Transcript Workshop Four: What works in Evidence

Workshop Four: What works in
Evidence-Based Advocacy
Linking Research to Action Regional Consultation
Charlotte Hord & Tamara Braam
23 March 2006
Workshop Objective
To provide an opportunity for advocates,
policy makers and researchers to share
experiences, skills and tools that would
help them to engage in advocacy
related to unsafe abortion on the
continent, and to apply these
approaches to their contexts.
Planned Outcomes
Participants would have shared information
and knowledge on their own experiences as
advocates.
Participants would have identified critical
success factors from respective country
examples.
Participants would have shared and
developed messages for effective advocacy
within their own contexts.
Participants would have shared experiences
on developing effective communication
strategies.
Process Agenda
Welcome - Opening Circle
Introductory Exercise & Feedback
Short input on other country examples
Engagement on successes and challenges.
TEA BREAK
Developing communication strategies
Feedback & group engagement
Closure
Welcome and Introductions
In pairs/ groups of four
talk about the following:
– Have you been involved
in advocacy / research/
both?
– Have you used research
for advocacy purposes?
– What were the
successes?
– What were the
challenges faced?
– Key lessons from your
experiences.
Examples- sharing
Ethiopia
Nigeria
South Africa
Kenya
South African Example
Reproductive Rights Alliance
National Structure – genesis – passing of the CTOP
Act.
Membership based – multi-sectoral.
Advocacy focused.
Centrally focused on creating an enabling sociocultural, political, economic and legal framework for
the realization of sexual and reproductive choice:
– Building support
– Defending
– Monitoring
– Coordination and networking
Contextual Factors
Democracy
Constitution – human rights framework
De-racialisation
Women’s health.
International Conventions
Enabling context – women parliamentarians
Women’s Health
MRC study – 1994:
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44 686 incomplete abortions each year.
425 women dying.
99% women – black.
Total annual costs: R 18 700 000.
Sepsis, haemorrhage, infertility, death.
Direct, indirect and social costs.
Factors
Enabling political context
Levers for change
Organized civil society
Research base
Relationships and engagement with key
decision makers.
Lobbying
Framework for understanding
Advocacy
It is ACTION directed at change.
It involves putting a problem on the
table.
Proposing a solution to that problem.
Building support for that proposed
solution and
Working towards the realization of that
solution.
Minor Consent Challenge
Challenge to the legislation
29 –30 April 2003
Exception – validity of what plaintiff is saying.
Challenges:
– Definition of a woman as a female of any age
– Provision – no consent other than the consent of
pregnant woman – clause number 5.
Key Arguments used
Girl not capable of giving informed
consent.
Should obtain consent from parents.
Should be prohibited if she did not get
parental consent.
Should be prohibited if she did not get
permission from High Court.
In defense of the right to
choose
Removes a barrier from obtaining a safe
service.
Protects minor’s rights, health and lives.
Responds to context of high levels of
unsafe sex.
Provides safe, real alternative to child
bearing and child rearing.
Adolescents – a particularly
vulnerable group
Globally 60 out of every 1000 adolescent give birth every year.
15 million babies born to these mothers run double the risk of
dying in first year.
Girls under 18 are two to five times more likely to die in child
birth as women in their twenties.
Every year 60000 adolescent women die from health problems
related to pregnancy and child birth.
At least 25% of all unsafe abortions internationally are
experienced by girls between 15 and 19 years.
Why are adolescents
particularly vulnerable?
Typically discover pregnancy later than older women.
Tend to delay obtaining an abortion - pushes them
into second trimester – greater risk.
Often seek abortion based on hearsay from other
young women.
More likely to obtain it from non-medical, unskilled
providers.
Financial factors
Negative attitudes of health care providers.
Profile of country
41% of overall population under 18 years.
More so in rural based provinces: 50% of Limpopo
Province’s population <18 years, 47% of Eastern
Cape population and 30% o Gauteng.
National Youth Survey (2000) –78% had sex by age
of 15 years.
35% of women under 20 became pregnant (NDOH,
1999).
Levels of HIV infection amongst young women.
Unsafe Sex is widespread
Levels of HIV infection amongst young women:
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In relationships with men older than themselves.
Power relationships – have sex without condom.
Do not have skills and knowledge to negotiate safe sex.
Coercion
Rape by older family member or boyfriends
Levels of teenage pregnancy and teenage
motherhood.
Young women – particularly
vulnerable to violence
60% of teenagers surveyed in a Western Cape study reported
physical assault by male partners.
National Youth Survey (2000) showed that 4 in 10 girls indicated
that they had been forced to have sex.
Police statistics (2000) showed that in 40% of reported rape
cases survivors were <18 yrs.
SAPS Child Protection Unit (1998) and the Victims of Crime
Survey (1999) showed that rape is most prevalent crime against
children, accounting for 1/3 of all serious offences against
children reported between 1996 and 1998.
