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The South African government released a policy document for the introduction of a National Health Insurance (NHI) system planned to start in 2012. The consultation process for involving the public in the implementation of the NHI was also announced in August. When the consultation process on the NHI was announced, everyone assumed that the Government’s aim was to devolve power to communities and create a more patientfocused and community-oriented NHI. In this paper we look not only at how community engagement process on the NHI works, but we also review the democratic process to determine if it is a good means of holding decision makers to account to communities before and during the implementation of the NHI in South Africa. We review reasons for involving or engaging communities in health and related matters, the policy context of community engagement and review potential roles of nongovernmental organizations in assisting people to participate in debates for implementation of this new health policy initiative.
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