Advocating for Adolescent Reproductive Health in Sub-Saharan Africa[PDF]

Also available in French in [PDF] format.

Networks can play an important role in public education and advocacy on adolescent reproductive health. Networks allow different groups to work together toward a shared goal by coordinating strategies and pooling resources. Networks which include a range of organizations, groups, and individuals demonstrate to policy makers wide support for particular policies or programs.

The term network here refers to a group of organizations that communicate and collaborate on a shared advocacy strategy. Many organizations use the term coalition to describe a group of organizations sharing the same advocacy goals. This publication uses network to emphasize the important role of communication in bringing together members and establishing a common advocacy agenda. Whether the members choose to call the group a coalition or a network, the goal is to come together to resources and capabilities to advocate more effectively for adolescent health policies and programs.

Networks bring together people, organizations and resources from all parts of the community. Working together in a network can improve the quality and the quantity of work and spread responsibilities by allowing individuals and groups to contribute ideas, expertise, and resources. When advocacy efforts are successful, all members benefit.

A network is not necessary for effective advocacy; any committed organization or individual can build the skills and experience necessary to build support for adolescent reproductive health issues. However, a network can achieve results that would be difficult for any single member to accomplish alone. The process of building the network also strengthens members' skills in mobilizing support for an issue, a useful skill when advocating with opinion leaders, policy makers, and the public.

Challenges to Building a Network

Despite the benefits, building and maintaining networks is hard work. Network members must keep in mind the following challenges and be prepared to address them.

• Building consensus is a time-consuming process. Still, network members may not always agree on the goals, objectives, and strategies of the network.
• The network must build trust among its members. Member organizations and programs may compete for funding from the same donor agencies, hampering their ability to collaborate. Building trust in the face of such conflicts is difficult.
• Members may have previous experiences, both personal and professional, with each other, that affect their ability to work collaboratively.
• The larger the network grows, the more complex it is to manage its logistics. Keeping all members aware of meetings, actions taken, results, and upcoming activities is important.
• The network must find a means of dividing up work equitably among members.
• The network must remain a collaborative effort among all members, rather than the possession of one or several of the most powerful members.
• Members must agree on rules necessary for the network to operate smoothly and effectively.
• The network must decide how to leverage resources for its collaborative activities.

Guidelines for Effective Networks

Some basic tips follow for creating and maintaining an effective network.

Share information among members of the network. At the initial stages, it is important that members spend time learning about the roles and expectations of others in the network. This information sharing will help build understanding and trust among members, as well as provide useful information about the network's interests, strengths, conflicts, and weaknesses.

Develop a network mission statement and goals. The mission statement can be broadly worded to reflect the philosophy of the network and permit a wide range of groups to participate. Goals demonstrate how the network plans to shape policy to support improvements in adolescent reproductive health. A founding group of members may design the network's mission and goals, and then invite additional supportive organizations to join. An organization's membership in the network symbolizes its endorsement of the mission and its commitment to the goals of the network.

The mission statement of the network reinforces the shared connections between members and provides guidance on which other organizations should join. For example, if the network supports family life education which includes information on contraceptives, a group that insists this education should stress only abstinence will not be an appropriate member. The network can work with nonmember groups on other projects without jeopardizing the strategic work of the network.

The mission statement clarifies what issues the network supports and addresses obvious criticisms. Highlighting program components such as "involving parents" and "promoting abstinence" helps forestall criticism and prevent misunderstandings. For example, a network seeking comprehensive family life education might adopt a mission statement that the network seeks to promote family life education which stresses the importance of abstinence, provides young people with accurate information on how to protect themselves if they become sexually active, and builds communications skills with parents and peers.

Develop objectives and strategies. A clear set of objectives will define the specific policy changes that the network aims to achieve. Objectives must be specific, achievable, and measurable, and serve as a means of evaluating the network's activities. Network members must then consider which strategies will best allow them to achieve their objectives. Strategies may include a public education campaign, direct appeals to a specific leader to change a policy, or lobbying government to pass a law. Identifying proposed strategies and activities helps network members divide up responsibilities and highlights organizations and efforts that need additional training, support, or resources.

