Quality (315) Citizen voice and communicative learning (2)

8 December, 2021

A few months ago HIFA member Lani Marquez, citing Nancy White, wrote on HIFA about the value of communicative learning: 'learning to understand what others mean and to make oneself understood. The goal of communicative learning is to gain insight and to reach common understanding rather than to control.' "We need to work to ensure that spaces and processes for citizen participation in health care quality governance are truly focused on communicative learning."


The December 2021 issue of the WHO Bulleting has an excellent editorial on this subject, written by senior health leaders at the Partnership for Maternal and Newborn Health and UUHC2030. Citation, extract and a comment from me below.

CITATION: Bull World Health Organ. 2021 Dec 1; 99(12): 846–846A.

Published online 2021 Dec 1. doi: 10.2471/BLT.21.286554

Social participation, universal health coverage and health security

Helen Clark, Justin Koonin, Gabriela Cuevas Barron


The coronavirus disease 2019 (COVID-19) pandemic response is a good example of the growing chasm between people and their governments...

Many governments repeatedly fail to proactively listen to people’s needs, perspectives and expectations as part of their decision-making processes, let alone to do so in systematic and institutionalized ways. Furthermore, groups with less access to policy spaces such as women, children, adolescents, people with disabilities and low-income communities are rarely engaged.

In our experience, leaders’ reluctance to embrace a truly inclusive health governance approach is due to several factors. These factors include existing sociocultural power imbalances that prevent meaningful interaction between stakeholders and policy-makers’ persistent adoption of a predominantly biomedical health model. Another crucial barrier is the systematic lack of policy-maker capacities to create, manage, sustain and leverage long-term, institutionalized participatory processes.

The ability to convene people from diverse backgrounds, deal adequately with conflicts of interest, broker dialogue between people with differing views and – more challengingly – make sense out of sometimes chaotic input emanating from a participatory space, must be promoted. Such ability requires policy-makers to have specific skillsets that need to be fostered, valued and cultivated. This capacity gap is one that the World Health Organization seeks to fill with the recently released publication Voice, agency, empowerment - handbook on social participation for universal health coverage.


COMMENT: I invite HIFA members to review the new WHO Handbook and share your observations on HIFA: hifa@hifaforums.org

With thanks, Neil

Neil Pakenham-Walsh, HIFA Coordinator, neil@hifa.org www.hifa.org