Civil society has a role to play in all three pillars of UHC (See Part 1): health financing, service delivery, and, most importantly, good governance.

Civil society has always played a vital role in health service delivery to the wider community and expanding both the range of and access to quality health services. Health charities and community networks work in partnerships with government health systems. However, this is not where community engagement in UHC should end.

Civil society needs to engage fully in advocating more funding for health and UHC policies that are equitable, inclusive and evidence-based. This can be done through targeted advocacy (see C. Key Advocacy Messages). To note, civil society refers to a diverse range of actors, spaces and even types of institutions that may represent different communities, goals and values. To be truly addressing community needs and priorities, decision-makers must facilitate the participation of diverse civil society voices, especially those from marginalized populations. Importantly, civil society can act as a vital bridge to build community linkages, collaborate and coordinate between communities and other health actors. Moreover, good health systems governance is not possible without the active and meaningful engagement of civil society in decision-making spaces at all levels of UHC policy and implementation.


Three Pillars of UHC:  The Role of Civil Society


Health Financing

  • Campaigning for more funding for health that is better spent
  • Ensuring social determinants of health are addressed
  • Monitoring health expenditure and hold governments accountable for commitments
  • Mobilizing communities to increase demand.

Service Delivery

  • Reaching those left behind
  • Expanding the range of services
  • Providing integrated person-centred care
  • Training health workers on how to work with marginalized communities
  • Improving quality of care

Good Governance

  • Participating in policy and budget decision-making
  • Holding governments accountable for commitments
  • Advocating transparency and access to information
  • Ensuring UHC policies are equitable, inclusive and evidence-based.

For UHC to succeed, civil society needs to be active at all stages in designing, implementing and monitoring national health policies. In particular, CSOs and health networks have:

  • Lived experience as people living with health conditions and as end-users of health systems
  • Expertise in people-centred and community-led health systems and approaches, including integration of health services
  • Ability to reach the most vulnerable and marginalized populations
  • Strong commitment to equity, human rights and inclusion
  • Key data and information on health system strengths and weaknesses
  • Experience in health monitoring and accountability mechanisms


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Engage all relevant stakeholders, including civil society, the private sector and academia, as appropriate, through the establishment of participatory and transparent multi-stakeholder platforms and partnerships to provide input to the development, implementation and evaluation of health and social-related policies and to review progress for the achievement of national objectives for universal health coverage”.

UN Political Declaration on UHC, 2019