GENERATING MOMENTUM TOWARDS COMMUNITY ROLES IN UNIVERSAL HEALTH COVERAGE: KEY OUTCOMES OF A SERIES OF STATE-CIVIL SOCIETY CONSULTATIVE PROCESSES

The main challenge for a sustainability transition is to scale up successful solutions. Upscaling requires coalitions of public, private, and civil society actors who align their motivations. Pathways to upscaling may involve leveraging a dominant player's market power, integrating successful initiatives into public policy, or reinforcing government-led change with private efforts. Various actors agree to collaborate to take advantage of their complementary capabilities, e.g., government policies facilitate private action, market incentives reward progressive actors while government sanctions punish laggards, actors take up different tasks of the policy cycle, and large players absorb and disseminate pioneer efforts. To achieve durable impacts, the upscaling of solutions to reach sustainability must continually maintain a balance of incentives among key actors. We identify general lessons for successful upscaling that provide insights on the importance of motivating actors, designing collaborations for lasting success, and incorporating concerns of developing countries.

Restricting NGOs: From Pushback to Accommodation

Background In the pursuit of Universal Health Coverage (UHC), Community Action for Health (CAH) is considered a crucial strategy. CAH is when communities define healthcare priorities and monitor the effectiveness of health reforms. Globally, CAH has shown improved health literacy, population outcomes, strengthened health systems. In India, CAH has a long history, is integrated into the National Rural Health Mission and National Health Policy and yet, remains under-resourced and under-researched, posing challenges to both sustainability and scale-up. Promoting Community Action for Health- A Co-Produced, Technology-Enabled Platform to Achieve National Goals, or PATANG is a partnership between academic and civil society entities who have experience and interest in CAH. Methods We will employ a mixed-methods, realist-informed, co-production approach across multiple Indian states to 1) synthesise evidence on various CAH approaches, 2) coproduce a learning platform for knowledge sharing and network building, and 3) assess the platform's impact from the perspectives of civil society, community, and state actors. Under aim 1, we will conduct realist synthesis and critical discourse analysis to explore the contexts, mechanisms, costs and outcomes of CAH initiatives, supplemented by witness seminars and key informant interviews with state and civil society actors. Under aim 2, these insights will inform the co-production of the PATANG platform, comprising multilingual resources, tools, and exchanges that foster collaboration and knowledge-sharing between civil society, community and government actors across the country. Under aim 3, the platform will be evaluated using a mixed-methods, interrupted time series quasi-experimental design outcomes related to health literacy, service utilisation, empowerment, and community engagement. Conclusions PATANG aims to generate actionable insights on scalable CAH tools and practices, provide replicable frameworks, and strengthen collaboration between civil society and government actors. By bridging evidence gaps, PATANG will contribute to reinvigorating CAH as a critical lever for UHC and health equity in India.

Universal health coverage post-2015: putting people first

In 2018, a mass uprising, known as the Velvet Revolution, ousted an unpopular semi-authoritarian government in Armenia. The new government vowed rapid democratization through ambitious reforms. Key civil society actors enthusiastically supported the shift in the political atmosphere, embracing the post-uprising window of opportunity to engage with the new government and push for democratic consolidation in their respective areas of expertise. This paper examines anti-corruption and judicial reforms in post-revolutionary Armenia, focusing on the role of civil society actors in maintaining the pro-democratic momentum. The paper investigates the following research question: “What was the role of civil society organizations in anti-corruption and judicial reforms in Armenia after the 2018 Velvet Revolution?” We rely on document analysis and qualitative interviews with civil society representatives, policy experts and government officials to argue that the strength of civil society and availability of allies partially explain the differences in anti-corruption and judicial reform processes and outcomes. In the anti-corruption case, the main actors (the government, prominent civil society organizations, and the EU) were more or less “on the same page.” In the case of the judicial reform, there were strong divisions of opinion among civil society organizations, local and international experts. The findings contribute to broader understanding of the role of civil society in the early years of democratic transition.

