MID 217- COMMUNITY MIDWIFERY –SIR OKOROCHA CYRILGENTLE, MPH,

PhD©,FCBET

ADVOCACY IN THE COMMUNITY

COMMUNITY DEFINITION

1. A Community is a social group of any size whose members reside in a specific locality, share
government, and often have a common cultural and historical heritage.
2. A community is a social unit with a shared socially significant characteristic, such as place, set of
norms, culture, religion, values, customs, or identity. Communities may share a sense of place
situated in a given geographical area or in virtual space through communication platform.
Examples of existing definitions of “community” by identified themes

Themes Examples
Physical “There are communities that are defined primarily by the
proximity territorial dimension, as in the case of neighbourhoods…”
(Capece & Costa, 2013)
Shared “Communities are comprised of those with whom we share
the same values, beliefs, and worldviews…” (Bettez, 2013)
Group “Community was defined by a small group of friends…”
(Lehavot, Balsam, & Ibrahim-Wells, 2009)
Bounded “[C]ommunities are often defined as much by who they
exclude as who they include… (Stone 1992)” (Bettez, 2013)
Interaction “Wilkinson (1991) suggested that community should be
defined by placing primacy upon the field of interaction.”
(Nieckarz, Jr., 2005)
Belonging Community refers to the development of bonds between a
group of people… or feeling a sense of unity with one’s co-
workers.” (Vogl, 2009)
Support “If community is defined as support, then presumably what
these women are yearning for is help during times of
hardship.” (Rothblum, 2010)
Sustained “We will use the term ‘community’ to refer to any group
which is able to maintain itself in this way.” (Goodings,
Locke, & Brown, 2007)
Symbol “The ‘‘community’’ concept is a socially constructed symbol
that expresses boundaries (A. P. Cohen 1985;
Gusfield 1975)” (Ven, T. V. 2005)
Territory-free “… Theodori (2005) distinguishes between territory-free
communities
(groups of people, i.e., “the Internet community”) and
territory-based communities.” (Amsden, Stedman, &
Kruger, 2011)
Process “The community—defined as a place-oriented process of
interrelated actions…” (Theodori, 2005)
Diverse “A group of people with diverse characteristics who are
linked by social ties…” (MacQueen, 2002)
Tangible “[C]ommunity is therefore at once a lived experience and
a tangible entity…” (Mcclellan, 2011)
 Physical proximity was most often discussed in terms of neighbourhood

and geographical location. The notion of community as something shared was

reported in terms of shared ties, common interests, and common identity.

Definitions touching on group referred to a group of people, a network, a clan, or

nodes. Bounded was used for definitions that mentioned the boundaries that

separate the members of a community from those who are not (e.g., age cohort,

religious or intellectual tradition, or employment status). Definitions that included

mention of some sort of interaction, for example, working, social interaction, or

engaging, were also noted. Belonging refers to definitions specifying feelings or a

sense of commitment, belonging, or unity. A number of definitions mentioned that

community involved support, such as solidarity, cooperation, and help. Segments

that discussed community in terms of preservation, managing the clan, and ability

to maintain itself were grouped under the theme sustained, and emphasize that,

for a community to survive, it needs to be managed and preserved; it does not

simply exist because a group of people come together. Community as a symbol

was also common, and consisted of segments describing it as a conceptualization,

theoretic construct, or a titular concept. Some definitions suggested community as

being territory-free – for example, web-based or virtual communities.

Community as a process; Here, community was referred to as being elastic, and in

a constant state of changes.

Community as something that is diverse was also noted, though with less

frequency. Included here were segments related to community as covering a wide

range of situations, holding a variety of contradictory meanings, and diverse

social practices. Finally, the issue of community as being something tangible was

noted in two segments (i.e., tangible and that precedes and makes possible any

concrete formation or organization).

Broadly defined, a community is a collection of people who interact with one another and whose common
interest or characteristics gives them a sense of unity and belonging.

- A community is a group of people in defined geographical area with common goal and objective and the
potential for interacting with one another (Dryer’s den).
The function of any community includes its members’ sense of belonging and shared identity, values,
norms, communication, and supporting behaviors. Some communities who may share almost everything,
while other communities (large, scattered and composed of individuals) who may share only there common
interests and involvement in certain goals.
A community is often defined by its geographic boundaries and thus called a geographic community.
Example, a city, town or neighborhood is a geographic community. A community demarcated by
geographic boundaries becomes a clear target for analysis of health needs to form basis for planning health
programs and a geographic community is also easily mobilized for action.
Community can also be identified by a common interest or goal. A collection of people, although they are
widely scattered geographically, can have an interest or goal that binds the members-together called
common interest community. (e.g., Disabled individual scattered through out a large city may emerge as a
community through a common interest in their need for improved wheel chaired access or other
handicapped facilities).
CHARACTERISTICS OF A COMMUNITY

A community has three features, location, population and social system.

Location: every physical community carries out its daily existence in a specific geographical location. The
health of the community is affected by this location, including the placement of the service, the geographical
features…
Population: consists of specialized aggregates, but all of the diversed people who live with in the boundary
of the community.
Social system: the various parts of communities’ social system that interact which include the heath system,
family system, economic system and educational system.

ADVOCACY

The term ADVOCACY came from the latin word “Ad vocare” meaning speaking on behalf of someone

Advocacy seeks to ensure that all people in society are able to: Have their voice heard on issues that are important to them. Protect and
promote their rights. Have their views and wishes genuinely considered when decisions are being made about their lives.

