Reproductive Health Package CSR PFI Section VII Advocacy %26 Communication :: PFI Publication :: KNOWLEDGE MANAGEMENT CENTRE PORTAL, POPULATION FOUNDATION OF INDIA

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Reproductive Health Package CSR PFI Section VII Advocacy %26 Communication

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Reproductive Health Package CSR PFI Section VII Advocacy %26 Communication

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Section VII

Advocacy & Communication

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Section VII

ADVOCACY & COMMUNICATION

Communication for Behaviour & Social Change 1

Counselling

Advocacy

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chapter 18

COMMUNICATION FOR BEHAVIOUR

AND SOCIAL CHANGE

Behavioural changes are induced by effective information, education and communication (IEC).

Communication channels range from intimate interpersonal communication, traditional folk arts,

interaction with local community leaders to modern mass entertainment and coverage of issues by

national and international news media.

Communication is a two-way process. Components of this process are:

Communicator: The sender is the originator of the message. To be effective the sender must be clear

about (i) the objective of the communication, (ii) needs, interests and abilities of the receiver, (iii)

the content or usefulness of the message, and (iv) the channel to be used. It is important that the

message is sent in the language understood by the receiver before responding to it.

Message: It is the idea, feeling or information that is to be sent to the receiver. It may be verbal or

non-verbal but it needs to be clear and unambiguous.

Channel: The medium of communication can be audio, visual or both. Communication should be

adjusted to local cultural patterns and cultural media; for example, use of folklore through folk theatre,

folk music, and so on.

Effect or outcome: Good communication results in changes in the receiver of the message. These

changes comprise changes in knowledge, attitude, and actions.

Mass awareness strategies are employed to reach development-related messages to the people in the

community. Health-related messages are conveyed through interpersonal communication either in

group meetings or one-to-one. Behavioural change, however, is a slow process. The process involved

is presented in Figure 18.1. Table 18.1 illustrates this further.

The experience of the family planning campaign in India is an illustration of this. Initially, most

people did not adopt family planning methods as they were unaware of the type of methods or where

they were available. Even the benefits of a small family were not known. After exposure to messages

on family planning methods over the years, most people are now aware of the methods, but the

awareness has not led to a change in behaviour. There are still many myths, misconceptions, incomplete

knowledge about the methods and their availability. Further exposure to messages through different

media resulted in many people getting motivated to adopt family planning and eventually some started

using a contraceptive. Only when they were satisfied with the benefits they adopted the family

planning method regularly. At any point in time, there would be groups of people at each stage of

behaviour change. The key to effective communication is to be able to identify the stage at which

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- - - - - - - - -C-O-R-P-O- R- -A-T-E-S-O-C-I-A-L-R-E-S-P-O- -N-S-IB-I-L-IT-Y- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

most of the intended audience is and design the communication accordingly. Many health workers

think that specific groups of people resist family planning. This attitude gets reflected through verbal

and non-verbal communication, in turn creating a block in the receivers’ minds against healthcare

providers and the healthcare system. Healthcare providers therefore need to learn some essential

communication skills and techniques for effective communication with the clients.

Figure 18.1. Process of Behavioural Change

Unaware

Aware

Motivated/Concerned

Change

Sustain Change

Table 18.1. Steps to Behaviour Change Model

Knowledge

Approval

Intention

Practice

Advocacy

• Can recall family planning and other reproductive health messages.

• Can understand what the messages mean.

• Can name products, methods, or other practices and/or sources of services/

supplies.

• Responds favourably to the messages.

• Discusses the messages or issues with personal networks (family, friends).

• Thinks family, friends, and community approve of practice.

• Approves practice.

• Recognizes that specific health practices can meet a personal need.

• Intends to consult a provider.

• Intends to practise at some time.

• Goes to a provider for information/supplies/services.

• Chooses a method to practise and begins use.

• Continues use.

• Experiences and acknowledges benefits of practice.

• Advocates the practice to others.

• Supports community programmes.