Silence around issues of
sexuality
Parents / adults not communicating
adequately with young people about sex.
Information from peers- misinformation, in
certain instances.
Factors:
– Fear
– Feeling inadequate
– Cultural and religious beliefs
Key Messages of anti-choice
It is anti-God – against our religion.
It is against our culture.
Young women will be irresponsible and
use it as a form of contraception.
Women who need abortions have loose
morals.
Messages
Young people count.
Making good choices saves young
people’s lives.
Democracy is about choice.
Pro choice- pro woman, pro child, pro
life.
Assessing political opportunity
space?
What are the levers for change in the current
context?
Where is the consciousness around the
issue?
What are the opportunities to shift this?
What is the likely opposition?
How can this be neutralised - who are our
allies in this process?
How does the issue relate to competing
political priorities?
What is the discourse?
For reflection
What were the factors
that derailed the
advocacy process?
What have been your
own experiences about
what went wrong?
How can we plan for
these?
What kind of
information do we need
to be proactive and
preemptive?
To think about
What factors do we have control over?
What factors don’t we have control
over?
How do we define success?
Meeting your advocacy objective I.e. bringing
about the change that your sought to bring
about.
Managing the change process in ways that
optimize the direct and indirect outcomes and
spin offs for your change agenda.
Effective and wide engagement with a cross
range of stakeholders to build ‘ buy in’.
Championing of the issue.
Elements that contribute
towards success
Important within advocacy to be very clear on
what specific problem you wish to address.
Critical to understand the nature of the
problem that you wish to address.
To be clear on what specific change you wish
to bring about.
To understand who the key stakeholders are
and what their specific ‘ stake ‘ is in the issue.
Change Agenda Framework
Change Strategy Development
(Braam&Dangor, 2002)
Situational Analysis:
What is the situation at
the moment in relation to
unsafe abortion? Extent
of problem, costs,
impact, political
opportunity space.
Visioning:
What would we like to
see in the respective
countries in Africa?
Think of law and policy,
health systems and sociocultural context.
What are the nature of the
gaps between what is and
where we would like to
be?
What is required for us to
implement change?
Strategies?
Research base?
Processes?
Alliances?
Platforms?
Messages
Resources?
Strategies to address it
Understand:
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the full extent of the problem
the flaws in existing policy and legal framework
impact of unsafe abortion on health system, individuals and family
who the key stakeholders are
where consciousness is in relation to the issue
Opposition and supporters
Build support with strategic sectors:
– Formation of Alliance
– Targeting key sectors: policy makers, media, NGOs, women’s rights
groups, other
– Engage with challenging sectors e.g. religious sector
Effective Advocacy
Understand your issue.
Believe in your issue.
Have your arguments ready.
Get your messaging right.
Understand your constituency you wish to win:
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What makes them a special group?
What makes them tick?
What are their fears?
What are their hopes?
Communicating on abortion
To talk about
What stops us from
effectively
communicating on
the issue of
abortion?
What are our fears?
Discomfort zones?
How do we address
these?
Why is it a difficult issue?
Morally charged.
Emotive
Stigmatised.
Pushed under the mat.
Highly gendered
Dual community morality
Seen in a dichotimized way.
To think about
Who makes the key decision about the issue?
What about the issue makes it relevant to
them?
What do they know about it?
What are their beliefs and attitudes about it?
What kind of information do they need to
have to shift them?
What other interventions do we require to
shift them?
Policy Makers
Critical decision-makers, public figures, have
constituencies, have power to influence
policy and resourcing.
Political mandate - support from the
electorate - growth.
Fears - losing support, seen to be ineffective.
Hopes - continued political role - political
agenda realised.
Developing a change agenda:
to think about…
Where is the level of consciousness on the
issue amongst parliamentarians?
What strategies can be used to shift those
sitting at respective levels?
How can the issue be positioned to link to
other critical competing political priorities?
What are the key messages that are needed
to put the issue of the political agenda?
Developing a change agenda:
to think about…
What are the possible political benefits to putting the
issue on the agenda?
What are the possible political drawbacks to putting
the issue on the agenda?
How do we optimise political benefits?
How do we minimise drawbacks / put mechanisms in
place to address these?
Reaching our audience
Need to move them:
– Understand cognitive
– Feel
– See
– Hear
Being moved is an
emotional
experience
For plenary discussion
What is our advocacy agenda?
What key change do we wish to bring about on the
continent in relation to the issue on unsafe abortion?
What information / research base do we need to
bring about that change?
What interventions are required to shift attitudes?
How do we know that that information is required?
Who needs that information?
How should we communicate that information ?
For group engagement
Define your advocacy/change agenda.
How would this information be translated into
messages?
What are the key messages?
For which target groups?
Who are the best messengers?
How would they be packaged differently?
In summary
Understand the issue in
its context.
Understand the context
and the players.
Develop effective
strategies to
communicate these.
Bring role players
together.
Address and plan for
barriers - internal and
external.