How can civil society roles in health be enhanced?

The roles of civil society extend across all dimensions of health systems. Interactions between the state and its citizens are a basis for major public health actions and help to shape and enforce public health standards. Civil society complements health services, particularly in mounting responses to urgent health problems such as HIV/AIDS. Civil society is especially valuable in its ability to organize social action for health. Some civic organizations provide health services. State and non-state services should therefore be better coordinated, and complementary civil-state roles should be more clearly identified.

What contribution does civil society make to dealing with priority health problems?
Civil society can contribute to managing public health problems in a number of ways. It is important, however, that the health sector does not promote 'from the top' any roles that it wants civil society to take. There must first be dialogue with civic stakeholders.

What do health services need to do to facilitate civil society roles?
Health systems need to accommodate community perceptions and roles. Health personnel need to understand how civil roles can challenge health service roles and performance. The health sector needs to use client centred approaches and to provide incentives for health staff to build positive interactions.

What role does civil society play in strengthening accountability over policy in health systems?
Civil society involvement can enhance policy accountability, but needs to be backed by access to information. The diverse interests and strengths of different civic groups have to be recognized so that the poor are not excluded. Civil society also plays a role in international policy debates.