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 its 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 Kenyas 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
Percent of WRA using any FP method

50 40 30 35 32

20
10 0 9 Jun-Aug 09 11 Jan-Mar 10 14

CBDs Facilities

0
Jun-Aug 10
(N=2,599)

The pilot projects success set the stage for advocacy

Pilot projects 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.

Goal, objectives, decision makers

STEP 1 Decisions STEP 2 Context

Smart Chart - Spitfire Strategies Approach

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

STEP 3 Choices

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

STEP 4

Activities

What type, who will do what, when, budget

STEP 5

Measure
Success

Inputs, Outputs, outcomes

STEP 6 Final Reality Check

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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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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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