Chapter overview on ensuring sustained participatory engagement over time.

What do we mean by this topic?

•  Participatory mechanisms in health take time to set up and become functional

•  Examples of such mechanisms are: Thailand’s National Health Assembly, Portugal’s Health Council, Tunisia’s Societal Dialogue for Health, many community mobilization efforts at local levels to improve district service delivery, etc.

•  Once these mechanisms are established, countries are faced with the challenge of keeping populations, communities, and civil society motivated to stay engaged

•  We thus seek to understand how participatory engagement can be sustained over a longer time period.

Why is it important for policy-makers to address this topic?

•   Participation in consultation mechanisms is largely voluntary

•   Volunteers can easily lose their motivation to stay engaged over a longer-term period, or may not prioritize their free time for participation-related activities

•   Participatory mechanisms themselves can only be sustained and embedded as part of the DNA of the health sector if those who participate in them continue to be willing to participate

Selected key messages

•   Using existing participatory structures at local, regional, and national level can help sustain engagement for a longer time period. However, good intelligence is needed on which groups and organizations are truly respected by and represent the community.

•   Formal and institutionalized mechanisms for participation can give both a funding and capacity boost to existing and new community groups and civil society. In many countries, this formalization has come via administrative decentralization processes, an opportunity which can be leveraged more for increasing participation levels and maintaining them over time.

•   Independent community and civil society funding to help amplify people’s voice and pursue community- focused objectives can be facilitated by governments, with the caveat that it might need more regulation and governance capacity in government institutions.

•   Population, communities, and civil society are motivated by seeing the fruits of their efforts. When participatory platforms are designed to genuinely listen to people’s voice and take them into account, then results are more likely visible to those participating. This is a real motivating factor to continue participating.

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