How community organizations and civic engagement drive the success of global health aid. What makes health-related development assistance truly effective? In How Ordinary People Make Aid Work, Stefan Kruse argues that the answer lies in the power of ordinary citizens. By examining the role of community organizations and social movements, Kruse challenges conventional approaches to aid, showing that true accountability requires more than institutional reforms or participatory spaces that offer citizens a seat at the table. Through rigorous analysis and compelling case studies, the book reveals how traditional forms of exercising voice-especially in politically challenging contexts-drive the success of donor-funded health projects. Kruse demonstrates that reducing infant mortality since the 1990s owes more to an engaged citizenry than to formal accountability mechanisms. Surprisingly, state capacity and democratic institutions show little effect on the success of health aid once citizen involvement is accounted for. By bridging macroeconomic studies of aid effectiveness with research on political behavior, these findings underscore the indispensable role of civic engagement in building resilient health systems. How Ordinary People Make Aid Work critiques the limitations of traditional, top-down development models and advocates for empowering communities to lead their own progress. It highlights how social ties and collective action equip citizens to oversee health projects and create sustainable solutions to public health challenges. Offering fresh insights for policymakers, development practitioners, and scholars, this book redefines what it takes to make aid truly impactful.
Stefan Kruse is an international development consultant and former postdoctoral research fellow at the Center for the Study of Democracy at Leuphana University, Lueneburg, Germany.
1. Participation in Health Development 1a. Citizen Participation and Development 1b. Plan of the Book 2. Participation, Accountability, and Aid Effectiveness 2a. Accountability in Development Projects 2b. The Effectiveness of Foreign Aid 2c. Citizen-led Accountability Action and Service Provision 2d. Social Capital and Public Service Performance 2e. Theoretical Framework 3. Analyzing Conditions of Aid Effectiveness 3a. Measuring Civic Engagement-The Cultural Context 3b. Measuring Political Context 3c. Monitoring Health Aid and Population Health 3d. Methodological Challenges and Solutions 3e. Empirical Approach 4. Mapping Differences in Civic Engagement among Aid Recipient Countries 4a. Social and Political Engagement in Recipient Countries 4b. Correlates of Social and Political Engagement 4c. The Coevolution of Health Aid, Civic Engagement, and Infant Mortality 4d. Case Study Evidence 5. The Moderating Role of Civic Engagement 5a. Population Health and Aid Effectiveness: Cross-National Evidence 5b. Individual Well-Being and Aid Effectiveness: A Multilevel Perspective 6. Civic Engagement in Varying Political Contexts 6a. The Role of Bureaucratic Governance 6b. The Role of Liberal Democracy 6c. The Role of Decentralization 7. Why Civic Engagement Matters References Appendix List of Appendix Figures List of Appendix Tables
How community organizations and civic engagement drive the success of global health aid.
