Dashboard East Africa: Advocacy Working with Champions for the Promotion and Allocation of Resources Towards FP/AYSRH Programs

East Africa Toolkit: Advocacy

The Mayor of Mukono – an advocate for resources for family planning in Uganda.

Working with Champions for the Promotion and Allocation of Resources Towards FP/AYSRH Programs

A champion is a key influencer who believes in and actively supports family planning (FP) and adolescent and youth sexual and reproductive health (AYSRH). A champion(s) draws on their expertise, networks and position of authority as well as their visibility, social recognition and power to positively influence perceptions, attitudes, and decisions. They foster a supportive policy and social environment for acceptance and implementation of FP/AYSRH interventions.

TCI recognizes that promoting FP/AYSRH requires a diverse array of champions from the community, health facility, geography and national levels.

The categories of champions include advocacy champions, accountability champions, gender champions, youth champions, male champions and FP/AYSRH champions.

Why are Champions Important?

The Mayor of Mukono addressing riders on the importance of seeking health services, including family planning services.

Serve as internal catalysts in building goodwill and support across communities from within community, religious and political leadership structures.
Add credibility to interventions that aim to increase financial resources and supportive environment for FP/AYSRH interventions.
Advocate for FP/AYSRH intervention support from all levels, including national, subnational, community and facility leadership levels.
Help to promote social acceptability of FP/AYSRH and decrease stigma.
Create an environment for acceptance of FP/AYSRH at all levels.
Help to disseminate FP/AYSRH information and messages for increased support and uptake.

TCI in collaboration with local government recruits and trains FP champions to:

Keep FP/AYSRH issues on the government’s agenda.
Advocate to local and national governments to allocate more financial resources for FP/AYSRH programs and gender-focused activities.
Advocate for timely release of committed funds and improved utilization and accountability of those funds.
Advocate for supportive and friendly policy and social environment that foster access to contraceptive services by women and adolescents and youth.
Increase awareness of the benefits of FP/AYSRH by making positive public statements, including dispelling myths and misconceptions, at the community level, including sermons and prayers and on radio/TV shows.
Disseminate achievements made by the project to garner continued support.
Attend joint planning, monitoring and dissemination meetings.
Participate in intra- and inter-city cross-learning activities.
Take part in activities and key decision-making forums (e.g., planning meetings, public forums, educational forums, technical working groups, etc.)
Ensure gender roles are represented among champions and in key forums.
Advocate for gender-focused activities in all the evidence-based FP/AYSRH interventions, starting with the use of CHVs/CHWs/VHTs and whole site orientation.

Levels of Champions

National-level champions – include ministers of health, cabinet and permanent secretaries of health, members of parliaments, senators, directors, commissioners, media, religious leaders, cultural leaders, celebrities.
City/county/district/municipal-level champions – include governors, mayors, district chairpersons, district health officers, secretary for health, directors of health, county commissioners, key religious leaders, key cultural leaders, youth leaders, gender champions, media, local celebrities among others.
Health facility – include health workers, members of the Health Unit Management Committee, county health management teams and facility managers.
Community-level champions – include local leaders, both elected and appointed, mothers-in-law, religious leaders, cultural leaders, youth leaders, village elders, CHVs/CHWs/VHTs, satisfied FP clients, local artists among others.

Community-level champions in action

At the community level, champions will identify key advocacy issues hindering FP uptake at community level. They will bring to the limelight of decision makers at facility and geography level. In case issues are beyond the facility decision makers, champions will amplify to geography or national level decision/policy makers to advocacy for increased allocation and utilization of financial resources for FP/AYSRH.

Interrelationship between champions

Characteristics of champions include:

Highly influential individuals at national, district/community level.
Highly respected members of the community.
Key role models in the community.
Dependable and trustworthy persons in the community.
Willingness to serve beyond self-interests.
Gender and age sensitivity.
Representation from religious and cultural institutions, vulnerable/key population groups, such as People Living with Disabilities (PLWD), People Living with HIV/AIDS and Most at-Risk Populations (MARPs).

Evidence

The 2021/2022 advocacy efforts of FP/AYSRH champions have resulted in $2,166,777 being committed in East Africa for the implementation of evidence-based FP/AYSRH interventions, with 55% ($1,191,152) being spent.

The table below illustrates the local government commitments towards implementation of TCI’s evidence-based interventions across East African countries.

How has this been achieved?

Prioritization of evidence-based FP/AYSRH interventions and incorporation in annual work plans or strategic plans of local governments.
Strengthened integration of FP/AYSRH services at health facilities in all service delivery points.
Consensus among community leaders in support of FP and contraceptive services through community dialogues and sensitization forums have yielded a common voice in support of FP/AYSRH.
Continued discussion around FP and contraceptive services in the media due to sensitization and training of journalists. Radio programs have also been aired to educate and create awareness of the benefits of FP.
Establishment/creation of FP male champions, including boda-boda riders.

Hear from champions

“Kilifi County is among the counties that have been grappling with high cases of teenage pregnancies and the involvement of TCI in the fight against this vice is a big boost to our intervention. I’m determined to champion the course on teen pregnancy reduction in this county, working hand-in-hand with other key players like TCI and other stakeholders and I am sure we will win this fight”. – Governor Amason Kingi, Governor of Kilifi County, Kenya.

“I have instructed all sub-county chiefs to ensure that family planning is prioritized in their sub-county annual work plans for this financial year 2020/21. The District Council will approve no sub-county annual plan or budget, unless family planning is prioritized. This will ensure that our people have access to family planning information and services”. – Mr. Patrick Kayemba, former chairperson LC V Iganga district.

