"A" Is for Advocacy
Some Thoughts on Advocacy for Reproductive Health Programs
by Phyllis Tilson Piotrow, Ph.D.
As the UN looks forward to implementing the remainder of the ICPD program over the next 15 years, the importance of advocacy grows clearer. Without advocacy, neither personal behavior nor political commitment can be sustained.
"People now know about family planning, quite a few of them are using it, and some of them are beginning to advocate its use to others," according to one West African family planning official. But other elements of the Cairo agenda, such as safe motherhood, an end to female genital mutilation, and more schooling for girls, are not well known. Moreover, reproductive health organizations promote knowledge and provide services, but advocacy usually remains off the agenda.
Advocacy is often the ultimate step in the process of behavior change—a process that begins with knowledge and moves through approval, intention, and practice. For reproductive health clients, speaking up for family planning or other healthy behavior validates their choices and sustains their commitment. As more and more people speak up, their behavior becomes the community's social norm. Healthy behavior becomes not just accepted, but also expected.
Similarly, reproductive health organizations are spreading knowledge and encouraging approval, particularly through the mass media. With expanding services, they are helping millions of people practice healthier behavior, too. Now more organizations need to move into advocacy to make sure their achievements are sustainable.
For reproductive health advocacy, a vital need is giving a voice to the silent majority that supports these programs, even in the face of sometimes vocal minority opposition. As funding from international donors falls behind the promises made in Cairo, many developing countries have to dig deep to find sufficient support. Policy-makers will support reproductive health programs adequately only if they feel a groundswell of demand from the grass roots. And grassroots organizations can express this demand effectively only by making advocacy a top priority.
The ICPD Program of Action states: "Governments, non-governmental organizations and the private sector should make greater and more effective use of the entertainment media...to encourage public discussion of important but sometimes sensitive topics related to the implementation of the present Programme of Action." The words "encourage public discussion" are key. Raising the priority of an issue—for example, starting public debate and creating opportunities for successful practitioners to speak out—is crucial to changing policy and increasing funding.
Public discussion does not happen in a vacuum, however. It can occur through strategically planned action. Effective advocacy is a 6-step process—Analysis, Strategy, Mobilization, Action, Evaluation, and Continuity. This framework covers working with the news and entertainment media, handling controversy and rumors, persuading the undecided, and identifying potential advocates. Identifying potential advocates is a central task in the initial, Analysis step. Many reproductive health programs involve community members in designing and carrying out activities. With a little help, these people can become powerful advocates. So, too, can satisfied clients: Their personal advocacy can lead the way to public commitment.
—Phyllis Tilson Piotrow, Ph.D., Director, Johns Hopkins Center for Communication Programs
(This article is based in part on "A" Frame
for Advocacy, published by the Johns Hopkins Center for Communication
Programs.)
