Skip to main content
Printable page generated Friday, 29 March 2024, 9:54 AM
Use 'Print preview' to check the number of pages and printer settings.
Print functionality varies between browsers.
Unless otherwise stated, copyright © 2024 The Open University, all rights reserved.
Printable page generated Friday, 29 March 2024, 9:54 AM

Health Education, Advocacy and Community Mobilisation Module: 18. Advocacy Tools and the Role of Health Extension Practitioners

Study Session 18  Advocacy Tools and the Role of Health Extension Practitioners

Introduction

This study session is based on providing you with the knowledge and skills needed to enable you to identify and describe the main tools of advocacy. You will learn how to describe the support needed, your targets, channels and methods for your advocacy work. You will also be encouraged to think about your local community’s cultural, social and economic environment in order to help you identify the main health issues and to identify and collaborate with the different stakeholders found in your locality or kebele (Figure 18.1).

A team of three health workers standing together.
Figure 18.1  Health workers working together will be a strong team for advocacy work. (Photo: I-TECH/Julia Sherburne)

Learning Outcomes for Study Session 18

When you have studied this session, you should be able to:

18.1  Define and use correctly all of the key words printed in bold. (SAQs 18.1 and 18.2)

18.2  Describe the main tools of advocacy. (SAQ 18.1)

18.3  Identify support, targets, channels and methods for advocacy campaigns. (SAQ 18.2)

18.4  Describe what your advocacy roles are. (SAQ 18.3)

18.5  Explain how to plan, conduct and monitor advocacy activity. (SAQ 18.4)

18.1  Advocacy tools

In this section, you are going to learn about some of the different methods that you will be able to use for your advocacy work. These methods are called advocacy tools (Box 18.1). One of the advocacy tools you will use is lobbying, which means influencing the policy process by working closely with key individuals in political and governmental structures, together with other decision makers. Another tool is the use of meetings, usually as part of a lobbying strategy or negotiation, to reach a common position. Project visits are another useful tool of advocacy to demonstrate good practice and information, education and communication as various means of sensitising the decision makers. In addition, community organising is another important tactic that can be used.

Box 18.1  Key principles to help you get support for your advocacy activities

Remember to consider the following principles which can help you to get support for your advocacy activities:

  • Use several tools for advocacy to reach a wide audience (for example, not only the public, but also officials and decision makers), and be sure to form good relationships with your local media representatives.
  • Have good relations with the private sector and all the NGOs working in the area around you. Collaborate with them and all the people who can help your advocacy work.
  • Have good strategic planning.
  • Use effective monitoring tools.
  • Lete Birhan, who was a student with you on your previous course, is currently working in one of the woredas in Tigray region. She wrote to ask you to explain to her the different tools you would advise her to use for the advocacy activity that she is planning to conduct. What are the tools you are going to suggest that she uses to reach a wide audience?

  • She needs to consider the most effective advocacy tools in her locality and to choose a range so that she reaches a wide audience. For example, she can use the Tigray regional media for reaching the public as well as the policy or decision makers, NGOs, etc. She may also be able to use her local traditional media. Her work should include using all local forms of communication, as well as a combination of posters and film shows, or perhaps radio spots to convey messages to the influential people or decision makers.

18.2  The advocacy approach

The advocacy approach uses many different methods of reaching people. Inter-personal meetings or face-to-face approaches with the decision makers are the most effective advocacy approaches for those people. However, with the limited availability of advocates in the field, the potential number of people reached is limited using this form of communication, and further work like that may be expensive. As mentioned in earlier Sessions, you can also use other channels for reaching the public, for example newsletters, flyers, booklets, fact sheets, posters (Figure 18.2), video, dramas and folk media.

A health information poster.
Figure 18.2  Posters might be part of an advocacy campaign. (Photo: Ali Wyllie)

As an advocacy coordinator, you will need support and technical assistance, and possibly extra personnel to carry out your advocacy activities. You may need help in the areas of identifying health issues, planning, and message or material production. Some organisations that can help you carry out an advocacy campaign will have expertise in conducting advocacy campaigns, or be able to help you carry out needs assessment and issue identification. Other organisations may help with advocacy activities such as message development and broadcast work. Some will have expertise in audio-visual and media message production, while others may have expertise in training field workers for developing their advocacy and networking skills.

You may also need help when conducting meetings with higher officials. This experience and capacity may exist in either the governmental or non-governmental agencies found in your locality. Remember that the selection of supporting organisations able to assist you when you carry out your advocacy activities will depend on the political commitment that exists for the Health Extension Programme. This level of support is necessary to ensure that other governmental and non-governmental sectors collaborate and assist with the advocacy coordination. This in turn is affected by the particular health issue to be addressed, and the available funds to implement advocacy activities.

