TCI University Toolkit: Advocacy
COVID-19 and Family Planning/Reproductive Health
The Challenge Initiative is working to provide additional resources and tools to help those working in family planning and reproductive health respond to the COVID-19 pandemic. LEARN MORE
Advocacy at the Sub-national Level
What Is It?
The process of getting buy-in and support for family planning among leaders and decision makers in discrete areas within the country (including regions, provinces, districts and counties). Such advocacy is especially important in countries with decentralized governments where decision-making power is spread throughout the system, rather than being concentrated at the national level.
What Are the Benefits?
- Provides current information on the economic and health benefits of family planning to elected officials at the local level
- Helps local leaders make informed choices about population and family planning policies using data from their own community
- Helps local governments make commitments to prioritize resources for family planning at the regional, provincial, district and/or village levels
- Ensures that governments follow through on family planning commitments at all levels of a country, reducing dependence on donors and national governments
- Builds a supportive environment for family planning by encouraging community ownership and by helping to scale-up effective programs in new areas
How to Implement?
Identify key stakeholders at the defined sub-national level
- Include Ministry of Finance staff and others in charge of budget decisions.
- Include Ministry of Health staff and others who create policy related to family planning, health care providers and service delivery.
Form an Advocacy Working Group
- Referred to by different names – such as an Advocacy Working Group, Advocacy Core Group or District Working Group – this working group includes the individuals identified in Step 1 and will be the community voice for policy change. The working group will be a way to engage with key decision-makers, build consensus and secure funding and support for family planning.
- Within this group, form a budget task team to support and influence budget processes and decisions.
Convene regular meetings with the Advocacy Working Group
- Meetings should be held monthly, or more often if needed.
- During these meetings, share relevant data with the group including:
- Unmet need for family planning in the area
- Family planning commodity needs of the area
- Evidence related to infrastructure, facilities, equipment and human resources
- Evidence of impact of strengthening family planning services in nearby areas (if available)
- During these meetings, come to consensus about the important issues in the given area and for what the group will advocate such as additional funding.
Conduct formative research and analysis
- Conduct a Family Planning Effort Index assessment to understand the family planning environment. You can complete the tool with the Advocacy Working Group to understand how to communicate the family planning situation in your area and what to prioritize in the advocacy strategy.
- Conduct key informant interviews to better understand the policy environment for family planning. The Nigerian Urban Reproductive Health Initiative (NURHI) created a tool, which you can use or adapt, to conduct these interviews.
- Working with the budget task team, use a budget questionnaire, such as the one used by NURHI (p. 9), to identify and map out family planning resources in your area.
- Analyze the results from your formative research and determine main challenges to overcome during the design of the advocacy strategy.
Design and implement your advocacy strategy
- Convene the Advocacy Working Group and design a site-specific advocacy strategy.
- Based on the result of the budget questionnaire, develop specific goals related to family planning funding. For example, the first goal may be to establish a budget line item for family planning at the local level, followed by increased resource allocation. You may also want to include goals that address policy barriers, for example, allowing lower-level providers to deliver injectable contraceptives.
- Implement the specific activities of your advocacy strategy, which can vary widely depending on your strategy. For example:
- The budget task team members may meet with their Ministry of Finance colleagues to advocate a budget line item and increased funding for family planning.
- Other members of the Advocacy Working Group may organize sensitization meetings with other leaders (e.g., mayors, governors) to mobilize support and share information about the impact of family planning. One objective may be to include family planning within the integrated five-year plan at the province, village or district level.
- You and the other Advocacy Working Group members may hold community dialogues to exchange information about family planning services.
Hold advocacy trainings to increase skills and competencies of Advocacy Working Group members
- Training Advocacy Working Group members will help sustain the advocacy activities and ensure members can advocate on your behalf with their colleagues. The AFP SMART advocacy tools can be used in advocacy training.
- Training members on budgeting and financing, for example, with resources included in the guide Enhancing Contraceptive Security Through Better Financial Tracking, can help them better track resources for family planning commodities. The Health Policy Plus Project also hosts the helpful SPECTRUM tools, which provide policymakers helpful analytical tools to support their decision-making.
Develop and use advocacy materials
- Prepare appropriate advocacy materials such as briefs and presentations that will meet the decision-makers’ needs, focusing on the latest evidence in your area. Meet the decision-makers where they are, and be creative. Think about using stories, photos, infographics or videos, along with data and facts, to communicate your message. Be specific, direct and succinct; many of these decision-makers may not have a strong technical background in family planning or have little time. Most importantly, concentrate on the “ask” – what do you want the decision-makers to do?
- Using data is a key element of advocacy materials. For more on using data effectively for advocacy and decision making, read about the experiences of the Urban Reproductive Health Initiative in India here.
