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Concept: Civil society


Volunteering has been advocated by the United Nations, and American and European governments as a way to engage people in their local communities and improve social capital, with the potential for public health benefits such as improving wellbeing and decreasing health inequalities. Furthermore, the US Corporation for National and Community Service Strategic Plan for 2011–2015 focused on increasing the impact of national service on community needs, supporting volunteers' wellbeing, and prioritising recruitment and engagement of underrepresented populations. The aims of this review were to examine the effect of formal volunteering on volunteers' physical and mental health and survival, and to explore the influence of volunteering type and intensity on health outcomes.

Concepts: Health care, Health economics, Public health, Epidemiology, Population health, Community, United Nations, Civil society


Sustainable Development Goal Three is rightly ambitious, but achieving it will require doing global health differently. Among other things, progressive civil society organisations will need to be recognised and supported as vital partners in achieving the necessary transformations. We argue, using illustrative examples, that a robust civil society can fulfill eight essential global health functions. These include producing compelling moral arguments for action, building coalitions beyond the health sector, introducing novel policy alternatives, enhancing the legitimacy of global health initiatives and institutions, strengthening systems for health, enhancing accountability systems, mitigating the commercial determinants of health and ensuring rights-based approaches. Given that civil society activism has catalyzed tremendous progress in global health, there is a need to invest in and support it as a global public good to ensure that the 2030 Agenda for Sustainable Development can be realised.

Concepts: Sociology, Sustainability, Society, Civil society, Community building, Ecological economics, Voluntary association, Mass society


Policy Points: Many barriers hamper advocacy for health equity, including the contemporary economic zeitgeist, the biomedical health perspective, and difficulties cooperating across policy sectors on the issue. Effective advocacy should include persistent efforts to raise awareness and understanding of the social determinants of health. Education on the social determinants as part of medical training should be encouraged, including professional training within disadvantaged communities. Advocacy organizations have a central role in advocating for health equity given the challenges bridging the worlds of civil society, research, and policy.

Concepts: Understanding, Sociology, Profession, Awareness, Community, Society, Civil society, Advocacy


Civil unrest is a powerful form of collective human dynamics, which has led to major transitions of societies in modern history. The study of collective human dynamics, including collective aggression, has been the focus of much discussion in the context of modeling and identification of universal patterns of behavior. In contrast, the possibility that civil unrest activities, across countries and over long time periods, are governed by universal mechanisms has not been explored. Here, records of civil unrest of 170 countries during the period 1919-2008 are analyzed. It is demonstrated that the distributions of the number of unrest events per year are robustly reproduced by a nonlinear, spatially extended dynamical model, which reflects the spread of civil disorder between geographic regions connected through social and communication networks. The results also expose the similarity between global social instability and the dynamics of natural hazards and epidemics.

Concepts: Mathematics, Sociology, Systems theory, Society, Civil society, Civil disobedience, Civil disorder, State of emergency


The use of non-drug, non-health-service interventions has been proposed as a cost-effective alternative to help those with long-term conditions manage their illness and improve their health and well-being. Interventions typically involve accessing activities run by the third sector or community agencies and may also be described as non-medical referral, community referral or social prescribing. To be effective, patients need to be “transferred” from the primary care setting into the community and to maintain their participation in activities. However, it is not currently known how and why these approaches enable which people under what circumstances to reach community services that may benefit their health and well-being.

Concepts: Health care, Medicine, Illness, Primary care, Community, Civil society, Primary care physician


Experiences in adolescence may have a lasting impact on adulthood. The objective of this study is to evaluate the association between adolescent (12-18 years of age) volunteerism with the incidence of illegal behaviors, arrests, and convictions in adulthood (>18 years of age).

