3 rd Module: Advocacy and Lobby

1. 3rd Module: Advocacy and Lobby “A European network on cervical cancer surveillance and control in the new Member States - AURORA”

2. Partner www.aurora-project.eu This publication arises from the project «AURORA» which has received funding from the European Union in the Framework of the Health Programme.

3. What is advocacy • What is an advocacy campaign? • How to frame an Advocacy Issue? • Advocacy Campaign’s goals • Who Advocate and Lobby? • Coalition building • What is lobbying? • Influencing clinicians, and professional medical associations • Monitoring and evaluation of your advocacy activities • Communication Campaigns at the European level Index:

4. 1. What is advocacy? Advocacy is the act or the process of supporting a cause or issue. We advocate a cause or issue because we want to: • Inform or create awareness about a cause or issue • build support for that cause or issue • influence others to support it and/or • try to influence or change policy that affects it

5. 5 Steps of Advocacy Victoria Ayer & Colin Bunn - Advocacy Expert Series, Book 1. AdvocacyCampaign Management, Edition 1 - March 2004. Publication #1-2004

6. Stakeholders Victoria Ayer & Colin Bunn - Advocacy Expert Series, Book 1. AdvocacyCampaign Management, Edition 1 - March 2004. Publication #1-2004

7. Advocacy Activities

8. 2. What is an advocacy campaign? Itis a set of targeted actions to influence policymakers or general population to support a cause or issue that you wish to change. To begin an advocacy campaign you need to: • Identify the cause or issue you're advocating for; you need to analyze it and define it precisely • Decide who you want to support your cause or issue - who are you trying to influence or change so that they support you? • Decide what you want to be the outcome of your advocacy efforts what concrete result do you want to achieve? • An advocacy campaign cannot be left to a few individuals. It needs the commitment and support of everyone working in an organization and many outside too.

9. 3. How to analyze/frame the issue? Key questions

10. KeyAdvocacy Issues on Cervical Cancer:

11. Know your facts and figures on your issue • Collecting data about specific issues can be critical to any public event or media effort you pursue. • But substantial, reliable data collection is expensive and time-consuming so try first to tap into all the existing relevant research • The more facts you have to substantiate your case, the more informed and trustworthy you will appear to the public, to policy makers, and to others you are trying to reach. The most effective messages emerge from solid foundations of facts about your issue and your group.

12. Collecting data on yourissue Organizations working on health advocacy issues should collect data and analyze them, both for their own knowledge and to report to stakeholders. If you are looking for information beyond what you can collect yourself, there are several sources of public data available on the Internet. Use different search terms to find ready-to-use statistics or data you can analyze yourself. • RESOURCES – FINDING CERVICAL CANCER DATA: • International Agency for Research on Cancer (IARC) • European Center for Disease Prevention and Control (ECDC) • European Cervical Cancer Association (ECCA) • European Network for Indicators on Cancer (EUNICE), • European Network of Cancer Registries (ENCR), • International Federation of Gynecology and Obstetrics (FIGO)

13. Using Data Take some time to understand the source of data. When and how was the data gathered? For example, a sample may be statistically representative at national but not at local level. Get comfortable with the basic concepts of percentages, rates, per capita and standard deviation. You will be in a position to better explain to your audience what the numbers really mean. Almost all data you will use will be “samples.” There are a variety of sampling methods, but generally, when using large government databases to produce descriptive statistics, you can be sure that the data you’re using is from an acceptable, representative sample. For deeper analysis, particularly one that you expect to yield controversial results, consult with an experienced researcher.

14. Searching data about cervical cancer in your country • Key questions when gathering data for cervical cancer advocacy: • Is there specific epidemiological data for cervical cancer? • How many women are newly diagnosed with cervical cancer? • What’s the incidence of cervical cancer in your Member State? • How many women die for cervical cancer? • Is there a Cervical cancer screening program and its coverage; and, • Is there data on program costs and the cost-effectiveness of screening as a cancer prevention tool?

