Workshop Four: What works in Evidence-Based Advocacy

Linking Research to Action - Regional ConsultationCharlotte 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 socio-cultural, political, economic and legal framework for the realization of sexual and reproductive choice:– Building support– Defending– Monitoring– Coordination and networking

Contextual FactorsDemocracy

Constitution – human rights framework

De-racialisation

Women’s health.

International Conventions

Enabling context – women parliamentarians

Women’s HealthMRC study – 1994:– 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 factorsNegative 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:– 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

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 socio-

cultural 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?

Change Strategy Development (Braam&Dangor, 2002)

Strategies to address it

Understand:– 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:– 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.