Guidance: How to Mobilize and Support Champions for Promotion and Allocation of Resources Towards FP/AYSRH Programs

Support local governments to identify and select men and women throughout the health system who possess the characteristics of champions described earlier and are known for their enthusiasm for FP and motivated, willing and eager to serve as public advocates for FP/AYSRH. NOTE: Supporters may be difficult to identify for lesser known, or more controversial, topics such as support for contraceptive services for adolescents and youth. In these cases, work with community influencers to identify who can be engaged.
Orient the selected champions on advocacy tactics. Champions are drawn from a broad range of backgrounds and different sectors of the community and are oriented and utilized accordingly based on their spheres of influence. Tailor the orientation based on the audience they will target and tailor message(s) to be delivered to them accordingly. The orientation should be based on the SMART Advocacy manual.
Share program briefs, gaps identified, and information packages, including IEC materials like fliers, fact sheets, and the myths and misconception booklets.
Develop and schedule an action plan for advocacy activities they can support providing room for any ad-hoc advocacy opportunities, such as mobilizing funds from high net worth individuals.

Sample Advocacy Messages

Target audience	Message	Desired outcomes
National & local government level technical and political leadership. This includes ministers, members of parliament, governors, mayors, district chairpersons and secretaries for health, commissioners, directors & district health officers, Reproductive Maternal, Child and Adolescent Health Coalition, UFPC, FP advocacy groups such as National Population Council (NPC) in Uganda or the National Council for Population and Development (NCPD) in Kenya, etc.	Advocacy issue to address: High rates of teenage pregnancies High unmet need for FP High rates of maternal death High school drop-out rates Increased poverty level And prioritization of resource allocation for FP and the implementation of evidence-based and gender-sensitive FP/AYSRH activities and interventions. Messages: Allocating more funds for FP/AYSRH will ensure that contraceptive services are made available for all the target population. This will improve on the health and wellbeing of women, adolescents and youth. Ensure a healthy and productive population. Increase modern contraceptive prevalence rate (mCPR), thereby meeting national FP goals and commitments.	Increased and sustained resources for FP/AYSHR/RH Development, implementation, and dissemination of supportive RH/MNCAH policies. Institutionalization of the TCI’s evidence-based interventions within city work plans and budgets.
Facility level-health workers. This includes health management teams (HMTs), medical officer, directors of health and accountants.	Advocacy issue to address: Persistent stock outs Staff capacity – inadequate FP skills Inadequate FP service provision space Messages: Persistent stock out of FP commodities has limited access to contraceptive services and method mix which contributes to missed opportunities and unplanned pregnancies. This can be addressed through strengthened management of FP supply chains. Capacity building of health providers will ensure quality of FP services offered. Provision of adequate space for FP services provision will enhance privacy and confidentiality.	Provision of quality FP services. Utilization of evidence-based approaches. Integration of FP/AYSRH activities according to the MoH guidelines. Promotion of FP and provision of accurate information.
Community-level champions. This includes religious leaders, gatekeepers, mothers in law, traditional birth attendants, CHWs/CHVs/VHTs, peer champions, boda boda riders	Advocacy issue to address: High rates of teenage pregnancies Demystify myths around FP Linkage to FP services through CHVs/CHWs/VHTs and health facilities Enhancing access to quality FP/RH services Messages: FP benefits for the baby, mother, father, community and nation. FP empowers women to engage in other economic and productive activities.	Dispelled myths and misconceptions about FP/AYSRH Increased knowledge about the benefits of FP Improved attitudes towards FP and AYSRH Improved knowledge of services available, including referral services
Media. This includes Radios and TV journalists, news reporters and social media influencers.	Share program achievements on FP/RH including beneficiary success stories. Messages: Investment in family planning can accelerate attainment of the demographic dividends. Dissemination of FP/RH policies and guidelines to support implementation of evidence-based interventions. Political support from local governments towards implementation of quality FP/RH services.	Dissemination of accurate information on FP/RH Public dialogue around FP/RH Educating the general public about benefits of FP Demanding policy implementation

Tips for motivating champions

Identify opportunities for recognizing active champions, such as sponsorships to share learnings from working with TCI and other partners.
Reward and recognition during local government and partner activities.

Key Outcomes

Increased and continued commitment of financial resources for FP/AYSRH programs.
Timely release and utilization of committed funds to support provision of FP/AYSRH services.
Reduced myths and misconceptions at community level around FP/AYSRH.
Increased uptake of family planning services.
No missed opportunities to offer FP information or services at facilities.
Increased resource allocation for implementation of FP/AYSRH interventions.

Monitoring Processes

Track the implementation of the champions’ action plan.

Success Indicators

Increased budgetary allocation for FP or RH
Increased uptake of FP and contraceptive services
Reduced teen pregnancies, maternal deaths, etc.

Cost

Orientation of champions, using a FP champions orientation package
Printed IEC materials: fliers, fact sheets, myths & misconceptions booklets, t-shirts, banners, etc.
Progress and update review meetings with the selected champions
Recognition of active champions, e.g., media awards ceremonies
Transport costs for participation in intra- and inter-city cross-learning activities

Sustainability

Linking community champions with health management and administration teams.
Inclusion of community volunteer champions as part of the MOH cadre.
Capacity building of the advocacy champions in policy, advocacy and social accountability.