This study aims at demonstrating civil society's integral role in poverty reduction through its participation in and enhancement of the public policy process. I argue that civil society participation in public policy is the missing link in the fight against poverty in the continent. Through a multiple comparative panel regression analysis of 43 African countries, this study assesses the impact of civil society participation in public policy on out-of-pocket health expenditure per capita. Findings show that civil society participation in public policy led to pro-poor policies that contributed to reduced out-of-pocket health expenditure per capita, demonstrating how participation in public policy is instrumental and strategic for poverty reduction. The study highlights the empirical evidence needed to establish the indispensability of and desire to support civil society and institutionalize civil society participatory processes in public policy for the effective and efficient reduction of poverty in Sub-Saharan Africa.