Create and follow a realistic time line. A realistic time line is one of the most important tools for a network. From the initial meetings to the first advocacy activities, building a functioning network can take months or years. An achievable time line, with targeted activities every month, will help ensure the network remains focused on its goals and realistic in assessing different activities to be considered. A short-term activity might be to conduct a focused needs assessment on school policies. A medium-term activity might be to meet with community leaders and parents to encourage them to advocate for improvements in school policy. A long-term activity might be to persuade the school officials to approve the network's proposed changes to a school policy.

Establish a structure and leadership roles. Networks are most effective when all members have a voice and know they will be heard. Nonetheless, the group must have leadership and structure. The members should choose at least one chair and clearly define the chair's responsibilities. Co-chairs, whose skills complement each other and who represent organizations willing to commit significant time and/or resources to network efforts, can greatly strengthen networks. To facilitate an equal division of duties and responsibilities, the network may wish to establish a mechanism to share or rotate leadership among the members. The network may choose to create a broad leadership team that includes representatives of major groups and organizations. A diverse team can be highly successful in providing effective leadership on issues as complex and multi-faceted as teen reproductive and sexual health.

Be explicit about how decisions will be made. Networks often make decisions by consensus. This does not mean that everyone has to agree on everything. Rather, the majority agree, and no member organization feels so strongly opposed that it will veto or publicly oppose the effort. Members must decide what will happen when consensus cannot be reached and determine which decisions will be made by the leadership team and which decisions are so important or sensitive that the entire membership must be involved.

Share responsibilities through committees. Committees allow more people to participate actively, and can be either permanent or limited to a specific project. Define responsibilities and the decisions that committees can make without full network approval.

Expand the base. Increase the network by inviting and admitting new organizations which agree with the mission network's mission and goals. New members should understand what the network is trying to accomplish as well as the need for action. The network must make clear how new members will benefit from being part of the network. Outreach through member organizations' existing resources, such as newsletters and meetings, can educate and enlist more support for the network goals.

Hold regular meetings. Hold meetings often enough to respond to current events and on a regular basis—at least monthly. Hold meetings at a convenient time and location for all members; strive to start and end on time. Consider whether meeting times should rotate between day and evening hours and vary in location.

Involve youth. Articulate and committed young people can help the network remain true to its mission of serving youth. Youth are excellent representatives for programs designed to address their needs. Young people can organize students, friends, and other young people to support the network's advocacy campaign. Many community groups already work closely with youth and can help bring them into the network. Young people's participation may be hampered, however, by their fear that taking a leadership role among adults would be inappropriate. Some adults may have difficultly considering young people as full partners in the network. To promote active, meaningful youth participation, network members should commit to being open to young people's suggestions, actively seeking their input, and finding appropriate ways to ensure their full participation.

Keep people informed. Maintain up-to-date mailing, phone, fax, and e-mail lists of network members and key contact people. Keeping members informed maintains trust, interest, and involvement. It also minimizes misunderstandings and identifies points of disagreement before they become problems. Network members should always receive minutes from meetings, updates, news clippings, and information on future events. Adequate advance notice of meetings and other events encourages participation in important discussions and decisions.

Select spokespeople who will represent the network to the media. Early in the network's development, identify members who have experience in public speaking or interacting with the media. The spokespeople may or may not be the same people as the leadership team. One spokesperson should be a young person. Members should agree on a process for handling inquiries from the media.

Resources and Funding

Many networks falter or fail because of funding. With many member organizations operating on limited budgets, a large-scale advocacy campaign may be difficult without additional sources of income. The costs of travel, communications, resource development, and training can hamper efforts to build the network.

Faced with the need for resources and support, network leaders may choose to make the network into an NGO. While this offers the possibility of a stable source of funding, a network NGO may have difficulty maintaining inclusiveness and responsiveness to its members. Turning an open network into an NGO may cause the network's activities to be identified only with the chair and his/her organization. Other members may feel that they are receiving no credit for their contributions or that funding is not being divided fairly among members. If the network seeks funding as an NGO, it will need responsive leaders, a clear understanding of what will be done with funds, and open discussion of how all members will receive credit and attention for their activities.

