This chapter draws on the findings of the doctoral dissertation examining grassroots community action for health equity and justice, and the relationships between local community-based groups and nonprofit agencies. My research is a critical inquiry into the realities of everyday work of community groups and local nonprofit organisations that are positioned as intermediaries between the communities and higher-level policymakers and administrators in a tightly controlled and monitored fiscal environment. This chapter focuses on nonprofit organisations and grassroots groups relations in the context of community development work that involves community participation as both a goal and an intrinsic value embedded in process. Drawing on governmentality theory, the chapter analyses structural factors that enable or constrain nonprofit organisations’ capacity to support meaningful participation of grassroots groups. The discussion is informed by the researcher experience of integrating participatory action research and institutional ethnography. This integration of two methods informed insights into what makes participation meaningful for community members, and what roles nonprofit organisations perform as partners in nonprofit-community partnerships.