Enabling sustainability through advocacy: Key principles to better articulate program value and advance program objectives

September 28th, 2016

Neglected Tropical Disease Programs (NTDPs) have long known that advocacy can be a powerful tool for engaging stakeholders and catalyzing action. Over the past decade, many national NTDPs have used advocacy campaigns to encourage citizens to take preventive medicines for neglected tropical diseases (NTDs) such as trachoma and lymphatic filariasis. Yet all too often campaigns have tried to shock audiences into action by showcasing the physical impact of these diseases on individuals, thereby not realizing the full power of effective advocacy.

Recording data from blood samples from the 2016 transmission assessment survey for lymphatic filariasis in Ghana. Photo: FHI 360

Recording data from blood samples from the 2016 transmission assessment survey for lymphatic filariasis in Ghana. Photo: FHI 360

Research has shown that fear is an ineffective motivator when it comes to getting people to take action to protect their health; in some cases, it is even counterproductive.[1] Instead of using fear-based advocacy that focuses on the negative physical, social, and financial consequences of getting sick, NTDPs should consider using more impactful advocacy campaigns that appeal to stakeholder values and address the many components of combatting neglected tropical diseases.

With support from the USAID-funded END in Africa program, NTDPs in West Africa are taking a fresh approach to advocacy. These NTDPs are using aligned, targeted, and positive messaging that emphasizes the advantages of collaboration to form mutually beneficial relationships, like those found in strategic social partnerships. By incorporating key advocacy principles, such as the principles outlined below, NTDPs are beginning to create successful and impactful advocacy campaigns.

Blood samples at the 2016 lymphatic filariasis transmission assessment survey in Ghana. Photo: FHI 360

Blood samples at the 2016 lymphatic filariasis transmission assessment survey in Ghana. Photo: FHI 360

Ensure that NTDP goals and advocacy efforts align. The purpose of advocacy extends beyond basic awareness-raising. Effective advocacy campaigns and related activities should also contribute to the achievement of overall program goals. Thus, NTDP advocacy should align with the overall program objectives in order to advance those objectives.

In Ghana, the national NTDP first discussed its advocacy objectives, and then documented the alignment between those advocacy objectives and the program’s Master Plan objectives in order to create a comprehensive advocacy and communications strategy and action plan. The process included developing a work plan that mapped out the NTDP’s overarching advocacy and communications goals; identifying decision makers, partners, and other “change agents;” crafting key messages; and identifying the institutional capabilities and systems required to deliver these messages.

Identify key change agents that must be engaged. Most NTDPs have multiple advocacy objectives and achieving each objective requires reaching different (sometimes multiple) change agents. Change agents are individuals who have the authority to directly enable the achievement of an objective. For example, the Ministry of Health decision-makers responsible for finalizing an annual budget would be a change agent for advocating for an increase in NTD integration funding.

A Ghanaian child bravely provides a blood sample for the 2016 TAS for LF. Photo: FHI 360

A Ghanaian child bravely provides a blood sample for the 2016 TAS for LF. Photo: FHI 360

NTDPs need to target change agents who are in a position to catalyze action, as well as the decision-makers and stakeholders who influence them. Identifying the right mix of change agents requires thinking “outside of the box” and finding ways to engage public, private, non-profit, and faith-based stakeholders. In Ghana, for example, the NTDP forged an effective relationship with the Ghana Health Service (GHS) School Health Education Program to advocate to parents, teachers, and communities on school-based deworming campaigns. In addition to raising awareness about the work of the GHS/NTDP, such efforts are improving integration of activities related to NTD control and elimination by reaching out to a variety of traditional and non-traditional stakeholders and investigating possible points for collaboration.

Craft messages that speak to change agents’ values. When mass communications are disseminated, they often do not resonate with many stakeholders. Different change agents require tailored messages that appeal more directly to them. Before crafting a message, NTDPs should identify and fully understand the alignment between the NTDP’s interests and those of each change agent, as well as the change agents’ nuanced values. Only then can NTDPs craft messages that address these specific values, showcase assets of the program in alignment with those values, and outline the benefits of a potential partnership.

When crafting messages, NTDPs should understand change agents’ organization, business, and values; the issues that they care about (e.g. private sector development, poverty alleviation, etc.); and the people they serve (e.g. their constituency or customers). For example in Ghana, the NTDP submitted a proposal to uniBank for a management campaign that made a succinct business case, showing how the potential partner’s values aligned with the goals of the NTDP. The proposal states, “By supporting mass-drug distribution that reaches and educates thousands of individuals, uniBank can raise brand visibility and increase name recognition in new markets. Further, this program meets a critical social need, contributing to the corporate social responsibility mandate of uniBank and illustrating commitment to improving the lives of Ghanaians.”[2]

Identify staff to conduct advocacy and strengthen their capability. Strong advocacy campaigns require staff with strong organizational knowledge, strong verbal and written communication skills, stakeholder engagement abilities, strategic planning skills, and sector knowledge. Strengthening these capabilities within NTDPs supports advocacy strategies and implementation plans.

Engaging in a thoughtful session walking through each of the principles noted in this article is an opportunity to think broadly about the intended audiences and then narrowly on how to reach them. Participating in such an exercise prior to rolling out a revitalized, strategic advocacy and communication campaign improves the NTDP’s ability to inform a broader set of stakeholders about the value of its work and increase recognition of the NTDP’s value and efforts, while maximizing its investment in advocacy and communication

[1] Ruiter, R. A. C., Kessels, L. T. E., Peters, G.-J. Y. and Kok, G. (2014), Sixty years of fear appeal research: Current state of the evidence. Int J Psychol, 49: 63–70. doi:10.1002/ijop.12042

[2] uniBank Proposal for LF Management Campaign