How should implementing actors advocate for sector-level change?
Implementing actors should consider advocating for policy changes throughout all phases of the policy change process, from agenda setting to policy evaluation. For policy implementation, the removal of obstacles, such as financing and developing the human resources needed, is very important. While advocating, key sources of information on the health and non-health impacts of hygiene programmes should be included and the economic case for health and water, sanitation and hygiene (WASH) sector interventions should be made. It is expected that some advocacy strategies will need to be adapted in response to the disease outbreak.
In the same way that programmes are adapted over time, it is important to incorporate adaptation into your policy plans and be responsive to the changing social, economic and political landscape. In this section, we describe some tools and approaches for advocating to decision-makers and policymakers. This includes setting up an advocacy plan with creative ways to influence and persuade key actors and actions organisations can take to ensure they are in a strong position to influence policy in the longer-term.
Develop an advocacy plan: Advocacy work, just like programming, is likely to be much more successful if a clear plan is developed from the outset. The WASH in Healthcare Facilities Advocacy Toolkit includes practical guidance on how to develop an advocacy plan. Part of advocacy planning includes being clear on your specific objective, who your target audience of decision-makers are and what actions you would ultimately like them to take. To develop a clear advocacy plan, the following tools can be of use:
Stakeholder analysis: Identifying and analysing the actors who have interest and play an important role in your issue will help determine how your programme is developed and can help gain support for the initiative. Conducting a stakeholder analysis can also help in amplifying your cause. Here is a set of guidelines that outline how to conduct a stakeholder analysis.
Power analysis: A power analysis may follow a stakeholder analysis and can help to identify actors who have a lot of influence, or power, over the issue your programme is meant to address. This requires identifying both actors who may be in support or opposition of your programme, and analysing how to potentially gain the support of any opposers.
Political Economy Analysis: A Political Economy Analysis can help you to understand how change happens, identify how best to influence change, and make more politically informed decisions. This toolkit from WaterAid can be used to guide the approach.
Identify positive examples: If you are advocating to the government, or even internally within your organisation, it can be useful to look at the policies adopted by other governments or similar organisations and find good examples of hygiene-related policy change. Inviting individuals who led this change to speak with key decision makers could be a powerful way to motivate change and help them to view change in a way that seems feasible. Make sure to articulate why they worked well, what led to their success and what about the case study could be replicable within your context.
Identifying ‘champions’: ‘Champions’ are individuals, usually government officials, who have the ability to directly promote or influence policy. This resource helps define who a ‘champion’ can be, and how their level of support for a cause can be measured to help determine to what degree they will advocate for your cause.
Influencing policy: Individuals in decision-making roles may be influenced to act through different types of information. Some people may find detailed health data or economic information persuasive, whereas other people may be compelled to act based on human stories or personal experiences. Below we outline some ways of sharing advocacy information and influencing decision makers:
Policy briefs: Short, clear and detailed letters targeted to decision-makers can be influential in relaying your message. For instance, Sanitation and Water for All have created a document with information about COVID-19 and messages targeted to policymakers about the importance of prioritising WASH during outbreaks. However, you should make sure that policy briefs are followed up by direct engagement with decision-makers, as this is more likely to lead to concrete action.
Media work: The media can be leveraged in many ways for advocacy and helps increase the reach of your message and mobilise support, whether it be through traditional channels, such as newspaper op-eds, the radio and television, or through social media. Utilising media can be a cost-effective means to relay information and present it in various creative ways.
Creative use of media: The way you convey information can also make a difference. Consider creative approaches to influencing, such as the use of videos, infographics, social media, data visualisation and so on.
High-level events: High-level events, such as conferences or other public events, may provide an opportunity to advocate to a larger audience or specific stakeholders who are important to your cause. However, consideration should be given to how advocating at high-level events will need to be adapted depending on severity and scale of the disease outbreak. For instance, during the COVID-19 pandemic, there was a shift towards ‘digital advocacy,’ due to there being fewer opportunities for in-person events and conversations.
Policy papers: Findings from academic research may present recommendations for WASH policy changes that are based in evidence (Study 1, Study 2, Study 3) or evaluate government programmes to hold them accountable for their WASH policies (Study 4). Policy papers published during outbreaks can be harnessed to advocate and put pressure on international actors and governments to implement or adapt policies. .
