Strengthen i ng Advocacy for Child Health and Well-Being A Workshop Report Proceedings of a Workshop heldJanuary 12-13) 1993 at Rockefeller University's Seven Springs Conference Center Mt. Kisco) New York Sponsored by Rockefeller Foundation • Agency for International Development • UNICEF GIVING VOICE TO CHILDREN: Strengthen i ng Advocacy for Child Health and Well-Being A Workshop Report January 1993 Sponsored by Rockefeller Foundation Agency for International Development UNICEF E"atum Cover illustration credit should read "A child advocacy poster by Katie Rush, age 10. " CONTENTS Acknowledgemerits~ ............. :· .... :. ... :. ......................................................................... 2 Preface .................................................................................................................... 3 Introduction ............................................................................................................. 4 Welcome and Highligh!~ .o~ Opening Remarks ..................................................... 6 The International Challenge ............................................................................... :; .. 7 Working With Governments on Advocacy ....................................... :. ..... ~ ............. 9 I. Developing Leaders and Mobilizing Communities for Advocacy and Action ............................................................................... 13 II. Policy Advocacy ....................................................................... ·. ..................... 17 III. Monitoring the Status of Children ................................................ ~ ................ 2l N. The Role of Communication ......................................................................... 24 V. Resource Mobilization ................................................................................... 29 VI. Forging Alliances ........................................................................................... 34 The Agenda for Children ...................................................................................... 36 Conclusions (edited) ............................................................................................. 40 Summary of Recommendations ............................................................................ 44 Annex A: World Declaration on the Survival, Protection and Development of Children ........................................................... 50 Annex B: Meeting Agenda ................................................................................ 53 Annex C: Participant List .................................................................................... 56 Annex D: Demographic and Health Charts ....................................................... 59 Annex E: Conclusions (full text) ........................................................................ 62 Annex F: References ......................................................................................... 67 1 ACKNOWLEDGEMENTS The workshop sponsors would like to express their appreciation to the following people and organizations for their assistance in the preparation and follow up to the meeting. The staff of the sponsoring organizations listed on the front cover, and especially to Susan Muir of the Rockefeller Foundation for her help with logistics and smooth communication. The staff at Rockefeller University's Seven Springs Conference Center for their hospitality and excellent meals. W. Henry Mosley of The Johns Hopkins University, Peggy Curlin of CEDPA and Petra Reyes of the Agency for International Development for their thoughts and insights during the planning of this meeting. We are extremely grateful to STATISTICA INC., under contract to AID, for their assistance in the planning and coordination of the meeting and the preparation of the final report. In particular we would like to thank Kamran Grasselly for his work in preparing the information packets; Nada Brice for her outstanding work in coordinating travel arrangements for U.S. and developing country participants; Aaron Bowles for his assistance with the graphic design; and Ellyn Ogden for editing the workshop report, supervising the preparation and logistics for the meeting and for working with children on advocacy posters for the cover art. To the children of Highland View Elementary School in Silver Spring, Maryland, USA and their art teacher, Margaret Guerin, we offer a special thank you for creating the beautiful and provocative child advocacy draWings submitted for the cover of our report. We're sorry we could only select one. The Agency for International Development Rockefeller Foundation UNICEF April 29, 1993 2 PREFACE When I pretend that I'm looking at the present from some place else, I can easily see RESULTS!, the Children's Defense Fund, Bread for the World, and other groups here writing under the pen name ofE uripides, because social justice was the underlying theme in almost everything that he wrote. The value studying history is that 'We realize that everything, every idea, every product, every person, every problem has a history, and that it's a cause-and effect reaction that we can trace all the way to the present time. It is this realization that this is a cause-and-if.fect world that gives us the responsibility for the future. That is the reason to study history- to understand our responsibility to the future -because everything we do individually or collectively is going to determine what happens tomorrow. - William Foege 3 INTRODUCTION Advocacy: the act or process of pleading a cause Advocate: one that defends or maintains a cause or proposal For the last decade, there has been a highly successful global effort to increase the survival of children. A coalition of countries, organizations, and donors have worked together to increase immunization, improve basic child health services and strengthen other programs designed to reduce child mortality. International awareness of and commitment to solving the problems of children have increased. There is increasing agreement that the technical means to improve children's lives exist; what is needed is the political will and social mobilization to deliver them on a sustained basis. The World Declaration on the Survival, Protection and Development of Children (Annex A) adopted at the World Summit for Children lays out specific goals that have been agreed to by 139 heads of state and include: reducing child mortality by one-third, ensuring that 80 percent of children complete primary education, universal access to safe drinking water and reducing child malnutrition by one half by the year 2000. Advocacy is required to make sure that these promises are kept. The Plan for Action calls for all forms of social mobilization and for, "non-governmental organizations, social, cultural, religious, business and other institutions ... to play an active role in support of the goals." The purpose of this retreat was to identify ways