… but with support for the poor so that they can exercise their demands effectively

These innovations represent an important opportunity to locate control over resources at the level of affected communities.

They are, however, based on the assumption that the poorest communities will be able to exercise effective demand over these funds, and be able to negotiate their own interests with powerful bureaucracies and service providers.

This is probably not a fair assumption. Either the state or civil society has historically played an important role in contributing to the community networking and capacities which are needed to do this. Without these skills, it is difficult for communities to identify their needs and suggest suitable programmes, to make organized demands on the funds or to monitor their use.

It is, however, important to ensure that, even while they transfer capacities, neither civil society nor the state take over the community role (Frigenti et al., 1998).


site map
forward and back

Enhancing civil society

Priority health problems

Facilitating roles
Interactive exercise

Policy accountability

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