From resolution to reform: Social participation as a foundation of health system governance

Abstract

The World Health Assembly resolution on Social Participation for Universal Health Coverage, Health and Well‑being represents a major global policy commitment to institutionalising social participation as a core element of health system governance. The resolution urges Member States and the WHO Secretariat to embed meaningful, inclusive and sustained participation of communities, civil society and affected populations across health policy development, implementation and accountability, to advance UHC, equity, health and well-being. The resolution clarifies the conceptual and normative foundations of social participation within WHO’s health systems framework. Social participation is approached not as an isolated engagement activity, but as a governance function that enhances transparency, legitimacy and responsiveness of health systems. Evidence shows that participatory governance contributes to more equitable policy choices, improved trust, and stronger alignment between reforms and population needs. This presentation situates social participation within broader health system transformation efforts, including responses to noncommunicable diseases, demographic change, and social and commercial determinants of health, highlighting its relevance in addressing persistent health inequities and ensuring people‑centred reforms. Drawing on early implementation experiences, it illustrates how countries are operationalising WHA77.2 through legal frameworks, permanent participatory mechanisms and dedicated capacities. It also reflects on the role of national and regional actors, including WHO Collaborating Centres, in supporting learning, evidence generation and dissemination of good practices in the WHO European Region and beyond. By providing a common policy and analytical framework, these approaches set the scene for subsequent country and practice‑based contributions and support informed discussion on translating global commitments into sustainable public health action.