A comprehensive examination of the European public sphere must consider Europeanization from below, of, and by civil society. As Jurgen Habermas argues, civil society has a key role to play in a democratic public sphere: civil society actors at the periphery of the formal political arena have the potential to bring new groups of citizens into the political debate and to highlight problems that may become central to the agenda (Habermas 1996c). If this potential were undermined, it would seriously exacerbate the democratic deficit in the European Union (EU) (Habermas 2006c). This chapter takes stock of the European public sphere with a focus on organized civil society and civil-society actors’ digital communication beyond the mass media. Earlier studies have found that civil society is weakly represented in the European public sphere, leading to concerns about the lack of broad public engagement or citizen-level political contention. When the capacity of the (national) mass media to employ Europeanized frames and attend to transnational issues or actors is analyzed, the picture that emerges is an issue-driven European sphere in which a few issues or claim makers may reach different national media using similar frames during common periods. However, there is little civil society in this picture: claims are overwhelmingly made by elites who communicate to largely passive audiences. For example, when the European financial crisis erupted in 2010, national papers across the EU were filled with similar pronouncements from various officials, including national leaders such as German Chancellor Angela Merkel and EU officials such as the head of the European Central Bank. Civil society tends to be sketched in terms of voters in Greece or demonstrators in Spain, with few concrete authoritative claims attached. Beyond demonstrations and elections, there is little in the way of media characterizations of broader public engagement with the crisis and other policy issues that cut across both EU and national-governance processes. The question is whether civil society engagement in European public spheres is weak in itself or whether it is simply not captured in these analyses of mass-media content. We suggest that part of the answer may be the latter possibility. To analyze civil society dimensions of European public spheres, it makes sense to look beyond the mass media to the increasingly common alternative forms of public communication that civil society actors utilize.

Civil Society Organisations have become influential actors in the global health arena and thus an understanding of who they are, their legitimacy, roles and the tensions they face is crucial to understanding global health governance. This chapter describes the growing role of Civil Society Organisations in global health governance. The first sections define the term Civil Society and then discuss the different types of organisation which may be regarded as Civil Society actors and their strengths and weaknesses. The following sections describe the roles that are played in global health diplomacy by these different actors with case study examples of the way Civil Society can shape global health through engagement in international meetings, championing specific causes and holding government and international agencies to account. In many cases Civil Society actors provide a vital link between the discourse on global health issues at international and national levels and the concerns and contributions of ordinary citizens. This Public Diplomacy function is described as a vital component of global health governance. The chapter concludes with some thoughts on the tensions Civil Society Organisations face and how their roles can be enhanced in the future architecture of global health governance.

Author's Introduction Civil society has become one of the most popular concepts within international development discourses. But, what is civil society? Civil society is defined as an arena of collective social interaction situated between the state, market and household, encompassing a range of non‐state organisations, groups and associations, including non‐governmental organisations (NGOs). The article assesses the range of different interpretations of civil society highlighting its diverse makeup at local, national and transnational scales. Why has civil society become so important within international development? Democracy and delivery of services . As people organised collectively against totalitarian regimes in the former Soviet Union, Eastern Europe and the Global South, civil society emerged as a manifestation of democratisation processes. The neoliberal agenda also wanted to capture and channel civil society to foster democracy, but also to take on service delivery functions as the role of the state diminished. This article outlines how these roles relate to two theoretical viewpoints – the Marxist or Gramscian that sees civil society as a site of resistance and counterhegemony, and the liberal democratic that views it as a beneficial force for good. Civil society in practice. In the 1990s, development agencies championed civil society from an undertheorised liberal democratic viewpoint as a saviour or ‘magic bullet’ as it channels more and more funds via NGOs. But, civil society has increasingly been criticised as undemocratic, unable to reach the poor and unaccountable. This article describes this evolution. The emergence of global or transnational society . In these days of globalisation, global civil society is increasingly important. This is neither civil society at a global level, nor is it a unified global force for good, lobbying and challenging the neoliberal order. Instead, viewed as ‘transnational civil society’, it is a complex mix of competing, overlapping and intersecting groups that operate beyond national borders for a range of reasons. Especially important actors in transnational civil society are diasporic civil society groups in the form of migrant associations. This article argues that as international migration increases, these groups are growing in economic, social and political importance, yet we do not know very much about them. Author Recommends Anheier, H., Glasius, M., and Kaldor, M. (eds) (2004). Global civil society 2004/5. London: Sage. This book is one of the annual reports on the nature of global civil society produced by the Centre for the Study of Global Governance at the London School of Economics. It has a range of interesting articles and is available to download at http://lse.ac.uk/Depts/global/yearbook04chapters.htm Howell, J., and Pearce, J. (2001). Civil society and development: a critical exploration. London: Lynne Rienner. This book provides an excellent overview of the theoretical and empirical debates about civil society at a national level. It provides a range of examples from around the developing world. Lewis, D., and Opoku‐Mensah, P. (2006). Moving forward research agendas on international NGOs: theory, agency and context. Journal of International Development 18, pp. 665–675. This article is an engaging review of the main themes revolving around civil society and development in relation to international NGOs in particular. Mercer, C. (2002). NGOs, civil society and democratization: a critical review of the literature. Progress in Development Studies 2, pp. 5–22. This article is an excellent state‐of‐the‐art review of the relationships between civil society and democratisation from a development perspective. It outlines the main theoretical approaches and assesses them in relation to development policy. Mitlin, D., Hickey, S., and Bebbington, A. (2007). Reclaiming development? NGOs and the challenge of alternatives. World Development 35 (10), pp. 1699–1720. This article outlines the issue of why NGOs have been so popular with development agencies and why this popularity is on the wane. Mohan, G. (2002). The disappointments of civil society: the politics of NGO intervention in northern Ghana. Political Geography 21, pp. 125–154. This article outlines the main thinking about civil society and then illustrates it with an interesting case study from Ghana. Munck, R. (2007). Global civil society: royal road or slippery path? Voluntas: International Journal of Voluntary and Nonprofit Organizations 17, pp. 325–332. This article is one of the most‐up‐to‐date accounts on the advantages and disadvantages of global civil society. Useful Links http://www.jhu.edu/~ccss/ website of the Centre for Civil Society, Johns Hopkins University, Baltimore, MD, USA. This site reports on policy‐related research on civil society and other more practically oriented projects. http://www.lse.ac.uk/collections/CCS/ website of the Centre for Civil Society, London School of Economics and Political Science, London, UK. This site publishes a range of research papers on civil society and runs academic events. http://www.nu.ac.za/ccs/</jats:ext-lin

