The Missing Indicator:The use of a strategic advocacy approach to promote data-driven decisions on task-sharing in Kenya

Authors:

Rose Maina, Jhpiego; Alice Olawo and

Dr. Marsden Solomon, FHI360; Dr. Bashir Isaak, Head Division of Reproductive Health, Ministry of Health Kenya;

Stuart Merkel and Dr. Isaac Malonza, Jhpiego;

Priya Emmart, Advance Family Planning

Background

• Under FP2020, Kenya made a commitment to increase it’s contraceptive prevalence rate (CPR) from 46% to 56% by 2015.

• Advance Family Planning (AFP) partnered with Jhpiego to advocate at a national level in Kenya since November 2011

• A demonstration project in Tharaka District (June 2009 - August 2010) established the effectiveness of community-based distribution (CBD) of injectable contraceptives to increase the CPR, but until this past year, such distribution was not permitted by Kenya’s national family planning service provision guidelines.

• Previous efforts to change these guidelines had stalled despite a new constitution that includes a right to health and FP

Data talks! Use of all FP methods increased – at both community and facility levels

Jun-Aug 09 Jan-Mar 10 Jun-Aug 100

10

20

30

40

50

9 11140

35 32

CBDsFacilities

Percent of WRA using any FP method

(N=2,599)

The pilot project’s success set the stage for advocacy

Pilot project’s results gradually became known over time Data continued to be collected – even after ‘formal’ pilot had

finished Investment from AFP came at the “right time.” MOH buy-in at district level and provincial level created a

base of supporters to answer questions from those not yet convinced.

Meeting held to develop Smart chart Strategy; adapted from spitfire strategy

21 stakeholders comprised

of MOH, NGOs and donors

Program Intervention

• Adapted a communication strategy called Smart ChartTM to help determine the advocacy objectives, decision makers, and targeted activities for a national policy on Community Based Distribution for injectables.

• This strategy follows six key steps that took 12 months to fully realize a new policy change.

5

STEP 1 Decisions

STEP 2 Context

STEP 3 Choices

STEP 4 Activities

STEP 5 Measure Success

STEP 6 Final Reality Check

Smart Chart - Spitfire Strategies Approach

6

Internal & external scan, define your position, who is the decision-maker, where are they on the issue

Goal, objectives, decision makers

Who to reach, their position on the issue (core concerns), how will you tap into your audience – theme, message, messenger

What type, who will do what, when, budget

Inputs, Outputs, outcomes

Results/key findings

• Policy changed!• Foundation laid for future FP policy changes, especially in

a devolved context• Data from Kenya, and best practices from other countries,

strengthened the advocacy process and voice• National advisory group formed and now turned into a

national coalition for FP advocacy. • Smart ChartTM methodology followed, guided development

of common strategic choices - policy asks - to targeted influential policy makers.

• Promoted local ownership and South-to-South leadership

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8

What worked well? (and could be important for others following up London Summit commitments)

SmartChart!! Targeted, specific objective. MOH commitment and leadership Wide stakeholder engagement Data data data: (FP and other) was

crucial to bringing a broad base of stakeholders on board

Having the right people on board, building on existing relationships.

“Swim with the current” Understand your audiences

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