  • Make a list from your initial thinking of organisations that may be able to help you with your advocacy work in the future.

  • Of course we do not know your particular circumstances. However, if you had difficulty with this, then we suggest that you arrange to talk to experienced health workers in your area, as they will know who to turn to for help of this sort. Building good working relationships is the most effective way to support your advocacy activities and efforts. You can get support for your advocacy activities by identifying the governmental and non-governmental agencies responsible for your locality, and building a good relationship with their officials. Do not forget to meet with these groups and their representatives regularly.

Some possible advocacy resources for your locality include the woreda Health Office, the nearby health centre, local NGOs and other governmental sectors such as the Departments of Agriculture and Education, as well as local women’s associations and kebele leaders.

You need support to form an advocacy network because of the amount of work and the number of activities that may be involved. You may need help in order to design effective messages, to form a task force, to decide the strategy, and for fundraising, as well as for calculating the cost of the activities.

You also need to identify potential supporters. This can be achieved by attending local events, enlisting the support of the media, holding public meetings, and talking to all the influential people in your community. To do these things effectively, you will also need to do a community diagnosis and get to understand the resources in your community or locality. To get good support for advocacy campaigns (Figure 18.3), you need to form a cooperative team for your advocacy activities, and you need to know the stages to go through in order to achieve the best results.

A group of health workers discuss their work in a classroom setting.
Figure 18.3  You may be able to get support for your advocacy work from other health workers in teams nearby. (Photo: I-TECH/Julia Sherburne)

18.2.1  Stages of team growth

It is advisable to implement the following stages to support your team building, in order to help you in your advocacy activities. These stages are called the stages of team growth.

Stage 1  Team forming

When a team or network is forming, you need to explore the boundaries of acceptable group behaviour as the people change from individuals to gain member status. At this stage, the members of the team may feel excitement, anticipation and optimism, as well as possibly suspicion, fear and anxiety about the advocacy activities ahead. Members attempt to define the task at hand and decide how it will be accomplished. They also try to determine acceptable group behaviour and how to deal with group problems. Because so much is going on to distract members' attention, the group may only make a little progress. However, be aware that a slow start is a perfectly normal phenomenon.

Stage 2  Storming

At the storming stage, the team members begin to realise that they do not know the task, or may consider it is more difficult than they imagined. They may become irritable or blameful, but are still too inexperienced to know much about decision making. Team members argue about what actions they should take, even when they agree on the issues facing them. Their feelings include sharp fluctuations in attitude about the chance of success. These pressures mean that members have little energy to spend in meeting common goals, but they are beginning to understand each other.

Stage 3  Norming

During the norming stage, members reconcile competing loyalties and responsibilities. They accept the team ground rules or norms, their roles, and the individuality of each member. Emotional conflict is reduced. There is increased friendliness as members begin to trust one another. As members begin to work out their differences, they have more time and energy to spend on their objectives, and to start making significant progress.

Stage 4  Performing

At the performing stage, members begin diagnosing and solving problems, and implementing changes. They have accepted each other’s strengths and weaknesses and learnt their roles. They become satisfied with the team’s progress and feel a close attachment to one another. The team or network is now an effective support, and ready to help you in your health advocacy work.

  • Let us suppose that you form an advocacy group on the issue of banning female genital mutilation (FGM) in your local community. Your group includes influential members of the community. However, though everyone in the group is in principle in agreement, some members think that those who still agree with the practice of FGM should be punished by a ‘naming and shaming’ policy, where everyone in the community knows who they are and they become excluded. Identify which stage the group is at, and what could help resolve conflict in the group.

  • This is a group at the storming stage. At this stage, the team members begin to realise that they do not know the full extent of the task, or perhaps they have underestimated how difficult it would be to address. Team members argue about what actions they should take. Their feelings include sharp fluctuations in attitude about the chances of success of their campaigning.

It is important to recognise these stages of team works as they will help you know what needs to be done at each stage and what you can expect to happen.

  • Stop for a moment and think about a team with which you have been involved. This does not need to be a health team. Any team will do. Look at the four stages outlined above and think about your involvement in this team. Can you identify some of these stages in the team that you are familiar with?

  • Most people recognise these stages in teams they are involved in, particularly that stage when people do not think it is going well and they do not seem to be pulling together! However, this is perfectly normal activity in team building, and is usually followed by everyone beginning to have a clearer idea and starting to work much more for the common good of the team.

Good team spirit alone cannot bring success for an advocacy campaign. Identifying and building a constituency to support the network’s advocacy campaigns is critical for their success. The better the support base, the greater the chances are of success. Network members must reach out to create alliances with other NGOs, networks, donors, civic groups, professional associations, women’s groups, activists, individuals and model families who support the issue and will work with you to achieve your advocacy goals.

