Citizen engagement is a form of interaction between citizens and their governments. It can happen at any stage of the development or implementation of government policy and the delivery of public services or be triggered by events in local areas.
As health can be determined by a myriad of social processes, participation in health implies the promotion of social participation as a general rule of governance in all policies.
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The World Health Organisation (WHO) define community/citizen engagement as “a process of developing relationships that enable stakeholders to work together to address health-related issues and promote well-being to achieve positive health impact and outcomes”.
There are undeniable benefits to engaging communities in promoting health and wellbeing. At its core, community engagement enables changes in behaviour, environments, policies, programmes and practises within communities.
There are different levels, depths and breadths of community engagement that determine the type and degree of involvement of the people.
Citizen engagement has been regarded as a critical element of successful health programmes to achieve “the health for all” goals. Numerous studies have shown that it plays a significant role in reducing inequalities, improving social justice, enhancing benefits and sharing responsibility for public health.
Citizen participation is now regarded as central to the promotion of sustainable health and health care. Involvement efforts create and encounter many diverse ethical challenges that have the potential to enhance or undermine their success.
It is contended that despite its prominence and the link between citizen empowerment and autonomy, traditional bioethics is insufficient to guide participation efforts. In addition, the turn to a “social paradigm” of ethics in examinations of biotechnologies and public health does not provide an account of values that is commensurable with the pervasive autonomy paradigm. This exacerbates rather than eases tensions for patients and citizens endeavouring to engage with health.
Citizen and patient participation must have a significant influence on the way we do health ethics if its potential is to be fulfilled.
Citizens’ involvement/engagement as a means to bring about better, more effective services or public health programmes better attuned to needs. In other words, citizen involvement is a means to an end. The goals are usually improved quality, identification of needs, increased uptake, or more culturally appropriate health programmes.
Samuel Julius, Centre for Social Justice Nigeria
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