THEME 1

Community action in governance and accountability for health systems strengthening

The 1978 Alma Ata Declaration of Health located community participation as integral to redefining health as a human right for all and as a fundamental principle for achieving it through the pathway of comprehensive primary health care. The discussion on the universality of accessible and affordable care has continued through policy approaches such as Universal Health Coverage, Millennium Development Goals (MDGs) and SDGs. Despite these advances alienation of communities has continued in several ways. On the one hand, the commercialisation of health care is undermining the gains of the Alma Ata. On the other hand, States have continuously failed to ensure citizen participation in planning, budgeting, implementation and oversight of the health services resulting in real needs and priorities of citizens - especially poor and vulnerable communities - being left out. Quite often, accountability deficits experienced in the community, are created in the global alignments of private and non-state actors who wield undue influence on global and national health governance. The dominant accountability discourses have not taken into account such local – global linkages in accountability deficits

The COPASAH Symposium seeks to centre-stage the transformative potential of the power of the communities rather than seeing social accountability as merely a tokenistic participation of the community. The Symposium positions communities and civil society at large as central to the governance and accountability of health systems (both public and private). It emphasises on community empowerment and transformation of the iniquitous power relations between the community and health systems. The Symposium will be a unique platform and opportunity for learning, exchange and knowledge building from practice. Such stories and strategies could include multi-level accountability practice (from community to local, national, regional and global levels), multi-sectoral efforts (both public and private sector accountability), multi-dimensional practice (e.g. budget watch, policy interventions, gender audits, social audits, WHO watch) and such other efforts for strengthening community centred policies and health systems to realise Health for All.

Sub-themes:

• The mechanics and processes of community action: This could include experiences of organising people, leadership building, strengthening collectives, building capacity for claiming rights, strengthening institutions for accountability etc.
• Innovations in community led accountability measures for health systems strengthening: Modalities of community action and health system engagement in the digital era (use of ICT for accountability), in conflict situations, emergencies, fragile settings etc.
• Role of the communities in multi-level and multi-sectoral accountability practice: such as in mandated committees in health care systems.
• Community action and innovations in emerging themes: such as resource (budgetary) allocations, accountability of private-commercial health care providers, and other determinants of health such as environment and nutrition confronting anti-democratic and anti-people policies impacting health.