Supporting groups or advocacy groups are often called on to make hard decisions. The groups may find themselves deciding whether to take on a difficult advocacy issue–perhaps one that has little popular support or is controversialor they may face the need to choose among pressing issues in response to limited resources. How well they work through the decision-making process is important to the overall success of advocacy campaigns (Box 18.2). Therefore, preparation is an important element in decision making.

Box 18.2  Guidelines for reaching agreement
  • Make sure that everyone who wants to speak is heard, and feels that their position has been considered.
  • Talk through the issue under discussion until reaching an agreement that everyone can support.
  • Understanding that agreement may not mean that all members of the network agree with it 100%. However, everyone should support the decision, at least in principle.
  • Ask questions and make sure everyone’s opinion is considered before reaching a decision.

To make informed choices, network members need information. They also need to know how to set limits on–and goals for–their discussion. Good listening and presentation skills contribute to the clarity of the discussion as does the ability to keep an emotional distance from the subject under discussion.

You should be aware that successful advocates are skilled negotiators and consensus builders who look for opportunities to win modest but strategic policy gains. Therefore, it is advised that you need to become a skilled and artful advocate by incorporating creativity, style, and even humour in your advocacy events in order to draw the public and media attention to your cause. The art of advocacy cannot be taught through training or workshops alone. Rather, it emerges from your practice and from sharing experiences with the network members.

  • Thinking of events in your life in general, what sort of negotiator do you think you are? Do you make sure everyone is heard? Do you allow time for discussion? Do you ask questions and include people when decisions have to be made?

  • Some people seem to be naturally good at negotiating, but it is a skill that everyone can learn with practice. Take time even when you are with friends and family to ask questions, to listen to make sure, everyone is heard that and you will be getting good practice at negotiating.

18.3  Your roles in advocacy

As a Health Extension Practitioner, your main role in advocacy will be to secure the resources necessary to meet the health needs of your communities. To do this effectively requires you to undertake several key tasks, such as understanding the health needs of your communities and identifying the government officials and stakeholders with the power to determine health policy (Figure 18.4). You also need to be able to identify fundamental barriers and their solutions as well as identify the main problems or issues to be addressed. You then need to develop effective messages. So find a support group, or form a network and collaborate with them. To do this you need to develop your advocacy leadership skills.

Health workers meet with significant people from the community in their office.
Figure 18.4  Your advocacy work will involve meeting with significant people in your community and wider afield. (Photo: I-TECH/Julia Sherburne)

18.3.1  Advocacy leadership skills

These skills include good listening skills, good written and oral communication skills, and the ability to develop supportive social networks and form strong coalitions and joint ventures. Also make sure that you are able to give attractive public speeches. In addition, you need to have good collaboration skills, good consensus - building skills, the ability to resolve any conflicts, and have good negotiation skills, as well as the ability to conduct meetings. You are expected to know how to write to your respective local organisations and government officials, and to use the local and traditional media effectively.

It is also important that you remain well organised and ensure that you document your advocacy work in detail. The main focus of your advocacy depends on the nature of the health problem you have identified. Its success also depends upon the knowledge and skills you have.

  • Imagine that you wish to carry out an advocacy campaign to stop female circumcision in your local community. You are keen to draw people’s attention to the fact that the government has introduced a new Act outlawing the practice.

    Identify what tasks you need to undertake, and what groups or community leaders you need to involve when starting an advocacy group on this issue.

  • You need to identify if this is a primary health need in your local community and who are the influential members of the community who would support you in this—or the groups that you can call upon to support your advocacy activity. You then need to identify the barriers to progress on this issue—possibly, older people in the village may still be practising older cultural traditions and may not realise the seriousness of breaking this law, or the possible health risks of this practice.

18.4  Planning, implementing, monitoring and evaluating advocacy

You need well-planned activities to achieve your advocacy goals and objectives. You also need to identify and attract resources (money, equipment, volunteers, supplies and space) to implement your advocacy campaigns.

The steps discussed in this section will help you when you are planning and implementing advocacy activities.

18.4.1  Identifying the issue

In this step you must think more specifically about what you aim to do. You need to identify the problem that requires a policy action.

18.4.2  Knowing your audience

This means you should decide which audience to target through advocacy, and you must carefully determine the advocacy goals and objectives. At this stage, you are also identifying the policy makers you are trying to influence to support your issue. Examples include politicians, local officials and ministry officials.

