gfh rtalk research-advocacy
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Advocacy for health
and social change
The role of ICTs
By Andrew Chetley
Director of Programmes
Healthlink Worldwide
Global Forum for Health Research
October 2006
What is advocacy?
Process to: influence policy and decision makers, fight for social
change, transform public perceptions and attitudes, modify behaviours, or mobilise resources. (GAVI)
use information strategically to change policies that affect the lives of disadvantaged people. (BOND)
change attitudes, actions, policies and laws by influencing people and organisations with power. (India HIV/AIDS Alliance, 2002)
change the policies, positions and programmes of any type of institution and plead for, defend or recommend an idea before other people.. (SARA Project)
speak up, draw attention to an issue, win the support of key constituencies in order to influence policies and spending, and bring about change. (WHO TB Programme)
Advocacy is about influencing or changing relationships of power (World Bank)
Whose voices are heard?
Representation: speaking on behalf of the voiceless (for)
Mobilisation: encouraging others to speak with you (with)
Empowerment: supporting the voiceless to speak for themselves (by)
What are ICTs?
Definition: tools that facilitate communication and the processing and transmission of information and the sharing of knowledge
Types: radio, TV, internet, email, websites, digital video and audio, print, interpersonal communication
Communication is central
Information
Communication
Technology
Using ICTs in the health sector
Literature review, interviews, discussion, scan of websites, practitioner review
More that 4000 articles and 50 websites
Not much ‘reliable’ evidence – 28 RCTs, most on information systems and biomedicine
Review of more than 100 case studies found examples of use of ICTs for advocacy
Examples of advocacy
and social change
Women’s Voices in Kenya – empowerment, confidence and government action
Using multimedia in Nicaragua, South Africa, Rwanda, Somalialand and Cambodia – awareness, attitude change, policy action, mobilisation, empowerment, social change
Mobile phones in South Africa and the Philippines – adherence to ARVs and TB medicines, awareness, care, mobilisation, empowerment
Combinations of media in Peru, Egypt and Uganda – reductions in maternal mortality, improvements to health systems, better interaction between health workers and communities
Key findings
Keep technology simple, relevant and local
Build on what is there and being used
Involve users in design (by showing benefit)
Strengthen capacity to use, work with and develop ICTs
Increase M&E, particularly participatory M&E
Include communication strategies in the design of ICT programmes
Continue to research and share learning about what works and what does not.
Not just technology
‘many innovative ICT uses in the heath sector are based on pilots and I would be very wary about making any recommendations where evidence is based on pilots, case in point being the Indian Institute of Technology, which has lots of interesting initiatives but their broader applicability is a problem. For example, they have an interesting telemedicine initiative, a remote sensor that takes temperature, BP, ECG, and stethoscope. The doctor at the other end of the computer line can read the indicators and speak to the patient, but the whole thing is let down by the inability of the doctor being able to prescribe a course of treatment.’ – Andrew Skuse, University of Adelaide
A major challenge
Too little priority has been placed using ICTs to increase the voice of people directly affected or threatened by health issues in policy development, programme review, critical thinking and programme management roles.
ICTs lend themselves to pushing information to intended beneficiaries.
Much less work has been done to enable those most affected by ill health to share their knowledge, understanding, experience and ideas for change.
More information
www.healthlink.org.uk
www.asksource.info
(Source is an international information support centre which strengthens the management, use and impact of information on health, disability and other development topics.)
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