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Advocacy is an integral part of ensuring the PHE approach is successfully implemented and scaled up to new areas and populations as well as institutionalized in policies, programs, budgets, and more. The HoPE-LVB project invested heavily in advocating for the PHE approach at multiple levels. Section 5 is written for development professionals and field practitioners engaged in PHE work who are interested in similarly positioning integrated PHE programs as a useful approach for achieving broader global health and sustainable development goals.
The HoPE-LVB project had two main advocacy-related objectives:
HoPE-LVB used a variety of advocacy strategies locally, nationally, regionally and globally to support its activities. Successes were achieved at all of these levels and momentum was built entering into and throughout Phase II, but with one challenge: the advocacy work kept multiplying with heavy demands on staff time/level of effort. This is a concern that PHE programs should keep in mind.
The efforts of HoPE-LVB champions complemented those of the project team. They lent their voices and credibility to support the project’s efforts. For example, the Lake Victoria Basin Commission, which began as an important policy target for HoPE interventions as a critical regional intergovernmental body working on sustainable development basin, became a strong and vocal partner and champion. This transition was key to elevating the visibility of PHE at the East Africa regional level.
The following sections offer tools for successful PHE advocacy modeled on HoPE’s experience.
Projects aiming to advocate for PHE should carefully document their implementation design and activity planning process. From the early design phase, this should be done in close partnership with multiple stakeholders—communities, local and national governments, and regional groups, among others—that share common concerns, are working in the relevant sectors, and/or are able to influence relevant policy, program, and budgetary decisions now and in the future. Additionally, in order for the results of your early pilot test to influence stakeholders in supporting action at scale, the results must convincingly demonstrate that the model is feasible, that it makes sense in the local and general contexts, and that it confers meaningful benefits to the targeted beneficiaries. The information you choose to share about the model must be relevant to stakeholders, and must be communicated within a timeframe that allows for sustained and scaled actions to avoid a loss of momentum. You may have one key message to convey to various stakeholders but will frame it differently for each of them depending on their interest, background and priorities.
Additionally, the rationale for model interventions that are integrated across sectors needs to be communicated in ways that facilitate understanding and which clearly identify “next steps” for sustaining and scaling integrated actions to multiple stakeholders and beneficiaries.
The diagram below shows how we envisioned the HoPE-LVB advocacy work to benefit local communities through the implementation and scaling up of direct service delivery and capacity building, but also to maintain a strong focus on policy advocacy that creates long-lasting change from local, sub-national, national, regional and global change towards the fulfillment of Sustainable Development Goals.
A key HoPE-LVB partner, ExpandNet, supported our project in engaging in advocacy for scaling up. Other PHE programs might consider adopting some of these steps in their scale up advocacy. For HoPE-LVB, a core team for the project was developed with the key project and technical partners. This core team then mapped out who the key focal points were from the larger external user organizations (entities that could adopt and scale-up the project in the future) nationally from ministries and other government agencies, and then the external stakeholders including regional and global players such as the Lake Victoria Basin Commission, the Lake Victoria Fisheries Organization, UN agencies, and donors.
A very intensive process of community engagement took place especially in the start-up phase, but also continuing through the project as new community members became involved. A network of PHE champions drawn from community leaders, fisher folk affiliated with beach management units, local women’s groups, government policy makers, NGOs, young people in and out of school etc., were trained and maintained as critical advocates and messengers for the project interventions and related educational messages. Results were presented during various opportunities, from community meetings to higher-level briefings involving District Councilors, County Governors, and Members of Parliament to report on progress and project achievements. Potential donors were also actively contacted with attractive and professionally developed communication materials.
Momentum was built surrounding the excitement of the PHE integrated approaches—at the local level, the project made the right conceptual linkages that captured the imagination of local leaders and community members, and motivated them into taking concrete and voluntary actions. Even as the project was in its initial phase, there was always the scaling up “end in mind” with an eye towards community ownership and the idea of embedding the project activities into various ongoing and existing initiatives. Communities were made aware that the project would eventually leave them with the knowledge and the capacity, but not continued funding or new donors. Some of the community members began looking for sources of funds that could be tapped, such as community development funds and seedlings for their agricultural activities in model households.
Furthermore, working on policy changes, however local, was important to the concept of sustainability and institutionalization of the project. The project team uncovered some possible quick wins and were able to affect some local ordinances and service delivery guidelines that would help communities achieve better outcomes in health and environmental conservation. The communities were also connected to larger global movements and events, such as Earth Day, World AIDS Day, World Population Day, etc. to understand their local challenges in a more global context. A critical step in the journey towards scaling up was to reach consensus on the expectations for scale up. Different stakeholders have different—often sectoral—perspectives and expectations for future targets for scaling up. This requires much discussion and clarification, first within the core team members, and then within the Steering Committees and then involving the larger group of stakeholders. This process is often overwhelming and consensus building is challenging given that hundreds of good ideas and possible paths are raised, discussed and prioritized, while the project implementation is still ongoing and staff are tasked with present pressing duties as well as laying the groundwork for the future. Consider implementing one or more of the HoPE-LVB approaches for scale up advocacy, as is relevant to and feasible for your project.
The Homa Bay County PHE Steering Committee.
In Kenya, a PHE Steering Committee was established as shown in the photo above. The County leadership decided it was to be founded not as a project-specific entity, but rather as institutionalized from the outset in the county government system. This was a big advocacy win for HoPE in ensuring its continuity.
The sections below highlight HoPE-LVB advocacy successes in relevant PHE domains to provide some examples.
Solar Suitcases© support deliveries at night.
The project produced two Advocacy Briefs to document the latest successes for the project in Kenya and Uganda, and the briefs can be accessed in Section 6 of the Toolkit.
To see all HoPE-LVB tools, visit Section 6 of our Toolkit.
Population Reference Bureau, a technical partner for the project, worked with HoPE-LVB staff in 2015 to create infographics (see below) to explain the steps taken to achieve outcomes from local, sub-national, national, regional, and global advocacy. These infographics were used for presentations to global and regional audiences, and in the HoPE-LVB Advocacy documentary produced by DevCom consultants in 2015. Other PHE programs should adopt these infographics if they are relevant to their projects.
Produced by Population Reference Bureau©, 2015, with inputs from HoPE-LVB team. See HoPE-LVB advocacy video for a narrated presentation of these slides.
Among the many lessons that were learned during the implementation of HoPE-LVB Phase I, some that relate to the advocacy work are shared below.
Advocacy is an important component of PHE programs. Other projects should apply the lessons learned by the HoPE-LVB project to the extent helpful to advance their work and PHE as a movement to address the Sustainable Development Goals. The HoPE-LVB project believed that the support and capacity required for key stakeholders to adopt integrated PHE interventions in the LVB at meaningful scale would be achieved through:
According to plan, the cross-sectoral implementation teams were able to implement, advocate, and document processes successfully enough to achieve the required support and capacity to implement this model at a broader scale in the Lake Victoria Basin and beyond.