This article addresses strategies to inform and engage the public in policy development and implementation. The importance of engaging the public (both patients and citizens) at all levels of health systems is widely recognised. They are the ultimate recipients of the desirable and undesirable impacts of public policies, and many governments and organisations have acknowledged the value of engaging them in evidence-informed policy development. The potential benefits of doing this include the establishment of policies that include their ideas and address their concerns, the improved implementation of policies, improved health services, and better health. Public engagement can also be viewed as a goal in itself by encouraging participative democracy, public accountability and transparency. The article suggests three questions that can be considered with regard to public participation strategies: What strategies can be used when working with the mass media to inform the public about policy development and implementation? What strategies can be used when working with civil society groups to inform and engage them in policy development and implementation? What methods can be used to involve consumers in policy development and implementation?
Governance and participation in health
This essay begins by describing various areas of volunteering, such as volunteering to build social capital and skills-based volunteering, where volunteers offers specific skills, such as medical skills. It goes on to outline the benefits of volunteering. Volunteering contributes to the development agenda by strengthening the voice of civil society organisations so they can influence policy, both at local and national levels, for the promotion of sustainable development and the improvement of livelihood security. Volunteering also helps to support communities to participate in development at local and national levels, as well as support communities to gain access to resources for local development and the improvement of essential services and to respond effectively to the HIV pandemic through programmes of prevention, care and support. Volunteering can support communities to realise their human rights, especially those of women and children.
In varying degrees, most developing regions have formally embraced the democracy and development agenda and recognised the ‘democratic advantage’ in terms of delivering development. In Africa, a stream of policy declarations have been issued, pointing to the positive links between democracy and development. Both the NEPAD and the Africa Peer Review Mechanism (APRM) are premised on this belief. This analysis confirms that there are few dissenting voices when it comes to formally recognising the potential added value of democracy for development. Yet do these high expectations resist the test of reality? How do democratic processes actually operate in third countries? Admittedly, the impact of democracy on development is not simple and straightforward. Challenges include the current trend for democracy to be on the defensive, doubts about the delivery capacity of democracy and the difficulty of initiating and continuing dialogue on democracy. This paper offers key insights on the link between democracy and development.
This review seeks to detail recent initiatives by non-governmental organisations (NGOs) and civil society organisations in improving development practice. There are several attempts to provide a ‘civil society or NGO’ parallel to the Paris Declaration. These initiatives seek some form of standardisation and evidence that NGOs are as effective as they claim to be, and to counter criticism that they have not been diligent in ensuring the quality of their delivery. However, seeking to justify oneself is not the best use of time and resources. Accountability needs to be improved. The survey indicated that many of the initiatives do not go far down the route of participation, despite a theoretical (rhetorical) commitment to beneficiary participation. Improved quality control is also required. Some of the models now available seek to improve the quality of delivery rather than the quality of impact. Thus an emphasis on things like complaints procedures, transparent, consistent and shared procedures, deal with how aid is delivered not what is delivered and whether it has any real impact. Regular assessments of efficiency, effectiveness and impact should be done. However, efficiency is not the same as effectiveness or impact. Improved efficiency does not automatically lead to more effective development or greater impact.
The 2009 edition of the Right to Food and Nutrition Watch focuses on the question: ‘Who controls the governance of the world food system?’ For the first time in history, the number of undernourished people in the world has surpassed the tragic figure of one billion. The gap between promises and reality is increasing as the international community and national governments are far from realising the World Food Summit targets to halve the proportion of chronically hungry people in the world by the year 2015. It is clear that the global governance of the world food system needs to be remodelled in order to effectively overcome hunger and its causes. As an evidence-providing monitoring tool, this book pursues two aims: to put public pressure on policy makers at national and international levels to take the human right to food seriously and to provide a systematic compilation of best practices for the realisation of the right to food, while documenting where violations take place.