- Advocacy materials can be city-specific, such as the RAPID Tools developed in Nigeria, and can be used to stimulate community dialogue.
- Think about when, where and how you will deliver the message. What kind of response do you expect from your audience and how will you address their concerns?
- For in-depth guidance on developing advocacy messages, see the box on p. 21 of the AFP guidance on developing a strategy.
Examples of advocacy materials:
Follow-up and monitor advocacy efforts
- Convene quarterly review meetings to assess achievements – and any setbacks – of the Advocacy Working Groups and the budget task team. Shift activities as necessary.
- Hold annual site-specific implementation review meetings.
- Scale up successful interventions, as they are identified, to other areas.
- Work with Advocacy Working Group members and others (e.g., community organizations, religious organizations) to ensure sustainability of advocacy efforts.
- Track budgets to assess inclusion of family planning as a budget line item.
- Use a budget tracking tool, such as the tool used by NURHI, to ensure funding allocated for family planning is being used appropriately. For additional resources and tools, see AFP Advocacy M&E Resources.
Sample Indicators to Track Advocacy Efforts:
- Inclusion of family planning as a budget line item
- Increased allocation of family planning in the given area
- Inclusion of family planning in the integrated plan of the given area
What Is the Evidence?
Sub-national advocacy for family planning can help secure funding and increase access to contraceptives. For example, in Senegal, sub-national advocacy helped ensure that mayors and other local leaders made financial commitments to family planning.
Specifically, sub-national advocacy can help:
- Establish a budget line item for family planning at the local level (as evidenced in Kenya and other locations)
- Increase resource allocation at the local level (in Indonesia, village-level advocacy helped ensure family planning was in community-level budgets)
- Include family planning in local integrated plans
- Create more favorable public attitudes toward family planning, as evidenced in Nigeria
These results can in turn lead to greater contraceptive prevalence rates and lowered maternal mortality and infant mortality rates.
Take An Assessment and Get a Certificate
0 of 5 questions completed
You have already completed the assessment before. Hence you can not start it again.
Assessment is loading…
You must sign in or sign up to start the assessment.
You must first complete the following:
0 of 5 questions answered correctly
Time has elapsed
You have reached 0 of 0 point(s), (0)
Earned Point(s): 0 of 0, (0)
0 Essay(s) Pending (Possible Point(s): 0)
Advocating at the sub-national level is an important approach for countries where decision-making power concentrated at the national level.CorrectIncorrect
A key target of sub-national advocacy are financial staff and other budget decision-makers.CorrectIncorrect
What should be discussed at regular Advocacy Working Group meetings?CorrectIncorrect
How do you intend to use the information reviewed and/or tools that you accessed?
Grading can be reviewed and adjusted.Grading can be reviewed and adjusted.
This response will be awarded full points automatically, but it can be reviewed and adjusted after submission.
How useful did you find the information and/or tools presented on this page? Please write your response in the box below using one of the following phrases: Very useful, Useful, Somewhat useful, Not useful.
Feel free to comment on why you made that choice.Grading can be reviewed and adjusted.Grading can be reviewed and adjusted.
- When local decision-makers are leaders of the Advocacy Working Group, the advocacy activities are likely to have more local ownership and be more sustainable.
- Avoid asking for too many things at once at advocacy meetings. Present one specific “ask” – for example, adding a budget line item to the district budget.
- Engage with community members about issues that may be unclear – for example, private provision of contraception, use of or demand for long-acting methods.
- Adapt your messages to the needs of different decision-makers.
- When working with decision-makers who are unsupportive of family planning, think about what might motivate them to change their mind. For example, you can frame family planning in terms of family health, child health or economic empowerment.
- Busy decision-makers are often influenced by those around them, such as their assistants or deputies. Build relationships with these people.
- To overcome barriers related to staffing changes with the government, you can advocate for inclusion of family planning in the sub-national five-year strategic plans. This can help ensure government commitments for family planning, even when new staff join.
- Advocacy is a continual process and you may not see immediate results. To keep up momentum, it is important to focus on “quick wins” – small achievements leading up to your larger goal.
- It can often be hard to get decision-makers to meet with you or listen to your message. Identifying the best messenger – perhaps it is someone on their staff – is often just as important as identifying the decision-makers themselves.
Tools Related to This Approach
- Nigeria: The NUHRI Approach for Advocacy
- Family Planning Budget Tracking Tool
- Budget Questionnaire
- Media Stakeholder Analysis
- Key Informant Interview Questionnaire
- Handbook for Political Analysis and Mapping
- Handbook for Budget Analysis and Tracking in Advocacy Projects
- Towards a Common Framework for Measuring Government Spending on Family Planning