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- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -C-O-M- -M-U-N-I-C-A-T-IO- -N- -FO- -R- -B-E-H-A-V-IO- -U-R- -A-N-D- -S-O-C-I-A-L-C-H- -A-N-G-E- - - - - - - - -

Interpersonal Communication

Interpersonal communication means sharing of words,

feelings and communication between two or more

people. Establishing a common interest or common

meaning of words between two persons is the key to

successful interpersonal communication. This

communication must take place in close proximity,

i.e., face to face and must always be a two-way process

(see Figure 18.2).

Figure 18.2. Two-way Communication

Sender

Information

Views

Emotions

Channel and Medium

Receiver

Information

Views

Emotions

In one-way communication only the sender sends the message, e.g. a lecture. The receiver or the

audience does not interact. In two-way communication there is interaction between the sender and

the receiver, which allows for an opportunity to ensure that the message has been interpreted appropriately.

In healthcare, effective communication helps to develop rapport with the patient due to which the

diagnosis is accurate, compliance with treatment is better and follow-up is more regular. If the patient

is given information about the illness, the investigations that are to be carried out and the treatment

options, and when concern is shown to her, there will be greater patient satisfaction and better

treatment compliance. The long-term outcome would be reduction in morbidity, mortality, and

positive health status.

Thus, interpersonal communication is an important function of healthcare personnel at all levels, more

so in a counselling session.

Counselling

Counselling is a specialized process of communication. Counselling is a professional relationship

between a counsellor and a client whereby the counsellor helps the client to get direction towards

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dealing with her/his present and future problems and situations. A counsellor, therefore, must have

a clear understanding and sound knowledge of the subject being discussed and ability to appreciate

the specific problems of the client.

Barriers to Communication

Barriers to communication may come from both the sender and the receiver. Socio-cultural gaps lead

to differences in language, terminology and mannerisms. On the sender’s part the barriers could stem

from inadequate knowledge; inadequate skills; self-image; frame of mind; attitudes and mind-set;

biases and prejudices; poor listening skills; inappropriate verbal or non-verbal language; and inappropriate

use of audio-visuals. Bariers on the receiver’s part could be from attitudes and mind-set; biases and

prejudices; poor receptiveness to learning. Communication also suffers if the content is irrelevant to

the receiver’s experiences or if she/he does not feel respected, if he/she is disturbed or distracted on

account of physical pain. Among the other constraining factors could be noise, overcrowding, heat

or cold in the room, time constraints for sender and receiver, lack of privacy and workload.

Communication for Social Change

Community

Community is a multilevel concept ranging from local, geographically defined entities, such as

villages, cities and nations, to international entities widely dispersed in space and time. The concept

of community also includes issue-related groups, such as the gay community, professional organizations,

and even the development communication itself. The model also recognizes that communities are not

homogeneous entities but are comprised of subgroups with social strata and divergent interests. As a

consequence, disagreement and conflict are also incorporated into the communication for the social

change model.

The Brazilian educator Paulo Freire (1970) conceived of communication as dialogue and participation

for the purpose of creating cultural identity, trust, commitment, ownership and empowerment. The

paradigm of social change flowing from this perception of communication describes a process of

dialogue, information sharing, mutual understanding and agreement, and collective action. The model

of social change is based on community dialogue and collective action that clearly specifies social

outcomes as well as individual outcomes.

The communication for social change model describes a process by which leaders guide community

members through dialogue and collective action in order to resolve mutual problems for themselves.

Social mobilization is done through the following process:

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Recognition of a problem: As a result of a catalyst, someone in the community becomes aware of

the existence of a problem.

Identification and involvement of leaders and stakeholders: Members of the community who are most

affected by the problem (stakeholders) are asked to come to the meeting.

Clarification of perceptions: It is possible that different perceptions of the problem exist among

different members of the community. Dialogue is necessary to create a mutual understanding (common

framework) with which to solve the problem. Only after such perceptions have been clarified and

different points of view rectified can the process move forward with a clear understanding of how the

problem should be addressed.

Expression of individual and shared needs: One key element that community projects have to ensure

is the involvement of individuals who are among the most disadvantaged in the community. Otherwise,

projects run the risk of involving groups that may not be representative of those at the bottom of the

scale and whose perception of the problem and needs may be different. Not everyone will experience

the problem with the same level of severity.

