While the patient rights charters are a necessary intervention, they are often not sufficient. More proactive and collective approaches are needed to ensure quality of care and responsive health systems.

Civic networks have proactively surveyed and raised issues that reflect community and client satisfaction with health services, such as:

• ease of access to the service
• speed of delivery
• complexity of the procedures required to obtain services
• attitude of service providers
• transparency in handling cases
• adequacy or reliability of information on the service
• conditions of the hosting facility
• safety and security arrangements, especially for money.