[Re: https://www.hifa.org/dgroups-rss/role-civil-society-strengthening-eviden... ]
Dear Neil and Unni,
Inclusive, responsive and accountable decision-making is vital to achieving sustainable health systems strengthening (HSS) and Universal Health Coverage (UHC) across Africa and other developing economies of the Global South. Civil society organisations (CSOs) and community groups connect formal health systems with the populations they serve. When effectively engaged, they improve service design and accountability.
INCLUSION BEGINS WITH STRUCTURED REPRESENTATION
Governments and donors should institutionalise community advisory boards, participatory budgeting forums and regular stakeholder consultations that intentionally include marginalised groups — women, youth, persons with disabilities, informal workers and rural households. These platforms must be anchored in policy instruments that guarantee CSO roles in planning, monitoring and evaluation rather than token attendance.
RESPONSIVENESS REQUIRES INVESTMENTS IN CAPACITY AND SYSTEMS
CSOs and community health committees need training in health policy literacy, data use and advocacy, and modest operational funding to sustain participation. Community scorecards and mobile reporting can democratise information, allowing communities to identify gaps and track services. Health authorities must integrate feedback into planning cycles and report how inputs shaped decisions to build trust.
ACCOUNTABILITY DEPENDS ON TRANSPARENT INFORMATION FLOWS AND ENFORCEABLE OVERSIGHT
Publish budgets, procurement plans and performance indicators in accessible formats and local languages. Strengthen social accountability mechanisms — citizen report cards, community audits and public hearings — and connect findings to independent oversight bodies. Donors and governments should encourage direct funding to local CSOs and require evidence of community engagement in programme evaluations.
Partnerships between CSOs, academia and local government can co-produce relevant evidence. Support for decentralised data systems that aggregate community health metrics will ensure local realities inform national dashboards and resource allocation. Equitable funding practices — multi-year grants and simplified reporting — help redress power imbalances between international actors and local organisations.
CULTURAL COMPETENCE AND TRUST ARE NON-NEGOTIABLE
Programmes must respect local norms while using dialogue to address harmful practices. When communities see their priorities reflected in policy and improved services, legitimacy increases.
Transforming decision-making for HSS and UHC is both technical and political. By institutionalising participation, investing in capacity, enforcing transparency and rebalancing power, countries in Africa and the Global South can make their health systems inclusive, responsive and accountable to the people they serve.
Dr. Uzodinma Adirieje, FAHOA
Global Health and Dev’t Projects Consultant | Conferences Organizer | Trainer| Facilitator | Researcher | M&E Expert | Civil Society Leader | Policy Advocate
CEO & Permanent Representative,
Afrihealth Optonet Association (AHOA) – CSOs global Network & Think-tank
+2348034725905 /
afrepton@gmail.com / ceo@afrihealthcsos.org / X: twitter.com/druzoadirieje
https://www.afrihealthcsos.org, https://druzodinmadirieje.blogspot.com
LinkedIn: https://ng.linkedin.com/pub/dir/Dr.+Uzodinma/Adirieje
HIFA Profile: Dr. Uzodinma Adirieje is a leading voice in health education, community health, and advocacy, with decades of experience advancing people-centered development across Africa and beyond. His approach to health education emphasizes participatory learning, knowledge transfer, and behavior change communication, ensuring that individuals and communities gain the skills and awareness to make informed decisions about their health. He develops and delivers innovative health promotion strategies tailored to local realities, particularly in resource-limited settings. In community health, Dr. Adirieje has championed integrated primary health care, preventive medicine, and grassroots health initiatives. Through Afrihealth Optonet Association (AHOA), which he leads, he connects civil society, community groups, and health institutions to strengthen healthcare delivery, tackle health inequities, and improve access to essential services for vulnerable populations. His work addresses infectious diseases, maternal and child health, nutrition, climate and health, environmental health, and emerging public health challenges. As a passionate advocate, Dr. Adirieje works with governments, NGOs, and international organizations to influence health policy, mobilize resources, and promote sustainable development goals (SDGs). He amplifies community voices, ensuring that health systems are inclusive, accountable, and responsive. His advocacy extends beyond health to governance, environment, and social justice, positioning him as a multidisciplinary leader shaping healthier and more equitable societies. afrepton AT gmail.com