18.4.3  Building support

Build alliances with other groups, organisations and individuals who need to become committed to support you in your advocacy work on health issues. You should remember that the campaign will be most effective when individuals and organisations join together in networks in order to increase the strength of your advocacy efforts (Figure 18.5).

The community gathering.
Figure 18.5  In each community you will be able to find model families who are keen to support your advocacy campaigns. (Photo: FMOH/WT)

18.4.4  Developing your message

An advocacy message is a statement that may be tailored to different audiences. These messages define the issue, state solutions, and describe the actions that need to be taken.

18.4.5  Identifing the channels of communication

Identify the channels and the messages to be delivered to the various target audiences through radio, television, flyers, press conferences, or during meetings.

18.4.6  Resource mobilisation

This means you need to identify and attract resources such as money, equipment, volunteers, supplies and space in order to carry out your advocacy campaign.

18.4.7  Advocacy activity

Once you have mobilised all necessary resources, you will be in a position to implement a set of planned activities, sometimes called an action plan, to achieve your advocacy objectives.

18.4.8  Monitoring and evaluating the activities

You need to monitor the process of an activity and gather information about how it is going, in order to measure progress towards your advocacy goal. Then evaluate the data gathered about the advocacy activities and analyse them to support each step of your advocacy campaign.

  • In your community or in your work, have you seen an example of someone using advocacy? This may not even be in the area of health. People advocate for education, for children’s rights, for farming resources, and so on. If you have seen advocacy in action, think about it, and look again at the above list and see which stages you can identify.

  • We don’t know what your example will be, but we hope that you have noticed how many of the features of advocacy are ones which crop up time and again in health education, such as knowing your audience, being clear about the message, checking and monitoring your results, and so on. Underlying all health education issues are these processes that help to clarify what is going on and keep them on track. In the case of advocacy, these processes are applied to solving a problem using a group as a resource.

Summary of Study Session 18

In Study Session 18, you have learned that:

  1. A health advocacy issue is a problem or situation that an advocacy group seeks to tackle in order to improve the health of their community.
  2. You need to build support from the policy makers you are trying to influence to support your issue. This will include politicians, local officials and ministry officials. Also make alliances with other groups and organisations that are committed to your issue.
  3. Key skills for advocacy include good listening and leadership skills.
  4. Your role as an advocate for health improvement in your community includes planning, implementing, monitoring and evaluating activities.
  5. You should build support, develop your message, identify channels of communication, and mobilise resources to implement your planned advocacy activities.

Self-Assessment Questions (SAQs) for Study Session 18

Now that you have completed this study session, you can assess how well you have achieved its Learning Outcomes by answering these questions. Write your answers in your Study Diary and discuss them with your Tutor at the next Study Support Meeting. You can check your answers with the Notes on the Self-Assessment Questions at the end of this Module.

SAQ 18.1 (tests Learning Outcomes 18.1 and 18.2)

Can you name at least two advocacy tools that will help you to conduct an effective advocacy campaign?

Answer

Two of the advocacy tools you will use are as follows:

  • Lobbying to influence the policy process, by working closely with key individuals in political and governmental structures, or decision makers.
  • Negotiation, to reach a common position.

SAQ 18.2 (tests Learning Outcomes 18.1 and 18.3)

In the development of teams there are a number of stages. Match the examples of what goes happens in each stage to the stages 1 to 4 below. them.

Using the following two lists, match each numbered item with the correct letter.

  1. There is initial exploration of the nature of the work and the group

  2. The group doesn’t really know the task and is working with a lot of uncertainty

  3. Reconciliation of competing ideas and accepting ground rules

  4. The group is satisfied with progress and able to get on together

  • a.1. Forming

  • b.2. Storming

  • c.4. Performing

  • d.3. Norming

The correct answers are:
  • 1 = a
  • 2 = b
  • 3 = d
  • 4 = c

SAQ 18.3 (tests Learning Outcome 18.4)

What are the communication skills you think you will need to help you in your advocacy campaign?

Answer

The communication skills are:

  • good collaboration skills
  • good negotiation skills
  • good consensus-building skills
  • the ability to resolve conflicts.

SAQ 18.4 (tests Learning Outcome 18.5)

What are the steps you should follow when planning and implementing an advocacy campaign?

Answer

Steps in the advocacy process are:

  1. Identify the issueidentify the problem that requires a policy action.
  2. Know your audiencehe people and policy makers that you are trying to influence to support your issue, e.g. parliamentarians, local officials, ministry officials.
  3. Produce a message and identify the means for that message to be delivered.
  4. Resource mobilisation — dentify and attract resources (money, equipment, volunteers, supplies, space) to implement your advocacy campaign.
  5. Implement your advocacy activity.
  6. Monitor and evaluate the advocacy activities.