Strategic advocacy work: Advocacy work rarely leads to rapid change. Rather, change is more likely to occur when you have developed sustained partnerships and when your organization has gained a position of trust among key actors and decision makers. Below we outline some longer term actions that organizations can take to allow them to be more strategic about their advocacy approach.
Develop a range of local advocacy champions: Decision makers may be more likely to act when they are under pressure to do so from a range of stakeholders. Organizations can help to build the advocacy skills of a range of local actors, so that they can speak with a ‘collective voice’. This could include helping individuals to realize that WASH and health are human rights and encouraging people to demand these rights from their elected representatives or those that are accountable to them. It could also include supporting civil society organizations (CSOs) who may be better placed to speak on behalf of populations. This blog from IRC provides several examples of how their advocacy work with CSOs was adapted during the COVID-19 pandemic.
Develop relationships with media: Journalists working for mainstream media have a huge potential to shape how public health outbreak is perceived by populations and influence whether the crisis becomes a catalyst for longer-term policy change. It may be worth building relationships with journalists and strengthening their skills so that they are in a better position to report on the outbreak and associated health and hygiene issues. For example, early on in the COVID-19 pandemic, epidemiologists from Canada started online epidemiology courses for journalists in India and Africa. When COVID-19 cases started to appear in Sierra Leone, BBC Media Action were able to build upon their existing partnerships and training experience with media actors and develop a unique online training course for journalists.
Build a case for change by aligning your work to national priorities: Achieving policy change over the longer term should be viewed as a political, as well as technical, issue. This means that in addition to having a sound technical argument (i.e. related to health, hygiene and wellbeing), organizations also need to align their advocacy work to the political interests of the national government. The way an issue is framed can influence its policy success; for example, the ‘Clean India’ initiative aimed to rapidly scale up sanitation throughout rural India. To do this, toilets were positioned as an economic issue related to the modernizing of India rather than a health issue, and this resulted in a 56% increase in toilets in 5 years. Amid the economic impacts of COVID-19, many countries faced political change, economic uncertainty, social unrest, or increased tension between social/ethnic groupings. Advocacy efforts need to be constantly mindful of this, as these key moments of change can advance or hinder the policy agenda. Moments of change can also influence power dynamics, meaning that decision-makers or influencers you have spent time building a relationship with are suddenly no longer in charge or influential. Therefore, regular reflection, learning and adaptation is essential and it is important to pay attention to key political events like high-level meetings, strategy formulation processes and political elections.
Additional Resources on Advocacy:
CARE’s advocacy tools and guidelines – Gives a good introduction to what advocacy is, how it is used, and how to create a plan to advocate, along with tips on implementation
Commonwealth Foundation’s advocacy toolkit – A simple, illustrated guide on the advocacy process and strategies for advocacy
Global Handwashing Partnership Hygiene Advocacy toolkit – Provides simple and clear guidance on advocacy specific to hygiene programming and links hygiene promotion to SDGs
IRC webinar and article on adapting advocacy – This resource provides information, with examples from Kenya, Bangladesh, Burkina Faso and Ghana, on how to adapt WASH advocacy strategies in response to COVID-19
Tearfund’s advocacy toolkit – A comprehensive guide that explains the foundational elements of advocacy, breaks down the process of advocacy and provides case studies, training exercises
UNICEF’s advocacy toolkit – A very extensive document that provides in-depth information on what advocacy is, developing an advocacy strategy, monitoring and evaluating advocacy, managing knowledge and risks, and how to utilise partnerships
UNICEF’s guidance for advocacy in emergency settings – Describes various types of advocacy and gives overview of developing advocacy strategies with consideration of emergency programme contexts
WASH in Health Care Facilities advocacy toolkit – This document provides simple guidance on advocating to various stakeholders for WASH specifically in Health Care Facilities, but can be adapted for other settings
WHO’s guide to advocacy – A step-by-step guide on developing advocacy strategies, specifically for preventing chronic disease, but which can easily be adapted for other initiatives
Advocacy case study – Example of multi-level advocacy strategy implemented by Action Against Hunger in West and Central African countries during the COVID-19 pandemic.
Author: Elli Leontsini, Peter Winch and Anika Jain
Reviewers: Tracy Morse, Helen Hamilton, Dan Jones, Sian White, Jenala Chipungu
Last update: 01.03.2023