Questions need to be asked about the way these choices are made.

How do those who bear the consequences of these choices participate in making them?

Are health systems making the best use of civil society for meeting public expectations over health?

Public and civil involvement in health systems has in the past been structured around concepts of:

• participation or community involvement in health systems
• public contributions to health
• decentralization of the governance of health systems.

What have been people's experiences with these approaches? In this module, we will explore all three issues.