In order to resolve problems successfully it is important that all affected in the community get a

chance to express their own views and needs. If any conflict or dissatisfaction arises, community

leaders have to resolve the conflict before progress can be made with the problem. To resolve the

conflict, more clarification may be needed or new leaders and stakeholders may have to get involved

so that a majority can convince a reluctant minority to go along.

The Collective Action Model

The model identifies five key action steps, namely, (1) assignment of responsibilities, (2) mobilization

of organizations, (3) implementation, (4) outcomes, and (5) participatory evaluation.

1. Assignment of responsibilities: To convert a plan into action, specific people must take responsibility

to accomplish specific tasks within specified periods of time. The leaders must ask for volunteers

or else assign tasks to individual and/or community subgroups (existent or newly created for

executing the action plan). Someone must take responsibility for each of the activities identified

in the action plan. Depending on the complexity of the problem it may be necessary to create

community task forces focused on specific project goals and sub-goals.

2. Mobilization of Organizations: It may not be necessary for members of the community to take

responsibility for all of the tasks that need to be accomplished, especially if there are existing

organizations inside and outside the community that can help. Thus, one of the assigned tasks

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may be to obtain the support and help of pre-existing community resources. For example, in

most health interventions, health providers and schools should be asked to contribute.

In the experience of many communication activists, communication through the local media can

be an invaluable resource for mobilizing community support and activity. There are several ways

in which the media can facilitate the dialogue and action process. In the dialogue phase (a) it

can support the diagnosis of the problem situation and the presentation of the problem to the

community (there are many examples of how radio or radio tapes have assisted in getting the

“voices” of community groups in the dialogue process); (b) it can stimulate community deliberation

and the prioritizing of problems; (c) it can support the exchange of ideas and experiences among

distant communities; (d) it can help community organizations find solutions to problems. In the

action phase the communication and local media can contribute by – (e) informing the community

about available services and how to gain access to them; (f) training community members how

to use the media to inform the general public about their needs; (g) helping communities to

obtain legitimization and support from authorities; (h) providing feedback to the community

about the progress and achievements of community projects; and (i) praising/rewarding communities

for their achievements, and thereby enhancing the members’ self-esteem and sense of collective

self-efficacy.

3. Implementation: This step refers to the actual execution of the action plan and its monitoring.

No plan can be successful if the required work is not done. Furthermore, leaders, members, and/

or subgroups should take responsibility for monitoring all the tasks that have been assigned,

making sure that activities are moving according to the timetable and everyone is fulfilling their

responsibilities.

4. Outcomes: This step refers to the actual results that the community is able to achieve, given

the resources, organization and mobilization process specified by the action plan and then

carried out. To know the results of community projects, some type of observation and/or

counting of events/incidents need to be done to measure the level of achievement.

5. Participatory Evaluation: The achieved outcomes may or may not be what the community

originally planned in its specification of objectives. The comparison of the outcomes to the

shared vision and original objectives is an important self-evaluation process. For purposes of

group motivation, it is important that most of the community participate in the evaluation

process so that the lessons learned about what worked and why can be shared throughout the

community. The result of the participatory evaluation should be a new reassessment of the

current status of the community with respect to the problem.

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From here, the community is ready to renew the process, moving forward into further action for the

same problem, perhaps, or on to a different problem. It is by means of this reassessment process that

the community reinforces its sense of collective self-efficacy, which in turn leads to and increases the

community’s belief in and value for continual improvement. This improvement is one of the primary

outcomes of continual reassessment of the current status followed by a renewal of community

dialogue and collective action.

Community Dialogue

In community dialogue intended towards social change, the following characteristics may be seen:

1. Information is shared or exchanged between two or more individuals rather than transmitted

from one to another. All participants act on the same information; none are passive receivers

of information. The information can be created by the action of any participant, or it may

originate from a third source such as television or radio, a person or institution not directly

participating, such as church, school, NGOs, and so forth.

2. It stresses the important role of the perception and interpretation of participants, and treats

understanding in terms of a dialogue or ongoing cultural conversation.

3. It represents a horizontal, symmetrical relationship among two or more participants (A, B, …,

n) that is created by sharing information. The outcomes of information processing by the

participants are social – mutual understanding, agreement and collective action, as well as

individual – perceiving, interpreting, understanding and believing.

