Reviving Civic Engagement in Health Governance in India

• ‘Makkalai Thedi Maruthuvam’ and Karnataka’s Gruha Arogya schemes aim to provide health care at doorsteps for non-communicable diseases.

• Public engagement in health policy processes affirms self-respect, counters epistemic injustice, and upholds democratic values.

• Inclusive participation strengthens accountability, challenges elite dominance, and reduces corruption.

• The National Rural Health Mission institutionalized public engagement through platforms like Village Health Sanitation and Nutrition Committees and Rogi Kalyan Samitis.

• Challenges include ambiguous roles, infrequent meetings, underutilization of funds, poor intersectoral coordination, and deeply rooted social hierarchies.

• Resistance to public engagement stems from increased workload, accountability pressures, regulatory capture, and lack of a level playing field.

• A fundamental mindset shift is needed, empowering communities and sensitizing health system actors.