Social determinants of health

Civil society

Civil society refers to the space for collective action around shared interests, purposes and values, generally distinct from government and commercial for-profit actors. Civil society includes charities, development NGOs, community groups, women's organizations, faith-based organizations, professional associations, trade unions, social movements, coalitions and advocacy groups. However civil society is not homogeneous and the boundaries between civil society and government or civil society and commercial actors can be blurred. There is certainly no one 'civil society' view, and civil society actors need to contend with similar issues of representativeness and legitimacy as those of other representatives and advocates.

Despite its complexity and heterogeneity, the inclusion of civil society voices is essential to give expression to the marginalised and those who often are not heard. Civil society actors can enhance the participation of communities in the provision of services and in policy decision-making. Recognizing this, the Commission on Social Determinants of Health (CSDH) was set up with a separate civil society stream of work on social determinants of health, which contributed case studies and a separate report in addition to conducting workshops and contributing to meetings and the final report. The CSDH report identifies the need to tackle the inequitable distribution of power as essential to reducing health inequities. The continued involvement of civil society and the participation of communities in work on social determinants of health will thus be fundamental to the chances of success in closing the gap in a generation.

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