Partnerships between health systems and civil society can be mutually reinforcing. They do, however, demand greater attention to what happens at the interface between the state and civil society, or between health services and the community.

In terms of mechanisms, the health sector should understand and use a wide range of legal, financial and institutional tools to shape the activities of non-state actors. Examples of these are listed here. These are discussed further in the next section.

In terms of processes, health systems should attend more closely to procedural issues (Cornwall et al., 2000). Some of the most important are listed here.

Policy accountability and partnerships are not simply ends in themselves. Given the high level of inequality and poverty in many countries, does a greater voice for civil society in health enhance equity in health? This is the question we address next.