms reposition the relationship between the State and society in the construction of public policies closer to people's reality.

To this end, it is necessary to strengthen the main representative entity of the older person based on some aspects, among which we highlight: a) mandatory executive powers for their creation and guarantee of independence, with the aim of ensuring greater legitimacy and autonomy in their functions; b) training of councilors to carry out their activities; c) development of valid instruments so that they can evaluate, monitor and identify priority indicators for improving the quality of services provided to the older person, considering the different areas of social action and d) consolidation of the transversal principle of intersectoriality in view of the complexity and association of several variables that permeate the sociopolitical protagonism of the older person.

  • The authors declare that there is no conflict in the conception of this work.

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Edited by

Edited by: Maria Helena Rodrigues Galvão

Publication Dates

  • Publication in this collection
    26 June 2023
  • Date of issue
    2023

History

  • Received
    15 Oct 2022
  • Accepted
    26 Apr 2023
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