Transcript Advocacy Initiatives

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Overview
 Ipas South Africa
 Providers as Advocates
 Values Clarification and Attitude Transformation
 Community Based Advocacy
 Advocacy Work – the Past
 Advocacy Work – Current
 Questions
Ipas
 Non-Governmental Not for Profit Organisation that
has been working in South Africa since 1995.
 Only NGO focusing exclusively on Termination of
Pregnancy
 Ipas is a non-profit organization that works around
the world to increase women's ability to exercise
their sexual and reproductive rights, especially the
right to safe abortion. Ipas believes that no woman
should have to risk her life, her health, her fertility,
her well-being or the well-being of her family
because she lacks reproductive health care and
reproductive choice
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What is Advocacy and why do
we need to advocate?
 Advocacy is the strategic use of information to
change policies that affect people’s lives.
1. to expand the supply of quality, affordable,
acceptable and accessible services for safe abortion
2. to increase the demand from women and
societies for more accessible and non-judgemental
care for women seeking abortion care
3. to defend the law and ensure SRH and R remain
inviolate
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Advocacy perspective
 An advocacy perspective is one that sees many
opportunities for influencing the community
positively about the need for safe abortion care it
helps us communicate with…
 Our family and friends
 During or private encounters with our clients
 To our leaders and colleagues
 In more public arenas e.g. speaking at conferences, in
community meetings,
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Some risks
 Public confrontation
 Political stigma
 Being harassed or threatened
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Some benefits
 Helping clients access much needed services and
care
 Respect in the community
 Successful influence on policy makers and other
providers
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Things to remember
 Presenting too much or too little information to
substantiate our position
 Using out-dated information or information that is
irrelevant or mismatched
 Too much emotion can create problems
 Assumptions about who is and who is not on our
side
Advocacy roles
 EDUCATOR: providers are subject matter experts,
they have knowledge and experience:
 we find relevant information, we communicate our
knowledge and we discuss
 REPRESENTATIVE: providers are witnesses, their
experiences have taught them about specific issues
and struggles:
 We tell stories we seek compassion and we speak in
public about our experiences
 PERSUADER: persuaders use tools such as the latest
research data, they organise community members,
they deliberately manage specific topics, policies that
need change
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What is VCAT?
 Both a theory and an intervention
 People discovering their values through a process of honest
self-examination and open-minded search for life’s truths
(Maslow, 1959 & Rogers, 1961)
 Interdependent processes of reasoning, emoting and
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behaving
“VCAT” is the process of examining one’s basic values and
reasoning for the purpose of understanding oneself, to
discover what is important and meaningful”
“Valuing occurs when the head and heart…unite in the
direction of action” (John Dewey, 1939)
Values Clarification a proven method to inform people and to
create a safe space for people to evaluate their beliefs and
values
Not a magic bullet – needs committed leadership and follow
through
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Central Focus of VCAT
 Helping people to use rational thinking and
emotional awareness to examine personal
behavioral patterns and to clarify and actualize
their values
 Thoughtful reflection, honest self-examination,
and critical analysis of values and value conflicts
 Structured, facilitated opportunity for people to
experience new or reframed information that is
designed to be accessible and relevant
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Values Clarification and Attitude Transformation
Theoretical Framework for Personal Change
Commitment statements
Didactic
CTOP Act
Conscientious
Objection
SRH R&R
&
Consequences
of
Unsafe
abortion
Experimental
Tactile
•Singing CTOP Songs
•Touching MVA
•VCAT Exercises
Improved
KNOWLEDGE
Case
Studies:
Zanele’s
Story
Improved
ATTITUDES
Critical
Reflection
&
Small group
discussion
Problem
Solving
&
Action Planning
New
ADVOCACY
BEHAVIOURS
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Introduction
Community Engagement based on three objectives
1. Develop skills and increase knowledge on Sexual
and Reproductive Health Rights to:
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increase contraceptive uptake
avoid unwanted pregnancies
seek safe abortions (including medical abortion)
recognize abortion complications
2. Change social norms and practices that stigmatize
abortion
3. Expand women's, including young women's, ability
to obtain abortion including medical abortionrelated information and care
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Some Highlights
 Limpopo Program
 Partnerships with CBO’s
 Mphilonhle: 12 Schools, Mobile Clinics, SRH included in activities
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(Rural KZN)
Mosaic: increased access to MVA & MA through opening 2nd
facility Mitchell’s Plain (Cape Town)
Masisukumeni: Men and Boys and SRH (Rural Mpumalanga)
Masimanyane: Rural Eastern Cape SRH awareness women and
girls
University of Johannesburg SRH clinic (Urban Youth)
 Linking the voices of the community with provincial
services
 Focus is on positioning TOP as part of comprehensive
Sexual and Reproductive Health.
 Educate in and out of school of youth about their SRH
rights and choices; lead workshops with their peers
 Young Women and Abortion Study: Peri-Urban study
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Previous Activities 2002 to 2011
 Values Clarification workshops all 9 provinces for 1st
trimester access (throughout)
 VC for 2nd trimester access all 9 provinces 2008
 Providers As Advocates training 2008/09
 Strategic Plan for the Implementation of the CTOP
Act
 Conscientious Objection Manual and Policy
Document
 SRH Workshops all provinces, public and pvt sector,
always include advocacy initiatives
 2- year initiative (Ford Foundation) 9 CBOs in 3 Countries
Creating support for the Maputo Plan of Action :
Mozambique, South Africa and Zambia
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Cont….
 Values Clarification workshops with Communities, providers,
management and provincial departments of health in Limpopo
 Assisted Limpopo, Mpumalanga, Free State, North West,
Western Cape with updating of TOP policies to include MA
 Continued to work with National DOH re adoption of policy
 Provinces to adopt own policies from July 2010
 Successfully defended the Amendment Act: Act #1 2008:
1st quarter FY08 (National Project)
 Defended the CTOP Act through submissions to Parliament
(June 2010)
 Pvt Members Bill: C. Dudley – mandatory sonar, mandatory
viewing of the sonar and mandatory counselling
 Worked/working with SRH partners to include TOP in “National
AIDS Strategic Plan-2012-17”
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Lessons Learned
 Need to be vigorous in supporting and defending the law
 Legal environment does not always translate into access
 Implementation of strict selection criteria ensures that -
as far as possible - the correct person attends the
training
 Ensuring TOP is implemented through the system
(Limpopo) rather than by a person (Mpumalanga) leads
to sustainability of the service
 Working with CBO’s
 Greater reach, larger audience, message spread
 Greater knowledge = greater access
 Linking CBO’s with Provincial Departments of Health
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Training Totals per province
MVA Training FY08 - FY11 (Total = 482)
200
180
189
160
140
120
100
80
83
60
40
20
0
62
42
34
42
30
Provincial Clinical Orientations
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Clinical Orientations FY08 - FY11 (Total = 511)
300
250
250
200
150
136
100
95
50
0
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Eastern Cape
Gauteng
kwaZulu Natal
8
8
North West
Limpopo
Western Cape
MA Refresher Training
Public Sector
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Private Providers
Pharmacists
120
100
21
45
80
82
60
7
40
40
20
0
40
31
27
46
48
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Advocacy work limited to funding
 Donors
 Focus of Department of Health
 Need to have a focused approach
 Combine skills support each other
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July to November 2011 VCAT
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Questions?