Despite this, participation remains an important policy goal. It is also a value which informs many of the civic demands relating to health systems. It underlies both civic pressure for greater accountability from public and private health systems and health system concerns for greater responsiveness. It is a feature of health systems that facilitates shared goals and co-ownership amongst service providers and users (Cornwall et al., 2000).

(The next module explores ways of working with civic networks to strengthen participation in health.)