Some recommendations for developing and sustaining a collaborative network with limited resources follow:

• Start small. Although a large network brings the perspectives of more members, it is important to lay a solid foundation first. Start with a limited number of members from a defined geographical area. A small network is easier to manage, makes communication and travel less expensive, and helps members identify achievable goals and objectives which will help guide later growth.
• Identify resources among the members. While members may not be able to fund the network directly, they have other resources that can contribute to the group's growth. Early in the network's development, all members should identify what they will offer the network. For example, members may be able to provide a few hours of secretarial support each month or host meetings in their offices. Others may be able to conduct research or focus group discussions. This process will set a precedent for new members as they are invited to join.
• Use existing opportunities to meet and communicate. Hold meetings in conjunction with other events, such as a conference or workshop that members are already attending. Use members' existing newsletters and publications to disseminate information on what the network is doing.
• Encourage members to include funding for advocacy in their own proposals.
• Resist the urge to build the network too quickly. Consider which new partners will best support the goals of the network and invite them to participate.
• Stay focused. Encourage new members to express their organizations' interests and priorities but be slow to take on new issues.
• Remember the private sector, especially local businesses. Local businesses provide a large potential source of support and are often overlooked by advocates. Companies that actively advertise, especially to youth, and that already have established distribution networks can provide outreach for advocacy messages and public education campaigns. Business leaders can be sponsors, give donations, and create opportunities for public outreach. Businesses can benefit from associating their names or products with adolescent reproductive health issues. Sponsoring events and donating to programs demonstrate a company's commitment to social responsibility.

Case Study—The Kenyan Association for the Promotion of Adolescent Health (KAPAH)

In 1992, three hundred participants from twenty-eight countries attended the First Inter-African Conference on Adolescent Health in Nairobi, Kenya, to discuss the current situation of adolescent health in Africa. One of the principal recommendations from that conference was to establish "an umbrella body… to supervise and coordinate the activities of the various organizations dealing with adolescent health… to erase duplication of studies and programs and end the scramble for the meager funds that are available from donors." ¹ Delegates proposed the formation of the African Association for the Promotion of Adolescent Health (AAPAH) and mandated that it promote the formation of national networks focusing on adolescent health.

The YSOs in attendance at the conference had found their day-to-day work hampered by their small size and isolation. They reported facing organized opposition from religious groups wanting to restrict sexuality education and services to adolescents. There was little coordination between local, district, and national NGOs to establish consistent messages, health services, and policy goals for youth.

In 1994, the Centre for the Study of Adolescence (CSA) organized a workshop in Nairobi— Advocacy for Rational Approaches to Adolescent Reproductive Health—and invited YSOs from all over the country. In addition to providing an opportunity to discuss adolescent reproductive health at a national level, the workshop established Kenya's branch of AAPAH, the Kenya Association for the Promotion of Adolescent Health or KAPAH. CSA drafted a statement of policies, procedures, and objectives, which was revised and approved by the attending participants. Six KAPAH officials were elected to form the National Executive Committee, which met at least once a month. Individuals and organizational representatives made statements of commitment, indicating the steps they planned to take to promote adolescent reproductive health at the peer, family, community, and organizational levels. KAPAH members were divided into five subcommittees: 1) service delivery, 2) publicity and information, education, and communication IEC, 3) fund-raising, 4) research, and 5) administration. KAPAH set the following objectives to promote adolescent health policies and activities in Kenya.

• Recruit additional members to secure the objectives of the association.
• Support the establishment of quality adolescent health services including counseling, treatment, and community centers.
• Promote adolescent friendly activities through public education, primary health care, and school education programs.
• Encourage the establishment and implementation of positive policies by the government, ministries, and local authorities.
• Network and communicate with other groups with similar interests, locally and internationally.
• Fund-raise to sponsor adolescent health activities.
• Support adolescent research projects.
• Hold periodic workshops, seminars, and conferences on adolescent health.