Restriction of civic space is widely understood as a condition that constrains the autonomous role of civil society organizations. However, this conceptualization is delimiting. This paper explores civic space as constituted in the dynamics between civil society organizations and state actors, contributing to an emergent shift to a more processual, relational and agential understanding of civic space, involving a redefining of civil society roles by state and civil society actors acting and reacting within their everyday work. We explore the case of India. Based on 36 interviews with state and civil society actors, the paper. shows how the state marginalizes civil society through three pathways: delegitimation, displacement and repurposing. A fourth pattern, however, qualifies this marginalization: political roles for civil society continue to be sought and found, depending on situations and the specific actors involved, based on their interpretations and political advantages at stake for them. The broader significance of these findings is, first, that everyday understanding and experience of civic space may prominently revolve around changes in civil society roles. Second, these changes in roles may best be understood at the level of concrete cases of relating and political contention, doing justice to the agency of the actors involved.

The role of Civil Society Organizations (CSOs) in pursuing accountability for atrocity crimes through international law is more diverse than ever before, and the breadth of CSO activities and the modalities of their engagement with international justice institutions has been overlooked in the scholarship to date. This article explores various CSO approaches to advancing accountability, including at the International Court of Justice (ICJ), International Criminal Court (ICC), investigative mechanisms (for Syria, Myanmar, and Iraq), and selected United Nations treaty bodies and regional human rights courts. Civil society actors take on many roles, including as advocates, documenters, analysts, victims’ representatives, and international law experts. While often described as indispensable to international justice efforts, the relationship between civil society and formal justice mechanisms remains novel and can feel incongruous with traditional and ostensibly independent and impartial legal processes. This is evolving as CSOs enter traditional international justice spaces in diverse ways. This article provides a framework to understand the modalities of CSO engagement with international legal processes, as well as critical challenges.

Introduction The complexity of injury and the multi-sectoral nature of its prevention demands a whole-of-society approach. Engaging with civil society in a form of collaborative governance is central to this approach. Civil society, defined as neither state, nor market, nor family, includes organisations such as advocacy groups, charities, professional associations etc. This study looks at the role of civil society organisations in the implementation of child injury prevention interventions in Europe. Methods The method was built upon an existing approach, known as ’organigraphs’. Mintzberg and van der Heyden developed the approach to depict how organisations actually work. We further developed its practical application to explore how interventions in child safety are developed, implemented and monitored across the local, regional, national and EU levels. Professionals working in child safety in 25 European countries were asked to draw organigraphs for an intervention in one of four child injury domains: road, water, home safety or intentional injury prevention. The analysis focused on the action surrounding civil society actors, represented by the connectors leading to and from those actors. Results We received 44 organigraphs in total from 31 participants in 24 countries; nine for intentional injury prevention, nine for water safety, 12 for road safety and 14 for home safety. Civil society actors were present in the majority of Organigraphs and they played multiple and diverse roles including: ’advising’, ’funding’ and ’implementing’ child safety initiatives. Conclusions The role of civil society, described in this data set, appears to be relatively well-developed. Strong, functional and long-standing partnerships between civil society actors across policy sectors and government may lead to greater capacity to address the complexity of child injury. Key messages Effective child injury prevention requires multi-sectoral action to address its complexity. Stakeholders come from the public and private sector and from civil society. Greater engagement with civil society may represent an opportunity for countries and regions to improve their response to the challenges of injury prevention among children.

