Social participation in decision-making processes is essential for ensuring that health policies are responsive, equitable and effective. As such, it must be a priority reform in accelerating progress towards universal health coverage (UHC) and health security. Member States of the World Health Organization (WHO) acknowledged the importance of inclusive and participatory health governance in the Political Declaration of the High-level Meeting on UHC in 2019, and in the Executive Board resolution to prepare for the second High-level Meeting on UHC in 2023 (EB152/5). But despite these endorsements, political will for implementing social participation remains weak, and all countries could do more to institutionalize and strengthen participation in decision-making for health.

Key messages

  • Social participation means involving people, communities and civil society in decision-making processes.

  • In the 2019 Political Declaration on Universal Health Coverage, WHO Member States stated the importance and relevance of the principle of social participation in health governance. This has been reiterated in EB152/2 to inform the second High-level Meeting on UHC in September 2023.

  • The principle of social participation has not been adequately translated into practice, with countries’ experiences often ad-hoc and fragmented, seldom influencing health policy design.

  • Most government health institutions are well equipped with medical and technical skills but face a capacity deficit for facilitating social participation, such as expertise in designing and executing participatory spaces that foster meaningful interaction and can influence decisions that are made. This has been particularly evident in the response to the COVID-19 pandemic, where many governments struggled to bring in community voices systematically, resulting in mistrust and the spread of misinformation at times.

  • The upcoming High-level Meetings on Universal Health Coverage and Pandemic Prevention, Preparedness and Response, should identify institutionalizing mechanisms for social participation as a priority reform for Member States to bring about more responsive, equitable and effective health policies that accelerate progress towards UHC and health security. Such mechanisms foster trust with the population, and can be leveraged in the context of an emergency


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