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Advocacy

Advocacy for improved infant and young child feeding involves a process of educating and motivating influential audiences—like policymakers and program managers—to take actions to create a supportive environment for optimal feeding practices. The exact need, goal, or policy action is shaped by the country-specific barriers, political system, and social context.

Distinctive features of Alive & Thrive’s advocacy approach

  • Clear, specific policy goals and actions, not general statements about the need to prioritize infant and young child feeding to reach national goals
  • Tailored country strategies based on what is attainable and the level of engagement from government and partners
  • Evidence-based advocacy drawing on global and national evidence, stakeholder mapping, and opinion leader research to inform policy strategies and “asks” (action requested), develop convincing messages, and identify the right stakeholders
  • Advocacy at national and subnational levels with different, yet reinforcing and complementary activities  
  • Engagement with nontraditional stakeholders such as women’s associations, religious organizations, and journalists

Four-part process

Alive & Thrive follows a systematic, iterative advocacy process.

  • Establish and sustain partnerships
  • Develop the evidence base to inform strategies, build the case for policy change, and align allies and partners around a common set of goals and strategies
  • Develop compelling, targeted, and tested messages and materials
  • Build consensus through meetings, presentations at workshops and events, participation in working groups, and training influential individuals and journalists on effective advocacy and messaging skills

Results

Alive & Thrive’s advocacy efforts have contributed to changes in policy, priorities, and resources.

  • Policy change. On June 18, 2012, Viet Nam’s National Assembly made a landmark decision to extend paid maternity leave from four to six months. Three days later the National Assembly expanded the ban on advertising of breastmilk substitutes for infants under 6 months to children under 24 months.
  • Heightened priority of infant and young child feeding (IYCF). In Ethiopia, Alive & Thrive’s stunting reduction workshops for parliamentarians, journalists, and regional health bureaus, leaders, and women’s associations increased attention to the importance of improved feeding practices for the prevention of chronic malnutrition. In June 2013, the Federal Ministry of Health and partners launched the National Nutrtion Program, which gives highest priority to infant and young child feeding.
  • Leveraged resources for IYCF. Alive & Thrive’s policy “ask” in Bangladesh was greater financing of IYCF programs. New donor funding for IYCF totaled $60 million. In Viet Nam, provincial budgets included support for IYCF services in their budgets.
  • Increased media coverage of IYCF. In Bangladesh, a three-year media engagement and capacity building program included journalist trainings, fellowships, study circles, and site visits. An independent evaluation reported a significant increase in coverage of IYCF in the media, from 24 reports in 2009 to 261 in 2011, as well as improvement in the quality of the reporting.
  • Unified and empowered voice. Partners came together around shared goals and activities. Success empowered advocates to join forces for new policy initiatives.

Lessons

Advocacy partners should be selected based on their influence, technical ability, and commitment.

  • Trusted partnerships help to think bigger, share responsibility, mitigate cost, and leverage the unique strengths and comparative advantages of specific organizations.
  • Delegation of tasks among stakeholders encourages ownership and accountability.
  • A well-placed government partner, engaged from the outset, can help navigate government decision-making bodies and protocols and serve as a champion throughout the advocacy process.
  • Joint branding, shared activities, and shared success maintain momentum within the partner group.

Multiple types of evidence are needed to persuade policymakers. For example:

  • Scientific evidence: What is the impact of poor child feeding practices? What is the scientific evidence base that informs global feeding recommendations?
  • Socio-cultural evidence: In the case of maternity leave, do women and employers want this change? Will there be unexpected impact?
  • Economic evidence: Will the change hurt economically? Can the country afford it?
  • International evidence: How does the country compare with other countries? Is there an opportunity to be a leader?

Vigilance and continuous dialogue open opportunities for policy change.

Alive & Thrive seized opportunities to improve policies and protocols when governments or institutions were planning revisions to the labor code in Viet Nam, the medical and nursing curricula in Bangladesh, and the National Nutrition Program in Ethiopia. The Viet Nam team built on policy wins and several years of sustained engagement with policymakers in advocating for inclusion of nutrition counseling and treatment in national health insurance schemes.

Advocacy requires persistence, sufficient time, and adequate resources.

Policy change is a lengthy and iterative process. In the three countries, advocacy efforts represented about 15 percent of total program costs with dedicated full-time staff for implementation.