Concepts: Epidemiology, The Association, Adolescence, Crime, Criminal law, Civil society, Volunteering, Young adult


Civil wars divide nations along social, economic, and political cleavages, often pitting one neighbor against another. To restore social cohesion, many countries undertake truth and reconciliation efforts. We examined the consequences of one such effort in Sierra Leone, designed and implemented by a Sierra Leonean nongovernmental organization called Fambul Tok. As a part of this effort, community-level forums are set up in which victims detail war atrocities, and perpetrators confess to war crimes. We used random assignment to study its impact across 200 villages, drawing on data from 2383 individuals. We found that reconciliation had both positive and negative consequences. It led to greater forgiveness of perpetrators and strengthened social capital: Social networks were larger, and people contributed more to public goods in treated villages. However, these benefits came at a substantial cost: The reconciliation treatment also worsened psychological health, increasing depression, anxiety, and posttraumatic stress disorder in these same villages. For a subset of villages, we measured outcomes both 9 months and 31 months after the intervention. These results show that the effects, both positive and negative, persisted into the longer time horizon. Our findings suggest that policy-makers need to restructure reconciliation processes in ways that reduce their negative psychological costs while retaining their positive societal benefits.

Concepts: Sociology, Community, Society, Civil society, Social capital, Civil war, War, Sierra Leone


An epidemic of Ebola virus disease (EVD) beginning in 2013 has claimed an estimated 11 310 lives in West Africa. As the EVD epidemic subsides, it is important for all who participated in the emergency Ebola response to reflect on strengths and weaknesses of the response. Such reflections should take into account perspectives not usually included in peer-reviewed publications and after-action reports, including those from the public sector, nongovernmental organizations (NGOs), survivors of Ebola, and Ebola-affected households and communities. In this article, we first describe how the international NGO Partners In Health (PIH) partnered with the Government of Sierra Leone and Wellbody Alliance (a local NGO) to respond to the EVD epidemic in 4 of the country’s most Ebola-affected districts. We then describe how, in the aftermath of the epidemic, PIH is partnering with the public sector to strengthen the health system and resume delivery of regular health services. PIH’s experience in Sierra Leone is one of multiple partnerships with different stakeholders. It is also one of rapid deployment of expatriate clinicians and logistics personnel in health facilities largely deprived of health professionals, medical supplies, and physical infrastructure required to deliver health services effectively and safely. Lessons learned by PIH and its partners in Sierra Leone can contribute to the ongoing discussion within the international community on how to ensure emergency preparedness and build resilient health systems in settings without either.

Concepts: Non-governmental organization, Oxfam, Civil society


As pharmaceutical firms experience increasing civil society pressure to act responsibly in a changing globalized world, many are expanding and/or reforming their corporate social responsibility (CSR) strategies. We sought to understand how multinational pharmaceutical companies currently engage in CSR activities in the developing world aimed at global health impact, their motivations for doing so and how their CSR strategies are evolving.

Concepts: Medicine, Sociology, Civil society, Globalization, Corporation, Multinational corporation, Corporate social responsibility, Social responsibility


There is increasing concern about the conservation status of sharks. However, the presence of numerous different (and potentially mutually exclusive) policies complicates management implementation and public understanding of the process. Here we present the results of a survey that was distributed to members of the largest professional shark and ray research societies to assess member preferences for different conservation policies. Questions covered society member opinions towards available conservation and management policies, personal histories of getting involved in advocacy and management, and perceptions of the environmental conservation non-governmental organization (NGO) approach to shark conservation. Members of the shark and ray research community consider themselves to be knowledgeable about and actively involved in conservation and management policy. They are generally supportive of a variety of conservation policy tools that differ greatly in approach. Society members were generally less supportive of newer limit-based conservation policy tools, such as Shark Sanctuaries and shark fin bans, than of target-based fisheries management tools like fishing quotas that focus on species-specific sustainable exploitation. However, they provided few current examples of sustainable shark fisheries. Society members were generally supportive of environmental NGO efforts to conserve sharks, but raised concerns about some NGOs which are perceived as using incorrect information and focusing on the wrong problems. These results show that the ongoing debate in environmental policymaking circles between target-based natural resources management tools and limit-based conservation biology tools can also be found with respect to shark conservation and management. They also suggest that closer communication between the scientific and environmental NGO communities may be needed to recognize and reconcile differing values and objectives between these groups. This article is protected by copyright. All rights reserved.

Concepts: Conservation biology, Policy, Non-governmental organization, Oxfam, Civil society, Shark, Natural capital, Sharks