In recent years there has been a major shift in attitudes to community involvement in health care. Approaches that saw communities primarily as passive recipients of health care have given way to those which seek to make more of the potential that more active community participation might offer for enhanced accountability and improved responsiveness of services. With this shift has come a greater emphasis on issues of governance and on institutional dimensions of participation, whilst the introduction of partnership models in the health sector has further increased debates about participation in health care. In 1999 the IDS Participation and Health and Social Change groups convened a workshop to share experiences of the use of participatory approaches in enhancing accountability in the health sector and to explore some of these challenges. The fifteen articles in this Bulletin reflect some of the richness of experience on the ground in building effective participation as well as some of the many issues that arise in moving towards more active citizen engagement with service provision. They draw experience from current work in countries such as Zimbabwe, Cambodia, China, Nepal, Zambia and Pakistan to reflect on links between participation, accountability and improvements in health.
This edition of the IDS Bulletin features papers by researchers and practitioners associated with the Development Research Centre on Citizenship, Participation and Accountability (Citizenship DRC), an international research partnership dedicated to exploring the new forms of citizenship which are needed to make rights real for poor people.|The Citizenship DRC brings together over 50 researchers from research institutions and civil society groups based in Bangladesh, Brazil, India, Mexico, Nigeria, South Africa and the U.K. It encourages collaborative work across national, institutional and disciplinary boundaries. Researchers have formed thematic working groups, and each group has its own website to share experiences.|This issue is split into the following sections:|1. Meanings and Expressions of Rights and Citizenship: - Citizenship, Affiliation and Exclusion: Perspectives from the South - Agendas in Encountering Citizens in the Nigerian Context - Making Rights Real in Bangladesh through Collective Citizen Action - Citizenship, Science and Risk: Conceptualising Relationships across Issues and Settings|2. Concepts and Practices of Participation: - Locating Citizen Participation - Linking Citizenship, Participation and Accountability: A Perspective from PRIA - Deliberative Fora and the Democratisation of Social Policies in Brazil - Citizenship and the 'Right to Education': Perspectives from the Indian Context - Participation of Indigenous and Rural People in the Construction of Developmental and Environmental Public Policies in Mexico|3. Dimensions of Accountability: - From Responsibility to Citizenship? Corporate Accountability for Development - Who speaks for Whom? A look at civil society Accountability in Bioprospecting Debates in Mexico