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Patterns of public participation: Opportunity structures and mobilization from a cross-national perspective

Jean Slutsky (Patient-Centered Outcomes Research Institute, Washington, District of Columbia, USA)
Emma Tumilty (Bioethics Centre, Department of General Practice & Rural Health, University of Otago, Dunedin, New Zealand)
Catherine Max (Catherine Max Consulting: The Future Health Partnership, London, UK)
Lanting Lu (School of Public Administration and Policy, Renmin University of China, Beijing, China)
Sripen Tantivess (Health Intervention and Technology Assessment Program, Ministry of Public Health, Bangkok, Thailand)
Renata Curi Hauegen (Center for Technological Development in Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil)
Jennifer A Whitty (Norwich Medical School, University of East Anglia, Norwich, UK and School of Pharmacy, University of Queensland, Brisbane, Australia)
Albert Weale (Department of Political Science, University College London, London, UK)
Steven D Pearson (The Institute for Clinical and Economic Review, Boston, Massachusetts, USA)
Aviva Tugendhaft (School of Public Health, University of the Witwatersrand, Johannesburg, South Africa and Priceless SA, Wits School of Public Health, Johannesburg, South Africa)
Hufeng Wang (School of Public Administration and Policy, Renmin University, Beijing, China)
Sophie Staniszewska (RCN Research Institute, Warwick Medical School, University of Warwick, Coventry, UK)
Krisantha Weerasuriya (National Medicines Regulatory Authority of Sri Lanka, Colombo, Sri Lanka)
Jeonghoon Ahn (Department of Health Management, Ewha Womans University, Seoul, South Korea)
Leonardo Cubillos (Dartmouth Hitchcock Medical Center, Dartmouth Medical School, Lebanon, New Hampshire, USA)

Journal of Health Organization and Management

ISSN: 1477-7266

Article publication date: 15 August 2016




The paper summarizes data from 12 countries, chosen to exhibit wide variation, on the role and place of public participation in the setting of priorities. The purpose of this paper is to exhibit cross-national patterns in respect of public participation, linking those differences to institutional features of the countries concerned.


The approach is an example of case-orientated qualitative assessment of participation practices. It derives its data from the presentation of country case studies by experts on each system. The country cases are located within the historical development of democracy in each country.


Patterns of participation are widely variable. Participation that is effective through routinized institutional processes appears to be inversely related to contestatory participation that uses political mobilization to challenge the legitimacy of the priority setting process. No system has resolved the conceptual ambiguities that are implicit in the idea of public participation.


The paper draws on a unique collection of country case studies in participatory practice in prioritization, supplementing existing published sources. In showing that contestatory participation plays an important role in a sub-set of these countries it makes an important contribution to the field because it broadens the debate about public participation in priority setting beyond the use of minipublics and the observation of public representatives on decision-making bodies.



This paper arises from a collaborative project: author names have been listed randomly. The work arises from a Brocher Foundation Workshop on “Improving Equitable Access to Health Care through Increasing Patient and Public Involvement in Prioritisation Decisions”, November 10-13, 2015, Geneva. The authors should like to take this opportunity to thank the Brocher Foundation for its support, as well as two referees for comments expeditiously delivered. The authors also thank Alexandra Melaugh for valuable research assistance. Renata Curi Hauegen is supported by the National Institute for Science and Technology on Neglected Diseases (INCT/IDN). Sophie Staniszewska is part funded by the NIHR CLAHRC West Midlands initiative. This paper presents independent research and the views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. Aviva Tugendhaft is supported by funding to PRICELESS SA from the international Decision Support Initiative (IDSI) through the Bill and Melinda Gates Foundation, Grant Number 740671. The slides presented at the workshop can be found at: www.


Slutsky, J., Tumilty, E., Max, C., Lu, L., Tantivess, S., Hauegen, R.C., Whitty, J.A., Weale, A., Pearson, S.D., Tugendhaft, A., Wang, H., Staniszewska, S., Weerasuriya, K., Ahn, J. and Cubillos, L. (2016), "Patterns of public participation: Opportunity structures and mobilization from a cross-national perspective", Journal of Health Organization and Management, Vol. 30 No. 5, pp. 751-768.



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Copyright © 2016, Emerald Group Publishing Limited

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