15. Example: EPIDEMIOLOGY DATA OF CERVICAL CANCER IN THE AURORA’S PARTICIPATING COUNTRIES

16. 4. Advocacy Campaign’s goals Goals Start by listing the goals of your campaign. Be specific and precise. This will help you to see where you have had success, where you have not, and where you need to go next. Questions to help you to set goals • What is the campaign’s ultimate goal? • What specific landmarks (goals) do you hope to achieve on the way to that ultimate goal? • What are the short-term and long-term objectives needed to meet • What we define as our ultimate goal? • How can these be stated so that they are clearly understood? • What will constitute “success” or victory? How will be measured? • Select the target audience

17. Cervical Cancer Prevention Advocacy Goals • To raise awareness of cervical cancer and how it can be prevented among: • women so they will learn what they need to do to avoid this disease and access the services where they are available, • politicians and public health officials so they understand the benefits of prevention programmes and prioritise their implementation where they are not available. • To promote Cervical Cancer Screening, particularly focusing on hard to reach populations

18. What we want to achieve as trainers and as advocates • To promote Cervical Cancer • Screening, particularly focusing on • hard to reach populations • To raise awareness of cervical cancer • and how it can be prevented Goals Trainers Advocates Education Strategies To assess innovative approaches to Cervical Cancer Screening and to improve service delivery systems. Lobbing Strategies to seek political - legislative support for Cervical Cancer Screening’s Programs Mobilization Strategies to built support for Cervical Cancer Prevention and Screening Program’s Implementation

19. 5. Who Advocate and Lobby?

20. How to build support to promote Cervical Cancer Screening

21. 6. Coalition building • One of the most effective ways you can build support is by participating in a coalition. A coalition is a group of several like-minded organizations working together to achieve common goals. • An alliance or coalition with other organizations or individuals that pursue the same policy change is normally built upon specific policy issues and goals. • Coalitions can be permanent or temporary, single or multi-issue, limited to certain constituencies or geographically defined. Once a policy change has been achieved, a coalition may cease to exist, or may continue to address other joint policy concerns.

22. Coalition buildingA coalition can help you: build on a continuing base of support increase the influence of your campaign’s efforts develop new leaders for your campaign broaden the scope of your campaign Increase your financial and programmatic resources

23. Coalition building: Identifying allies • Having allies is critical for an advocacy initiative. You can usually increase your impact by collaborating with other individuals or organizations that are interested in the same policy issue. • Joint efforts, skills, and resources of several organizations and individuals are more likely to minimize risk, draw attention to key policy issues, and result in successful policy change. Make lists of: Local and/or national groups who are working on similar issues Individuals who work or volunteer for these groups Organizations that are working on different issues, but who have a commitment to cancer prevention and sexual and reproductive health will most probably support you.

24. Coalition building: Identifying Opponents Part of refining an advocacy strategy is finding out who may oppose your policy goal. This is just as important as identifying your allies. You can be more effective if: • You understand your opponents' reasoning and why they might feel threatened by your proposed policy change. For example, an initiative that seeks changes in policies related to contraception may encounter the opposition of religious leaders. • You include messages and activities targeted at your opponents. In that case, opponents can become a secondary audience for your advocacy initiative. • You assess whether there is anything you can do to persuade your opponents to change their opinions, or at least neutralize their influence on the policy change you want to pursue.

25. Coalitionmembers AdvocacyGoals Activities Example: The National Cervical Cancer Coalition (NCCC) is a growing coalition of people battling cervical cancer and HPV related issues in the USA • Primarily Women, family members, friends and caregivers, • Women's groups • Cytotechnologists, • Pathologists and Gynecologists • Laboratorians • Bio-Techcompanies • CancerResearchers • Hospitals • Organizations providing cervical cancer detection programs • Other related associations, both national and worldwide • Prevention, awareness and education efforts • FREE Pap Test Day held the second Friday of January for women that have not had a Pap test for three (3) years. • Conferences with CME credits for physicians along with the National Ovarian Cancer Coalition (NOCC) on gynecologic cancers. • The NCCC runs its award winning cervical cancer web site and is developing a national network of local state affiliates. • What they have in common is an interest in: Desire to provide a safe and educational place for women to go that have or had cervical cancer and HPV.

26. 7. What is lobbying? If you are seeking political or legislative change, you need to make contact with policy makers and ''lobby'' them to see the issue the way you see it. Lobbying is most effective when you are in need of something specific from the legislative system.

