Concerns with public participation, health service user involvement and citizenship have figured large in recent debates about health policy across the world. These debates have given new political currency to older ideas that emphasised the need to involve people in the design and delivery of health services.
This article draws on research carried out as part of a ten-year long collaborative international research programme, the Citizenship Development Research Centre. It draws on a series of case studies of citizenship engagement from Bangladesh, Brazil, South Africa and the UK, bringing together work on institutionalized participation and mobilization. To understand how public and citizen involvement shapes health services, this article suggests, closer attention needs to be paid to issues of representation, framing, and the politics of identity and knowledge. The article concludes by exploring some of the challenges for negotiating health citizenship.