Increasing Voice in the Health Sector in Rural Bangladesh: Is there a Role for Citizen Participation?

Increasing people’s voice and influence in the health sector is generally believed to be an effective way of improving the perfor- mance of health systems, i.e. in creasing access to services of the most vulnerable and disadvantaged groups, improving health outcomes generally and reducing heal th inequities. Participation of communities in decision making in the health sector, through ownership and implementation of local health services and interventions, is now a widely accepted means of ensuring such influence (Dasgupta et al. 2001, MoHFW 1997). Not only that, by creating public pressure and generating debate, community participation, actually facilitat es the democratic process, reduces the gap between state and citizens and complements state responsibility for ensuring citizen’s right to health and other services. In that respect inform ed and more inclusive community participation is not only good for the health system but also good for promoting citizenship practice and in claiming the right to good health care.