Transforming Advocacy for Global Impact
This content delves into the strategies employed to drive change in advocacy efforts, focusing on local-to-global approaches, impact assessment, and prioritization of outcomes to end pediatric HIV/AIDS. It emphasizes the importance of clear theory of change, networked advocacy, accountability mechanisms, and performance-based monitoring for successful campaigns. Specific priorities include paradigm-shifting policies, increased funding, strengthened accountability, enhanced civil society engagement, and institutional reforms.
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Changing the World through Local-to-Global Advocacy Scaling and Assessing Impact from the Campaign to End Pediatric HIV/AIDS (CEPA) by Dr. Paul S. Zeitz, Executive Director & Professor Sanjeev Khagram, iScale Advocacy Breakfast Series Aspen Institute Washington, D.C. 15 January 2011
Waging Justice A Performance-based Advocacy Approach Agenda Setting Conception Target Accountability Accountability Advocacy NOTE: GPAN s advocacy approach was developed utilizing the Annie E. Casey Foundation s Guide to Measuring Advocacy and Policy, conversations with interviewees, and analysis by Dalberg Global Development Advisors. 1
Overview of the Waging Justice Advocacy Approach 1. Develop clearly defined, campaign-specific Theory of Change and Theories of Action to achieve Agenda Setting strategic political advocacy outcomes that align with GPAN s overall Theory of Change. 2. Utilize criteria for prioritizing among network models and targeted advocacy outcomes in order Conception to successfully advance GPAN s priority initiatives or campaigns. 3. Develop a clear approach to achieving impact based on experience, environmental mapping, and an understanding of key gaps in the advocacy landscape. 4. Utilize a networked advocacy approach to pressure decision-makers, mobilize constituencies, Mobilize Public and build partnerships. 5. Create or support campaign networks to design and implement advocacy action plans that Advocacy prioritize specific outcomes and reflect the needs and priorities of affected communities. 6. Engage in strategic political communications that speak truth to power, help frame the advocacy debate, and ensure rapid response to emerging advocacy opportunities. 7. Support watchdog mechanisms and networks to hold political leaders and other stakeholders Target Accountability accountable for their commitments. Account- ability 8. Conduct performance-based advocacy through robust systems that facilitate monitoring, evaluation, and continuous learning, e.g., Impact Planning, Assessment, Reporting and Learning (IPARL) system. 2
Strategic Focus on Five Priority Advocacy Outcomes ADVOCACY OUTCOMES Paradigm-busting POLICIES Secure evidence-based policies that achieve ground-breaking progress, rather than small-scale incremental change Increased and improved needs-based FUNDING Mobilize significant, sufficient, and sustained funding from diverse sources, e.g., public and private, and ensure efficient disbursement and implementation mechanisms Waging Justice Performance based Approach Inter- Connected Strategic Objectives ACCOUNTABILITY for people-level impacts Strengthen and create watchdog and enforcement mechanisms to ensure improved implementation of global, regional, and national commitments CIVIL SOCIETY inclusion in decision-making and implementation Increase civil-society participation and engagement with global, regional, and national institutions, and ensure local ownership of program design and implementation New and transformed INSTITUTIONS Strengthen the performance and impact of existing institutions through policy, procedural, and governance reforms, and create new institutions as needed 3
Campaign to End Pediatric HIV/AIDS (CEPA) GOALS: Going to Scale with PPTCT+ and Pediatric Treatment 80% coverage for pediatric HIV/AIDS treatment and 80% coverage for PPTCT+ services by December 31, 2015 Current CIFF Support: May 2009 April 2012 GPAN/GAA Committed to CEPA(+), 2011-2015 4
CEPA Local-to-Global Partners Initiating Countries Kenya, Mozambique, Zambia, Nigeria, Tanzania, Uganda: indigenous civil-society networks Sub-Saharan Africa Region ANECCA, PATAM, HAI Stock Outs Campaign, Health GAP, OSISA, Gra a Machel Trust Global Partners GAA, Health GAP Evaluation & Learning Partner: iScale Funding Partners: Children s Investment Fund Foundation (CIFF), UNICEF, others 5
CEPA IPARL COMPONENTS Link IE and M&E activities with Strategy Clearly articulated CEPA-wide Theory of Change Clearly articulated global and national, regional, and global level Theories of Action for CEPA partners An integrated assessment framework aligned with global, regional and national level strategies includes: baseline data, score card of indicators, evidence of change journals, and periodic assessments (review and evaluation) 6
CEPA IPARL COMPONENTS Link IE and M&E activities with Strategy Learning and improvement activities Constituency voice and feedback Public and donor reporting 7
CEPAs Advocacy Objectives Objective 1: Comprehensive Family Centered Care and Nutrition Objective 2: Early Infant Diagnosis and Treatment Objective 3: Access to Appropriate Medicines and Commodities Objective 7: Overcoming Stigma and Discrimination End 2015 Goal: 80% Coverage for Comprehensive PPTCT+ and Pediatric HIV/AIDS Treatment Objective 6: Overcoming Human Resources Crisis Objective 4: Full Funding Objective 5: Reprogramming to Achieve CEPA Impact 8