that advocacy efforts can help sustain commitment to child health and well-being, especially through local and national efforts, and advocacy by non-governmehtal organizations. To that end, the Rockefeller Foundation, the Agency for International Development and UNICEF sponsored this retreat to assess the current global status of advocacy for child health and explore ways to strengthen and sustain it. Participants were leaders concerned with the health and well- being of children from both developed and developing countries. The meeting and this report were structured to: 1) introduce the issues surrounding children, document successes so far and indicate areas still needing attention; 2) describe the lessons learned with working with governments on advocacy thus far; and 3) look at the advocacy process and successful approaches Annex B for meeting agenda). The meetings focused on six key areas: I. Developing Leaders and Mobilizing Communities for Advocacy and Action II. Policy Advocacy III. Monitoring the Status of Children IV. The Role of Communication V. Resource Mobilization VI. Forging Alliances. 4 Discussions followed the panel presentations and allowed all participants (See Annex C for list) to offer personal insights, make suggestions and ask questions. We have included as much of the discussions as possible to give the reader a sense of the complexity and depth of thinking that has already taken place and highlighted particularly inspirational quotations. The meeting summary provides recommendations on how to create an "absolutely astounding advocacy association." We expected the meeting to be stimulating, but we had not expected that so much practical wisdom on how to advocate for children would be shared. One outcome of the meeting was that we all left feeling that we had tools to become better advocates. Each of the six key topic sections of the meeting report presents practical "how-to" information followed by discussion highlights. We think you will find them useful as well, as we work together to strengthen national advocacy in developing countries on behalf of children and their families so that the goals laid out at the World Summit can be realized. A second outcome of the meeting was the recommendation to create a sub-committee on child advocacy within the Task Force for Child Survival and Development. Originally formed in 1984 with support from WHO, UNICEF, UNDP, The World Bank and The Rockefeller Foundation, the overall mission was to assist its sponsors and others in accelerating global immunization and other child survival efforts. In 1990, it was recommended that the health goals resulting from the World Summit serve as the basis for continued efforts by the Task Force. The establishment of an advocacy committee offers NGOs and bilateral agencies a forum to contribute to the work of the Task Force. During this meeting, larger, more fundamental questions came under discussion: Why is child advocacy necessary at all? Is it because society does not value children? Are other things more important to parents, communities, governments? Are children not a scarcity? What are the perceived trade-offs to society or individuals if we invest in children? If we do not? Does the increasing demand for short-term, identifiable results cloud our eyes to the long-term investment in our children? Are the dividends from investments of this sort too nebulous or intangible for today's sound bites? Who is accountable? Can the hopelessness and cynicism most people feel be overcome? How do we empower people to think they can make a change? We did not answer these questions completely, but the two days of discussion recognized the need for action. We invite you to thoughtfully read the proceedings of our retreat and hope it prompts you to act. Quoting James Grant, "Ours is the first century -actually the first generation - which can think about bringing progress to mankind as a whole ... We have the means to affect the survival of children in our hands." The real questions for today are not WHAT? or WHY?, but HOW? and WHEN? Retreat Co-Sponsors ~f5./~ The Rockefeller Foundation C1-\)().M. Vu~, The U.S. Agency for International Development ~~ UNICEF 5 Welcome and Highlights of Opening Remarks The session was opened by Dr. Nyi Nyi of UNICEF, Dr. Ann Van Duseri of the U.S. Agency for International Development, and Dr. Scott Halstead of the Rockefeller Foundation. A common theme in their remarks was that the revolution for children's survival and well-being has not been secured despite the extraordinary progress of the last decade. Assuring attention to the problems of children requires a sound base and a sense of ownership by people. The essential ingredient of child survival, indeed the turning point in the war for children, will be how to assure advocacy on their behalf. After years of quiet struggle, the Anticipation of a peace dividend, the success of the World Summit, and the stars are in good ratification and support for the Convention on the Rights of the Child by most conjunction, as governments, indicate an increase in the political will to focus on children's needs. the Indonesians Signals from the new U.S. administration indicate that children are high on the say, for political agenda. promoting children's issues. -NyiNyi The fight for child survival and well-being has been compared to running a marathon or climbing a mountain: one does not stop half-way but pushes on to the top. The fact that EPI has achieved 80%-plus immunization coverage indicates things are do-able. Regional meetings have reached a good degree of consensus and support of common goals. These goals now include a broad range of development issues too, not just survival. We have learned that intermediate goals can motivate and stimulate continued activity. Goals reachable within the political life of decision-makers have a greater chance for support. Thus, UNICEF plans to embark on a series of regional meetings to look at intermediate goals. This movement needs both advocacy and operational capacity to be effective and more than money or a human resource base to be sustainable. Social mobilization is key to sustainable strategies. There has been growth in institutionalized capacity in many areas, but not yet advocacy. The elements The issue before us is how to maintain the socio-political commitment that lead to needed to build an gains in the 1980's. Gains are fragile and we are starting to see some decline. How environment for do we build the ability to monitor changes and make changes at the local level? We raising healthy need to re-examine our resource needs. Have we under-utilized or underestimated children are also the role of communities and NGOs? What mechanisms exist to broaden the goals of the building blocks NGOs? Now we see more clearly the strong role communities must play and the for open societies. need for access to information and people. - A. Van Dusen In many ways advocacy brings on a wide range of social improvements. 6