4. It implies a continuous, cyclical process as participants take turns creating information to share

with one another and then interpreting its meaning until a sufficient degree of mutual understanding

and agreement has been reached for collective action to take place.

“Information” is preferred to the term “message” to allow for both verbal and non-verbal information,

unintended as well as intended information. For example, if women suddenly show up at a community

meeting for the first time, this action by itself conveys information that can be stronger than all of

the verbal comments made about “allowing women to participate”.

In a dialogue, a process of turn-taking occurs as each participant seeks to clarify what others believe

and understand as well as one’s own understanding and beliefs. This turn-taking constitutes a minimal

form of collective action: joint action in the form of two or more persons engaged in dialogue. But

dialogue must mean more than just endless turn-taking. The underlying assumption of dialogue is that

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all participants are willing to listen and change, not just one of the parties. Communities that have

a long history of conflict may not be able to engage even in this minimal form of collective action

– talking to one another.

Turn-taking (conversation, dialogue) constitutes a feedback process for each participant which, if

effective, leads to a “series of diminishing mistakes – a dwindling series of under- and over-corrections

converging on a goal.”

Effective dialogue occurs when: (1) participants with differing points of view listen to one another,

as indicated by paraphrasing the other’s point of view to the other’s satisfaction, (2) each one

acknowledges the conditions under which the other’s point of view can be accepted as valid, and (3)

each one acknowledges the overlap or similarity of both points of view. But sometimes dialogue can

lead to disagreement and divergence, especially when the dialogue makes it clear each individual’s

true interests and values are in conflict.

Power relationships substantially affect the communication process. Power may be exercised by means

of authority (threat or use of positive and negative sanctions), influence (persuasiveness of participants),

pre-existing social norms or all three. Power and conflict represent another means of overcoming

differences and opposition within a group. But even in cases where a community leader or outsider

coerces recalcitrant individuals and subgroups to cooperate in a project, some minimal level of mutual

understanding and agreement is still required for them to comply and engage in collective action.

Negotiation represents a third means of overcoming opposition and conflict. Leaders of opposing

factions can propose trade-offs and agree to compromises in order to obtain sufficient mutual agreement

for collective action to proceed. For example, the subgroup within a village that wants to build latrines

rather than new wells can agree to cooperate with building the wells first if the other subgroups agree

to help with latrines later and if some of the wells are located close to their houses.

Third-party arbitration or mediation provides another alternative to conflict if dialogue and negotiation

fail.

Some initial amount of communication within a community or group is required to identify areas of

agreement and disagreement among those participating. When different points of view and beliefs

arise (divergence), further communication is required to reduce the level of diversity (convergence) to

the point where there is a sufficient level of mutual understanding and agreement to engage in

collective action and solve mutual problems. The method used to reach consensus is usually determined

by leaders within the community.

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Outcomes

The state of the community in terms of the status of the individuals who comprise it as well as the

community as a whole can be measured at any time before, during and after a development project

has been undertaken. The differences between individual or social characteristics of a community from

one point of time to another provide an indication of the change that has occurred while the

community was engaged in community dialogue and collective action.

The potential outcomes of dialogue and collective action for the individuals who participate include:

(1) improvement in the skills necessary to perform new behaviours; (2) ideational factors such as

knowledge, beliefs, values, perceived risk, subjective norms and even self-image; emotional responses

such as feelings of solidarity, empathy and confidence; and increase in social support and influence

from others as well as increased advocacy to others; (3) intention to engage in new behaviour in the

future; and (4) specific behaviours related to the problem addressed by the dialogue and collective

action.

An improvement in leadership is an indication of social change as well as change in the individual

behaviour of specific leaders.

When community dialogue and collective action are implemented in the manner specified by the

model, an improvement is expected in the community’s:

• sense of collective efficacy – the confidence that together they can succeed in future projects;

• sense of ownership – the degree to which they perceive themselves as responsible for the success

of the project and thus feel that they deserve the credit for and benefits from the project;

• social cohesion – the extent to which members want to cooperate in another community project

and the degree to which the social network of the community is interconnected as opposed to

divided into cliques and factions;

• social norms – the accepted rules for participation, especially regarding who should or should

not speak up and share in decision-making and “fairness” regarding the contribution and sharing

of benefits; and, finally,

• collective capacity – the overall ability of the community to engage in effective dialogue and

collective action that is a consequence of all of the social change indicators specified by the

model.