KAPAH is a loose network of organizations and individuals, which includes CSA, the Family Planning Association of Kenya or FPAK, Kenya's cultural associations, the Young Women's Christian Association of Kenya, the Girl Guides, the Program for Appropriate Technology in Health, Pathfinder International, the Single Mothers Association, the Ministry of Health's Division of Family Health, and youth representatives, among others.

KAPAH's Activities

The individuals and organizations that comprise KAPAH have worked together to 1) write a series of fact sheets, 2) publish articles in the Nairobi Daily Nation to present the facts on adolescent sexuality in Kenya, and 3) foster public discussion about incorporating family life education into the school curriculum. KAPAH has often met significant resistance from the Catholic church, which has long been opposed to family life education in schools. Yet, working together, KAPAH members have asked government officials to make speeches on youth issues at public events and have provided them with facts and talking points. As a result, other policy makers have asked CSA to write speeches for them on population and youth issues. In addition, CSA drafted the adolescent health sections of a pending population policy. CSA has marketed itself as a reliable source of information on youth and population, and it is frequently consulted by opinion leaders.

Case Study—The Ghana United Nations Student Association (GUNSA)

In 1996, GUNSA organized the First African Youth Conference on Sexual Health with the theme "Youth and AIDS: Challenges for the 21st Century." The purpose of the conference was to discuss the sexual health issues faced by African youth who grow up in a climate of rapid urbanization and social change. The International Youth and Students Movement for the United Nations (ISMUN) used its extensive networks to attract youth to the conference, while GUNSA supervised organizing and fundraising with the cooperation of other Ghanaian and international organizations.

GUNSA is an accredited member of ISMUN and works to empower young people to develop healthy knowledge, skills, and attitudes. Students run 150 branches of GUNSA in schools throughout Ghana, and the organization has a nationwide membership of 5,000. GUNSA created a variety of in-school programs which are designed to meet student interests and local needs. GUNSA chapters are careful to involve school administrators and to gain their support at each level of organizing and implementing youth activities. By engaging school leaders from the very beginning, GUNSA develops positive relationships based on responsibility, reliability, and trust.

Involving the Private Sector

GUNSA representatives believed that there was considerable fundraising potential from private corporations in Ghana. Recognizing that corporations might be reluctant to sponsor a controversial event, such as a conference on sexual health, GUNSA developed a strategy to convince corporations of the importance of their support. GUNSA sent corporations letters which explained the conference's goals and requested meetings with the company presidents. At these meetings, representatives outlined the scope and urgency of the threat pf HIV/AIDS to young people in Ghana. GUNSA emphasized that corporate sponsorship would provide an opportunity for the business to receive recognition in the communities for being sensitive to the needs of youth.

By framing the problem of HIV/AIDS as a public health concern for the country's youth, GUNSA was able to secure support and endorsement from a wide variety of Ghanaian businesses, including Coca Cola, Legend Design House, Ghana Postal Services, and the Ghana Broadcasting Corporation. The name and logo of each company appeared in the conference program, along with a message wishing "all participants at the First African Youth Conference on Sexual Health a successful conference." Companies became sponsors by providing an official service or product for the conference. For example, Astek Ghana provided the "official water" to the conference.

Although some companies declined to become sponsors either for financial reasons or because of the conference's content, GUNSA created widespread support for the conference in local communities and in the print media. In planning the conference, GUNSA already had the advantage of being well known for organizing successful workshops on adolescent pregnancy and on drug abuse and for raising awareness of adolescent reproductive health in communities. This established reputation made companies more likely to provide sponsorship when they might otherwise have been reluctant to do so.

Although often overlooked as a funding source, private sponsorship of conferences and programs provides benefits for both YSOs and businesses. Businesses benefit from having a new advertising outlet and having their products associated with a community-supported activity. YSOs benefit from having a new and influential way to promote their advocacy messages and from receiving desperately needed financial resources.

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1 Mbugua W, Kizito P, Takon T, ed. The First Inter-African Conference on Adolescent Health: Adolescent Health in Sub-Saharan African, Present and Future, 24th - 27th March, 1992, Safari Park Hotel, Nairobi, Kenya. Nairobi: s.n., 1993.