This book is about ways that people can build and exercise power to influence the systems that affect their lives. Each chapter provides a deep examination of a different approach. This introductory chapter begins with a discussion on definitions of empowerment and then lays out five perspectives that orient the contributions in the book. It then describes the structure and contents of the book, which are organized into six parts: (1) organizing and activism, (2) participatory governance, (3) civil society and coalitions, (4) enterprise, (5) participatory and community arts, and (6) education and engaged research. This is followed by reflections on the book’s scope and potential uses by different audiences.

This chapter focuses on how community engagement (CE) can be implemented at the national and sub-national levels. CE has been identified as an essential pillar of strong people-centred governance which is needed to underpin Universal Health Coverage (UHC) reforms. The “whole of society approach” acknowledges the importance of families and communities in support of the efforts for disease prevention and control. It provides an overview of the evidence and outlines processes that enable effective community engagement and highlights lessons drawn. In particular, Thailand’s Universal Coverage Scheme’s (UCS) participatory governance approach has been a practical example and one of the myriad ways in which the voice of Thailand’s people has been embedded in legislations and operations to ensure that the governance of UCS is responsive to their needs. Four lessons from this experience include leadership and commitment at all levels, transparency and accountability to enable sustained engagement, legal frameworks, and the need for strong capacities in both the government and among communities. Lastly, it proposes the lessons learned and key messages for a proactive approach to CE in health.

Communities are integral parts of health systems and their engagement in defining health needs, priorities, solutions and in the delivery of services is essential to improving health and well-being. All communities, regardless of how they are defined, include individuals or sub-groups who, for a host of reasons are disadvantaged and experience a disproportionate burden of ill health. Identifying and engaging them is both essential and challenging, and should be prioritized. Communities interface with the health system with varying degrees of engagement ranging from passively receiving information at one end of the spectrum to actively engaging in decision making through mutually accountable relationships at the other. This chapter explores the concepts of community and community engagement and consider their role in health systems. It examines the concept of health, the changing health needs of communities and the influence of community in defining health issues and informing solutions, including the delivery of services. Finally, the chapter discusses the modalities of community engagement for health systems, particularly within low- and middle-income countries (L&MICs).

Drawing on Sheila Foster and Christian Iaione’s generative work, The City as a Commons, this chapter applies commons theory to public housing in the United States, which, despite decades of disinvestment and mismanagement, remains a significant community asset serving affordable housing needs. Using New York City’s embattled Housing Authority (NYCHA), the nation’s largest public housing agency, as a case study, the chapter argues that public housing, though not a classic common-pool resource, serves a broad swath of vulnerable urban residents and can be reimagined under an urban commons framework. Doing so ensures that, in a time of transitioning uses of public housing assets, residents have meaningful input concerning disposition of space within public housing campuses.The democratizing implications of commons theory respond to NYCHA residents’ essential exclusion (despite requirements in federal law) from revenue-driven decisions increasing private developers’ control over NYCHA properties through long-term land leases and public-private partnerships. A commons analysis, grounded in residents’ urban knowledge, experience, and need, and informed by the social function of property theory, adds normative and theoretical heft to residents’ equitable stake in decisions concerning public housing’s increasingly threatened spaces.