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Strategic Planning for Communication

Communication interventions are most effective when they are planned strategically and follow a

systematic focused plan of action. The P-Process and Smart Chart can help in the process.

The P-Process

The “P-Process”, developed by the Johns Hopkins University/Population Communication Services

(JHU/PCS) organizes the planning and implementation of a communication programme into progressive

stages. The process provides a framework for strategic development, project implementation, technical

assistance, institution-building and training. The following are the stages of the P-Process :

• Analysis

Problem assessment and situation analysis: (a) Find out as much as possible about the

existing situation before designing the communication programme. (b) Identify potential

audiences.

Assess: (a) the social and demographic context; (b) prevailing knowledge, attitudes; (c)

practices regarding the specific health issue to be addressed by the programme; (d) ethnic

and linguistic affiliation.

Review existing health facilities, organizational resources, and communication infrastructure.

After analysing the situation, prepare a document presenting the situation and

recommendations for action.

• Design

Specify communication objectives.

Determine target audience(s).

Decide message, content, media channels and mix.

Establish a plan for coordination among media channels.

Outline an overall action plan.

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Define stages.

Define resource generation.

• Development, Pre-testing and Revision

The analysis and design conducted during the first two stages should guide this stage.

Be sure that the messages are simple, clear, specific, positive and action oriented.

Pre-test messages and materials with their intended audience.

Materials assessments should be based on attraction, comprehension, acceptability, self-

involvement and persuasiveness/believability.

Finalize messages and materials.

• Implementation, Monitoring and Assessment

Implementation

Identify, implement and monitor key elements of the project.

Inform key personnel of the implementation schedule.

Disseminate messages through appropriate channels.

Train personnel to use the materials.

Monitoring

Verify the amount of materials produced.

Review material distribution channels.

Determine whether the work schedule and budget are being followed.

Strengthen relationships with other agencies.

Modify project design as necessary.

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Assessment

Measure the impact of the project on the target audience in terms of the stated objectives.

Measure changes in knowledge, attitudes and/or practices.

• Review and Re-plan

Re-analyse the situation in the light of the effects of the communication project.

Design the next phase of the project.

Adjust to the changing needs of the audiences and build systematically on past experiences.

Make the communication project and planning process a continuous one.

The Smart Chart

Smart Chart 3.0™, developed by Spitfire Strategies, Washington, DC (<www.spitfirestrageies.com>)

helps assess the strategic decisions to ensure that the communications strategy delivers high impact.

The chart features six major strategic decision sections:

1. Programme decisions – broad goal, objective, decision-maker

2. Context – internal and external scans and position

3. Strategic choices – audience, readiness, core concerns, theme, message and messenger

4. Communications activities – tactics, timeline, assignments and budget

5. Measurement of success

6. Final reality check.

1. Programme Decisions focuses on drawing broad goal, objectives and pinpointing the decision-

makers who have the power to turn the goal into reality.

(a) The broad goal is basically a big, audacious statement about the world the communicator

is trying to create.

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(b) The objectives are different from the ambitious goal and are more specific and shorter term.

If, say, the goal is to reduce maternal mortality, one possible objective might be to increase

prenatal care rates by 15 per cent in three states by the end of 2007. Clear objectives are

the foundation of a good communication plan – every other decision to be made will flow

from the objective. The objective should focus on “SMART” (Specific, Measurable, Attainable/

Achievable, Realistic and Time-bound). A Smart Chart objective is programme-related, and

usually falls into one of two categories: behaviour change and policy change.

the communicator in making the goal a reality by saying yes to it.

2. Content: The content in Smart Chart is about knowing the organization’s strengths, weaknesses

and its position on the issue as also the external environment – the opportunities and the threats

outside the organization on the issues.

(a) An internal scan is an evaluation of all the assets and challenges an organization has

internally that may impact its communications work.

