‘Consultation’ or co-option? A case study from the Chilean health sector

Using a macro-meso-micro framework this paper examines the shifts in the hegemonic development model and the implementation of new participatory mechanisms. It argues that despite macro-level policy shifts, in the Chilean context, the implementation of these mechanisms at the meso- and micro-levels has limited opportunities for citizen input into policy-making processes. The analysis focuses on citizen engagement with the machinery of participation and argues that the co-option of NGOs and civil society groups by the state has meant that there has been little real challenge to the implementation from civil society and policy-making remains a top-down process.