Civil society is one of the
three arms of society. Health systems cannot ignore civil organizations
in the changing political and economic environment of the 21st
century. The health sector is increasingly setting itself goals
of greater participation, improved governance, accountability,
cofinancing and partnership in its models of health systems.
But it has paid inadequate attention to achieving these goals
in a manner that enhances successful outcomes. Civil society
itself is exerting pressure for a greater role. Yet there are
examples of how civil society can play a more effective role
within health systems, in dealing with major public health problems,
in enhancing accountability, in promoting equity goals and pro-poor
policies and programmes, and in monitoring and enhancing the
quality and responsiveness of health systems. There are tools
that can be used and capacities that need to be developed for
this. There are also civil society partners who can assist in
this. Civil society can offer a vehicle for technical knowledge,
services and resources to reach marginalized communities.
Is it worth the effort? This
is perhaps answered by a quote from one civil society programme
in Asia:
"In a world beset by
vicious cycles and downward ecological, economic and political
spirals, we can use some virtuous cycles and upward spirals in
which the 'poor get richer.'"
(Brown
& Ashram, 1996) |