Colombia has moved slowly and partially fromrepresentative to participatory democracy, facing resistance from various segments of society. Todays, the issues related to estrengthening citizen participation have acquired a legitimacy of a macroeconomic and managerial nature in the administration of public resources. This has become a first-class democratic alternative, allowing for the inclusion in different forums of the various points of view about the problems that concern to the citizens and promoting social agreement in the territory and/or segment levels. It is not just a governing style, but also a technical instrument for decision making with a competitive edge resulting in a desirable outcome when compared with the traditional bureaucratic and paternalist ways of carrying out public management. The political science may contribute in this regard by, among others, introducing the participatory dimension in plans, programs, and projects for preventive and promotional health intervention in communities; identifiying some of the main uderground resistance to participation; and suggesting the strategies to face them. Tather than emphasizing on decentratlization rules and consultant committes, it would be more convenient to incorporate a new thougth by the professionals that make decisions on improvement, coverage, and access conditions for the population to an essential human right as health.