Last thoughts...

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)


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Strengthening civil-state interactions

Identifying the civic organisations to work with

Working with communities
Supporting information exchange

Other skills
Checking our progress

Interactive exercise