The diverse interests and strengths of different civic groups have to be recognized…

Civil society groups representing health professionals have the longest history of organized involvement in health policy. They also enjoy the strongest legal and institutional links with health systems. Nursing, medical, dental and other practitioner groups significantly influence health systems, through a mix of:

  • formal stakeholder participation
  • technical input
  • political pressure
  • industrial action
  • bilateral lobbying.

The more skilled of the health workers have used their market scarcity to exact concessions that sometimes directly conflict with or reverse public policy (Equinet, 1998).

Sometimes, powerful professional associations and councils advance specific professional interests in conflict with wider health systems or client interests. This triggers both state and civil society intervention to bring consumer and ethical issues into the public domain (Bennett et al., 1995). Equally, where dealings between the state and professional groups are not transparent, consumer lobbies have grown up to safeguard client interests in reforming health systems.



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Enhancing civil society

Priority health problems

Facilitating roles
Interactive exercise

Policy accountability

Equity in health
Responding to communities
The potential for success
Interactive exercise