This article examines the expanding role of civil society organisations (CSOs) and the ‘fourth sector’ in reshaping international cultural relations over the past fifteen years. The authors analyse bottom-up approaches that challenge traditional state-led cultural diplomacy, focusing on how CSOs operate beyond ‘methodological nationalism’ while resisting both globalisation pressures and exclusive national identity promotion. Drawing on examples from the Balkans and other regions—including Nomad Dance Academy, Krokodil literary festival, and Red/Crvena feminist organisation—the study demonstrates how civil society employs innovative strategies such as festivals, art residencies, knowledge transfer, and regional networking. These organisations prioritise the ethics of solidarity and care, often working to decolonise and de-Europeanise cultural relations. The research reveals that CSOs function as ‘counterpublic’ spaces, creating platforms for dissent and social change while fostering equitable cultural exchanges. Unlike traditional diplomatic approaches, civil society initiatives emphasise fairness, mutual enrichment of peripheries, and bringing marginalised voices to global attention, offering alternative frameworks for international cultural cooperation based on responsibility and solidarity.

A few social media platforms have come to play a central role in civil society organizing, often functioning as organizing partners. But on whose terms? As organizing partners, commercial social media platforms shape the conditions under which civil society actors organize, also shaping organizational dynamics, visibility, and collective action. Far from being neutral partners, these platforms become battlegrounds where civil society actors and platform owners negotiate power, visibility, and control—differently affecting various forms of civil society actors and organizing. Therefore, we need to move beyond the notion of platforms as mere organizing agents to critically examine the opportunities and constraints they create for different civil society actors, as well as how different civil society actors navigate these. This requires considering both exogenous, contextual elements, and endogenous, actor-centered elements of civil society organizing. Doing so allows us to examine how organizing efforts emerge not simply on social media platforms but with them, requiring constant negotiation with platform logics. The collection of articles in this special issue shows how social media platforms enable civil society organizing, but also how platform-driven asymmetries emerge and play out differently according to the different features that characterize the civil society organizations at stake.

In the 1980s and 1990s, rapid market oriented reforms, liberalization and privatization ("shock therapy") in developing and transformational countries caused economic and social problems that began to undermine the legitimacy of political democratization and market reforms itself. Scholars in the field of transformation and development theory found that market coordination alone was not able to fill the void left by a weak or weakening state. In this essay, we look at the case of Korea to find out if an active civil society can substitute functions of the withdrawing developmental state since the 1980s. We show that civil society organizations (CSOs) in Korea have been relatively effective in influencing political processes, shaping public opinion, compensating the weakness of political instirucions, and contributing to general development. Korean CSOs achieved this remarkable impact despite substantial organizational problems and a relatively unfavorable socioeconomic and political environment. This effectiveness and the synergy between state and civil society make Korean CSOs very interesting to study for development scholars. Korea might offer some valuable lessons on how to improve advocacy CSOs in an unfavorable environment similar to that of many developing countries.

In the 1980s and 1990s, rapid market oriented reforms, liberal- ization and privatization (shock therapy) in developing and transformational countries caused economic and social prob- lems that began to undermine the legitimacy of political democratization and market reforms itself. Scholars in the field of transformation and development theory found that market coordination alone was not able to fill the void left by a weak or weakening state. In this essay, we look at the case of Korea to find out if an active civil society can substitute functions of the withdrawing developmental state since the 1980s. We show that civil society organizations (CSOs) in Korea have been relatively effective in influencing political processes, shaping public opinion, compensating the weakness of political institutions, and contributing to general develop- ment. Korean CSOs achieved this remarkable impact despite substantial organizational problems and a relatively unfavorable socioeconomic and political environment. This effectiveness and the synergy between state and civil society make Korean CSOs very interesting to study for development scholars. Korea might offer some valuable lessons on how to improve advocacy CSOs in an unfavorable environment similar to that of many developing countries.