(b) An external scan is an evaluation of everything happening outside of the organization –

the communication environment – that will impact the communications work.

includes an assessment of the current perceptions of the issue among various stakeholders

and then identifying the organization’s position on it.

3. Strategic Choices: The focus of this section is to bring the audience closer to the issue and

motivate them towards united action for the positive change. This generally talks about deciding

the target audience, what they care about, how to approach them, what to communicate to

them, and who is going to communicate to them.

(a) Audience basically are the target people who can move the decision-maker(s) and help in

achieving the objective.

(b) Readiness: For effective audience readiness the issue has to be seen from their perspective

and position.

they care about. By tapping into the audience’s existing values, they can be motivated to

make progress toward the goal in a relatively short timeframe.

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(d) Theme: The theme is the strategic approach of the organization to connect and gather the

attention of the audience. The theme would take into account the core concerns and values

of the target audience. For example, if the communicator is trying to get expectant mothers

in the community to give birth in hospitals rather than at home, the options for strategic

approach might be personal health (it is safer for you to give birth in the hospital) or family

well-being (if something happens to you in childbirth, your family will suffer).

(e) Message: The message is a short sentence of invitation that encourages the audience to take

action. Good messaging has no more than three to four main points – people cannot

remember more points. The message should always aim to address the communicator’s

questions, values, barriers and vision.

(f) Messenger: A messenger is the person who delivers the message to the target audience.

Messengers need to be influential to and credible with the target audience. For example,

if the target audience is the religious leaders in the community, the communicator may

need a messenger who is a member of the same religious group as the communicator

leaders.

4. Communication Activities: This aims at bringing people together based on the tactics/medium

to address and work for each objective, plot them on a timeline, assign key tasks to the people

(organization, volunteers, coalition partners and other key players) who will help in implementing

the strategy. It is also essential to budget for the activity in a realistic manner.

(a) Tactics: Tactics are the specific tasks or the media the communicator has under each

communication objective. For a media outreach activity, the communicator’s tactics might

include writing and distributing a press release, holding a press conference, meeting with

key journalists, etc. For a conducting one-on-one meetings objective, the tactics might

include developing materials to leave behind after the meeting, scheduling the meeting,

recruiting spokespersons to attend the meeting, developing talking points for the meeting,

following up after the meeting, etc.

(b) Timeline: is also known as the window of opportunity. This speaks about plotting out the

timing of important dates and events in the calendar.

may belong to the organization, volunteers, coalition partners and other key players who

will take part in the communication operation.

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(d) Budget: Costing the activity in a realistic manner to accomplish the given planned activities.

5. Measurement of Success: As the strategy is implemented, the progress will have to be monitored

along the way. Identifying both quantifiable and anecdotal ways to measure success helps signal

progress throughout the efforts to internal audiences like staff and volunteers and to external

audiences like funders and policymakers. Benchmarks of success are measures put in place to

chart progress towards the goal and assess at the end whether the goal has been achieved.

Benchmarks should include a mix of both outputs and outcomes.

6. Reality Check: It is essential to test the strategy before putting it into action. All the strategic

decisions should align to create a consistent approach. It is important to make sure that the logic

holds up to scrutiny before time and money are invested.

References

Figueroa, Maria Elena, Lawrence D. Kincaid et al., 2002. “Communication for Social Change: An

Integrated Model for Measuring the Process and its Outcomes”. Rockerfeller Foundation for

Communication Programs.

Material Published by Johns Hopkins University - Centre for Communication Programs.

Population Foundation of India, 1999. “Training Module Reproductive and Child Health”.

Spitfire Strategies, 2008. “The Spitifire Strategies Smart Chart 3.0. An Even More Effective Tool to Help

Nonprofits make Smart Communications Choices”. www.spitfirestrategies.com.

Women Centred Health Project, 2005. “Training Manual for Health Care Providers on Women Centred

Counselling in a Gynaecology Clinic”. Vadodara:. SAHAJ.

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chapter 19

COUNSELLING

Counselling is a professional relationship between a counsellor and a client whereby the counsellor

helps the client to get direction towards dealing with her/his present and future problems and

situations. A counsellor, therefore, must have a clear understanding and sound knowledge of the

subject being discussed and ability to appreciate the specific problems of the client.