Theories of Action that Include Evidence/KPIs to Monitor Progress Towards Advocacy Outcomes and Advocacy Outputs Advocacy Outcome Advocacy Output Bottleneck National policy strengthened to prevent discrimination against HIV positive mothers and children. Evidence/KPIs: Punishments for discrimination in National policy are made more severe Report on national stigma index is published Evidence/KPIs: Stigma Report Stigma Advocacy Output Bottleneck Advocacy Outcome National Training curricula is drafted by relevant actors Evidence/KPIs: Draft of Training Curricula Lack of coordinated care An accredited set of National Training curricula for task shifting is established. Evidence/KPIs: National Training curricula document Advocacy Outcome Bottleneck Advocacy Output Comprehensive and harmonized pediatric care policies, guidelines, and standard operating procedures are adopted by National Government, donors, and providers. Limited number and capacity of trained health care professionals Pediatric care policy guidelines drafted by Ministry of Health Evidence/KPIs: Draft of Pediatric care policy guidelines Evidence/KPIs: 9
Robot Traffic Light System Color Code for Monitoring Progress Outcome/Output STATUS Outcome/Output STATUS Achievement of outcome/output Progress towards outcome/output Some progress towards outcome/output, but significant challenges exist No progress to date (or) no achievement of outcome/output Insufficient data for status assessment* This describes the status of outcomes irrespective of CEPA contribution CEPA CONTRIBUTION Towards Outcomes/Outputs CEPA CONTRIBUTION Towards Outcomes/Outputs Significant CEPA contribution Some CEPA contribution No CEPA contribution Insufficient data, un-validated data, or contested data which makes contribution assessment difficult 10
MoH adopts Opt A of new WHO Guidelines by Aug 2010 Core Objective 1: Family centred care and nutrition Core Objective 1: Family centred care and nutrition By end of 2010 MoH implements more effective PPTCT interventions, based on phased implementation of the new WHO PPTCT Guidelines Priority 1.1 Rapid adaptation and implementation of new WHO guidelines on ART, PPTCT+ and infant feeding by 2011 5 training wksps by CEPA partners on Ped HIV/AIDS and PPTCT for Com/tradit religious lead, healers, activists Com/tradit religious lead, healers, activists are trained about PPTCT and Ped HIV/AIDs treatment by end of 2010, by CEPA partners and endorsed by MoH Core Objective 2: Early infant diagnosis and treatment Core Objective 2: Early infant diagnosis and treatment (EID+T) (EID+T) CEPA identify/participate in 5 thematic wk groups open for CS participation by Jun 2010 CS engaged by MoH and Development partners in 12 meetings of thematic wk groups Priority 2.1 Development and implementation of EID+T guidelines to increase testing of children within two months of birth by 2011 Core Objective 3: Access to appropriate medicines Core Objective 3: Access to appropriate medicines Priority 3.1 Effective policy and monitoring mechanisms in place to reduce point of care stock-outs of ART for adults and children, OI drugs, EDI and family planning commodities by 2012 Training plans and guidelines to authorize non-physician clinicians on PPTCT clinical manage include provis of HAART and to provide ART By Dec 2010 MoH implements task shifting to allow non-physician clinicians to prescribe Ped ART and PPTCT Core Objective 4: Full funding Core Objective 4: Full funding MoH approv new strat plan for pharm logistics by Jun 2010 Within the next 12 months, supply chain management systems decentralized and better coordinated by MoH Priority 4.1 Increased national budget for PPTCT+ Ped treat, and services by 2012 Priority 4.3 Achieve the Abuja declaration commitment by 2012 Gov+Multi-lat/Bi-lat donors commit to increase funding for Ped HIV /AIDs and PPTCT 15% of the 2011 annual national budget (internal resources) is allocated to health sector (Abuja Declaration) (and within this 15%, adequate resources to MCH including PPTCT, and paediatric ART Cross Cross- -Cutting Objective 5: Reprogramming to Achieve CEPA Cutting Objective 5: Reprogramming to Achieve CEPA Impact Impact Priority 5.1 Political commitments and nat plans/frameworks adopt CEPA goals and priorities by 2012 No Output identified in NAAP 80% targets for supplying PPTCT+ and paediatric treatment services to be achieved by Dec. 31, 2012 set by government Cross Cross- -Cutting Objective 6: Overcoming Human Resource Cutting Objective 6: Overcoming Human Resource Crisis Crisis Priority 6.1 Effective policies and guidelines to expand and improve HR capacity to support scale up of PPTCT+ and Ped treat services by 2012 11
Advantages of CEPAs IPARL Agenda-setting effect of extensive advocacy action planning Aligned Campaign-wide theory of change, partner theories of action and KPIs Shift in focus from activities to measurable advocacy outcomes and outputs Real-time learning to inform strategy and course correction Integration and triangulation of multiple types of evaluation data Enhances capacity in all partners, improving non-CEPA related advocacy Enhances a global action network (GAN) approach to transnational advocacy 12
Risks/Challenges of CEPAs IPARL Requires authentic ownership and trust amongst partners Low capacity of advocacy organizations to implement reduces potential learning and course correction benefits Overcoming KPI-fatigue Attribution of contribution remains elusive Donor-driven monitoring and evaluation can shift focus from strategic advocacy Risk that funders will rigidly link performance- based advocacy to funding 13
Lessons: Performance-based Advocacy (PBA) Should be an integral part of the early stage planning process, incorporating regular monitoring reviews and periodic impact evaluation Requires a cultural shift among advocates Requires intensive capacity building and robust peer mentoring systems Must be fit-for-purpose, with sustained financial support by funding partners 14
"True peace is not merely the absence of tension: it is the presence of justice." --Reverend Martin Luther King Jr. 15
