National and global trends
have centralised power in a small tier of political elites and
at the apex of hierarchical bureaucracies. This has led to growing
pressure for public accountability and for the elite to be responsive
to the views of citizens.
In this situation, civil society
offers an organized vehicle - which is complementary to state
structures - for people to exercise citizenship, to confront
poverty, to enhance their well-being and to promote their interests
within the state and private sector.
For the lowest-income and most
vulnerable groups, civil society may be a critical means to give
voice to their experiences, values and interests, or to service
their needs and demands, including those relating to health.