This brief asserts that research relating to humanitarian crises has largely focused on what international aid agencies and donor governments do in response to disasters. Instead, this paper focuses on the role of the affected state in responding to the needs of its own citizens. It found that one of the goals of international humanitarian actors should always be to encourage and support states to fulfil their responsibilities to assist and protect their own citizens in times of disaster. Too often, aid agencies have neglected the central role of the state, and neutrality and independence have been taken as shorthand for disengagement from state structures, rather than as necessitating principled engagement with them. States should invest their own resources in assisting and protecting their citizens in disasters, both because it is the humane thing to do and because it can be politically popular and economically effective. The roles and responsibilities of states in relation to humanitarian aid are four-fold: they are responsible for 'calling' a crisis and inviting international aid; they provide assistance and protection for themselves; they are responsible for monitoring and coordinating external assistance; and they set the regulatory and legal frameworks governing assistance.
This briefing paper aims to distil the core questions which the fragile states literature and experiences in fragile states present, with the aim of structuring space for discussion of these issues in non-governmental organisation (NGO) practice and exploring directions for further research. It found that networks are not guaranteed to work better solely by having increased resources and in many cases are not a genuine solution. NGOs must work in and strive to ameliorate the environment of mistrust through building trust and social cohesion at a community level. Underlying all fragile states discussion must be a thorough and continuous contextual analysis, as cases of fragility vary greatly and are individually extremely dynamic. There is clearly a need for civil society to innovate and pursue alternative solutions in fragile states where traditional methods do not seem to be working. The challenge for civil society is to engage more effectively in policy dialogue on fragile stages, building on their programmatic experience of working directly with poor communities.
This study sought to determine the best approach of integrating community interventions for TB control. It evaluated the records of 3,110 new TB patients registered in three Local Service Areas (LSAs), from quarter 1 2004 to quarter 4 2005. It found that bacteriological coverage, smear conversion and treatment success rates dropped in the interventional LSA, while the control LSAs remained consistent. The defaulter rates dropped in all LSAs, while the proportion of unevaluated cases increased in the interventional LSA. However, patients registered in the clinics had better chance of successful treatment outcome compared to their hospital counterparts. The study concluded that community participation by itself is not adequate to improve the performance of a TB control programme. Enhancement of the program’s technical and organisational capacity is crucial, prior to engaging purely community interventions. Failure to observe this logical relationship would ultimately result in suboptimal performance. Therefore, the process of entrusting communities with more responsibility in TB control should be gradual and take cognisance of the various health system factors.
In the last several years, a democratic boom has given way to a democratic recession. Between 1985 and 1995, scores of countries made the transition to democracy, bringing widespread euphoria about democracy's future, but more recently, democracy has retreated in some. These developments, along with the growing power of China and Russia, have led many observers to argue that democracy has reached its high-water mark and is no longer on the rise. The authors argue that that conclusion is mistaken and that the underlying conditions of societies around the world point to a more complicated reality. They note that it is unrealistic to assume that democratic institutions can be set up easily, almost anywhere, at any time. The conditions conducive to democracy, it is argued, can and do emerge – and the process of ‘modernisation’ advances them. Once set in motion, it tends to penetrate all aspects of life, creating a self-reinforcing process that transforms social life and political institutions, bringing rising mass participation in politics and – in the long run – making the establishment of democratic political institutions increasingly likely.
The People’s Health Movement (PHM), a world-wide civil society network, has a series of concerns about the World Health Summit (WHS), which is being planned as an annual event. Although the summit speaks of participation of nongovernmental organisations (NGOs), the costs ranging between 290–490 Euro for NGOs will exclude those that could legitimately reflect the voices and needs of grassroots and marginalised communities. The summit is also by invitation only, which suggests that NGO participation will be hand-picked and limited. PHM believes that, rather than creating a parallel policy forum, efforts and resources should be spent strengthening the World Health Organization (WHO) as the international coordinating body for issues related to people's health. WHO is one of the United Nation organisations in which each country has a voice. WHO thus provides a reasonably democratic decision making process, despite mechanisms used by powerful member states to direct the decisions. We are concerned that the declaration of the World Health Summit is likely to preferentially represent the interests of the Global North, corporations and those who financially sponsor the Summit.