Advocacy is defined as any action that speaks in favor of, recommends, argues for a cause, supports or defends, or pleads on behalf of
others.
Advocacy is working with other people and organizations to make a difference. (C5D9A, t995).
Advocacy is putting a problem on the agenda, providing a solution to that problem and building support for acting on both the
problem and solution.
Advocacy can aim to change an organization internally or to alter an entire system.
Advocacy can involve many specific, short-term activities to reach a long-term vision of change.
 Advocacy consists of different strategies aimed at influencing decision-making at the organizational, local, provincial, national and
international levels.
Advocacy strategies can include lobbying, social marketing, information, education and communication (IEC), community
organizing, or many other “tactics.”
Community advocacy is a strategic approach to influencing outcomes and driving change on behalf of your community. It involves
representing your community's rights and needs to the level of government best able to respond.
Advocacy is the process of people participating in decision-making processes which affect their lives.
Effective advocacy in the community or elsewhere may succeed in influencing policy decision-making and
implementation, by:

✦ educating leaders, policy makers, or those who carry out policies;

✦ reforming existing policies, laws and budgets, developing new programs;
✦ creating more democratic, open and accountable decision-making structures and procedures (InterAction, t995).
ESSENTIALS OF ADVOCACY
The main purpose of advocacy is to bring about positive changes to the health of the population.

Advocacy will address health issues through the implementation of a national health policy, or through the implementation of public
health policy — and it can also address health issues related to harmful traditional practices. Moreover, advocacy could help to meet the
goals of health extension programme policies, where specific resource allocation and service delivery models are formulated for
advocacy campaigns.

Advocacy is about helping one to speak up for the community; to make sure that the views, needs and opinions of the community are
heard and understood. It should always be an enabling process through which one, as a Health Extension Practitioner, together with
individuals, model families and others in the community — take some action in order to assist the community to address their health
needs.
Advocacy is person-centred and people-driven. It is always community-rights based. That is to say that advocacy is dealing with what
the community needs to improve its health. one could also say that advocacy is the process of supporting people to solve health issues.
It includes single issues and time-limited campaigns, as well as ongoing, long-term work undertaken to tackle a range of health issues
or health problems.

The goals and objectives of advocacy

The goals and objectives of advocacy are to facilitate change and the development of new areas of policy, in order to tackle unmet
health needs or deal with emerging health needs in a given community.

A goal is the desired result of any advocacy activity. An advocacy goal will usually be a long-term result, and it may take three to five
years of advocacy work to bring about the desired result. It is unlikely that your advocacy network can achieve a goal on its own; it will
probably require other allies to bring about the required change. It is vital to know what you are trying to do before you start your
advocacy work. This involves developing a goal that applies to the situation that needs to change.

Important points to note about goals are as follows:

 A goal is the overall purpose of a project. It is a broad statement of what one is trying to do.
 A goal often refers to the benefit that will be felt by those affected by an issue.
 A goal is long term and gives direction — it helps one know where he/she is going. It needs an accompanying route map or
strategy to show one how to get there.
 Without a goal, it is possible to lose sight of what you are trying to do.
 A goal needs to be linked to the mission and vision of your organisation.
Consider which of the following could be considered health advocacy goals:

1. Significant reduction of malaria in this district

 2. Reduction of infant mortality in this community
3. Washing hands after using the latrine is helpful in combating stomach upsets and other infections
4. Improvement in literacy in this district
5. Mosquito nets are useful in helping combat malaria.
STEPS/STAGES OF ADVOCACY

The First stage is the identification of an issue for policy action. This stage is also referred to as agenda
setting. There are an unlimited number of problems which need attention, but not all can get a place on the
action agenda. Advocates decide which problem to address and attempt to get the target institution to
recognize that the problem needs action.

Generally, the second stage, solution formulation, follows rapidly. Advocates and other key actors
propose solutions to the problem and select one that is politically, economically, and socially feasible.

The third stage, building the political will to act on the problem and its solution, is the centerpiece of
advocacy. Actions during this stage include coalition building, meeting with decision makers, awareness
building and delivering effective messages.

The fourth stage, policy action, takes place when a problem is recognized, its solution is accepted and there is
political will to act, all at the same time. This overlap is usually a short “window of opportunity” which
advocates must seize. An understanding of the decision-making process and a solid advocacy strategy will
increase the likelihood of creating windows of opportunity for action.

The final stage, evaluation, is often not reached, though it is important. Good advocates assess the
effectiveness of their past efforts and set new goals based on their experience. Advocates and the institution that
adopts the policy change should periodically evaluate the effectiveness of that change.
 The Basic Elements of Advocacy
While specific advocacy techniques and strategies vary, the following elements form the basic building blocks for effective advocacy.
Like building blocks, it is not necessary to use every single element to create an advocacy strategy. In addition, these elements need not
be used in the order presented. You can choose and combine the elements that are most useful to you.
As you examine the elements in the diagram, you may notice that some of these concepts are borrowed from such disciplines as political
science, social marketing and behavioral analysis.
1. Selecting an Advocacy Objective
Problems can be extremely complex. In order for an advocacy effort to succeed, the goal must be narrowed down to an advocacy
objective based on answers to questions such as: Can the issue bring diverse groups together into a powerful coalition? Is the objective
achievable? Will the objective really address the problem