There have been many examples of community involvement in health. These have predominantly taken the form of either community involvement in state health programmes or NGOs acting as service providers. In Asia and Latin America, civic organizations have been involved in mobilizing effective demand for services, building awareness of community needs and experimenting with innovative approaches that can be replicated by the state sector.

Primary health care is perhaps the best example of an approach that was initially pioneered by NGOs and then taken up by government agencies. In Africa, where new injections of resources have been made available through debt relief, civil society organizations have worked with state structures to use evidence-led planning and community preferences in order to select priorities for intervention (Reid & Kasale, 2000).

The most common NGO service providers have been the churches, particularly in rural health services in Africa (see box). Examples of community group involvement include forming community health groups or water user groups, or setting up community home-based care initiatives.