27. National policymakers What for? Who? How? How to lobby? • Familiarize yourself with tine system or legislative process itself - the written and unwritten "rules" of how it works • Also familiarize yourself with the individuals you are trying to reach. Because different policy makers have different priorities, you should tailor your presentation to their interests when you contact them; • If you want to lobby for a particular bill, law or issue with a policy maker you can communicate with them either through a letter, or even better a personal meeting or a phone call. Legislators To seek political legislative change in favor of Cervical Cancer prevention programmes Lobbing

28. Understanding the National Landscape Key questions: Barriers advocates can find: Little understanding of cervical cancer People often do not know that cervical cancer is preventable Lack of resources for the health sector National cervical cancer screening programs are not considered effective Minorities and unserved women are underrepresented Vaccination versus screening • Who is pushing for and tracking progress? • Who is responsible for cervical cancer prevention and control at the Ministry of Health? • Is there a National Cancer Registry tracking progress? If not, are there smaller registries at hospitals and/or clinics that offer screening? • Do national and community leaders see cervical cancer as a problem? • Are these programs ongoing? • Are national or sub-national cervical cancer advocacy or education efforts underway?

29. 8. Influencing clinicians, and professional medical associations To reach experts on cervical cancer issues: • Put them on your mailing list to receive selected materials • Invite them to your events and conferences • Consider inviting them to become a member of a special committee or working group • Send them an introductory letter and materials about your campaign • Go and visit them and ask them to be involved You need to know who these individuals and organizations are. Identify potential supporters

30. Influence clinicians, and professional medical associations to do what? • Review internal policies and procedures to ensure that programs are accessible and friendly to women. • Ensuring: • Affordability • Confidentiality and privacy • Availability in local languages • Availability at locations and times convenient for women.

31. 9. Monitoring and evaluation of your advocacy activities Monitoring is the process of routinely gathering information on all aspects of an advocacy campaign and using the information to make decisions and take action. Evaluation involves a systematic, objective analysis of the advocacy campaign, in terms of its effectiveness and efficiency, and its impact in relation to its objectives. In advocacy we evaluate: • Advocacy objectives • Message delivery and communications • Use research and data • Decision making • Coalition building • Overall management/ organizational issues

32. 10. Communication Campaigns at the European level 1. ECCA(European CervicalCancerAssociation): Campaigns at European levelinvolving general population and decisionmakers • European CervicalCancer Week • Petition to STOP CervicalCancer • Pearl of Wisdom • For more info: http://www.ecca.info/index.html 2. WACC (Women against CervicalCancer): Education Campaigns • Educational books and flyers • Interviews and videos • Publications • For more info: http://www.wacc-network.org

33. Reference • The Alliance for Cervical Cancer Prevention (ACCP) www.alliance-cxca.org • Center for Lobbying in the Public Interest (2007), Know The Legislative Process & Players. • Center for Lobbying in the Public Interest (2007). Working in Coalitions. • Cervical Cancer Action: A Global Coalition to Stop Cervical Cancer (CCA). (2007). Coalition Building: A Cornerstone of National Advocacy, Policymaking and Effective Cervical Cancer Prevention Programs • ECCA (EuropeanCervicalCancerAssociation): http://www.ecca.info/index.html • EuroNGOs (2011). SRHR Advocacy in the new aid environment: TargetingEuropeandonors at embassylevel • Fieldstone Alliance Nonprofit Guide to Forming Alliances: Working Together to Achieve Mutual Goals www.fieldstonealliance.org • Fox, Leslie (1997). Advocacy Strategies for Civil Society: A Conceptual Framework and Practitioner's Guide, • USAID/Global Bureau, Center for Democracy and Governance, Washington, D.C. • The International Planned Parenthood Federation (IPPF) (2011), From advocacy to accessTargeted political action for change • The Knowledge for Health (K4Health) project http://www.k4health.org/pr/advocacy/strategy.shtml • The National CervicalCancerCoalition (NCCC). http://www.nccc-online.org/about.html • WACC (Women Against Cervical Cancer) http://www.wacc-network.org • World Healthorganization (WHO) 2002, CervicalCancer Screening In DevelopingCountries. http://www.rho.org/files/WHO_CCscreening_2002.pdf