In counselling, clients and providers meet face-to-face to discuss reproductive health problems and

healthy practices. Service providers not only inform their clients but also listen to them and help them

to understand their feelings and needs, and thus to make more appropriate choices. In a good

counselling situation, the provider establishes a relationship with the client by expressing empathy

(that is, putting oneself in the other person’s position), being respectful, and telling the truth.

An effective counsellor understands the perceptions of the client and puts her/him at ease and allows

their beliefs and feelings to emerge. By providing information and assurance to clients, she/he assists

them to make their own decisions. She/he is empathetic, honest, respectful, trustworthy, confidential,

knowledgeable, and has good interpersonal communication skills.

Before starting the counselling process, it is necessary to ensure that the physical setting is conducive

to counselling. Certain techniques are used during counselling to make the client comfortable, which

facilitates effective communication.

Empathy. In empathizing with a client, the counsellor is able to leave aside her/his own frame of

reference and, for the time being, adopt the frame of her/his reference. Empathy is distinct from

sympathy, where the listening party assumes a position of superiority.

Positive regard for the client. The counsellor relates to the client as a person of equal status and

accepts that the client has a right to accept or reject what she/he proposes as a solution. Confidentiality

is also a part of showing respect. The counsellor assures the client that no one else will be told about

her/his problem.

Verbal and Non-verbal Communication Skills

Interpersonal communication may be verbal or non-verbal.

Non-verbal Communication Skills

Eye contact: Maintaining eye contact helps to put the client at ease and provides support for the client

to talk openly about her/his problems. One should balance the intensity of eye contact by not staring.

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• Look at the client when she is talking.

• It is all right to look elsewhere occasionally but one should not let the eyes wander aimlessly,

away from the client for long stretches.

Facial expression: Appropriate facial expressions assure the client that the counsellor is listening and

responding to her/his talk/sharing. Sometimes clients see their feelings reflected on the face of the

counsellor. Clients judge whether the counsellor is accepting them based on the facial expressions of

the counsellor.

Body language: The counsellor needs to be relaxed. However, if she/he sits in a too relaxed position

or with the feet on a stool or table, the client may feel that the counsellor is casual and disinterested

in her/him. If the counsellor’s body language indicates tension, the client may feel that either she/

he is not confident to address her issue or that she/he is impatient and will have difficulty in

discussing her issue. Body tension can, however, be used positively to respond to the client by leaning

forward to show attentiveness.

Appropriate physical distance: The client finds it easier to talk openly if her distance from the

counsellor is three to four feet. Less than 2 feet or more than 4 feet can create a psychological

distance.

Active listening and observation: Listening may be active or passive. The counsellor may unconsciously

attend to the client while continuing to do her own work. The counsellor may hear what the client

says, but may not be listening to what she is saying. Active listening is understanding what the client

is communicating, including the feelings and thoughts behind the spoken words. The counsellor needs

to observe the expressions and feelings reflected on the client’s face, her body language and body

movements, tone of her voice and the silences and pauses. Unexpressed thoughts and feelings can be

picked up through non-verbal communication.

Appropriate use of smile: Clients feel encouraged to talk if the counsellor smiles and nods while

responding. But smiling continuously or inappropriately can discourage communication.

Verbal Communication Skills

Not interrupting: Interruption can annoy the client. If the client is wandering away from the subject

a polite intervention can direct the conversation back to the topic.

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- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -C-O-U-N-S-E- L-L-I-N-G- - - - - - - - -

Use of encouragers: Verbal encouragers such as “uh … uh”, “okay, then …”, during the conversation

at appropriate points show that the counsellor is listening.

Appropriate use of voice: Counsellors should learn the skills of modulating the tone of voice, the

speed of speech, etc.

Quality of information given to the client: It is necessary to consciously avoid using technical words.

Simplifying the technical information for clients in their own language is a challenging task.

Asking questions to facilitate conversation: Questioning effectively facilitates the process. These

guidelines may be helpful:

• Use a tone of voice that shows interest, concern and friendliness.

• Ask only one question at a time. Wait for an answer.

• Ask questions that let clients tell their needs.

• Ask questions that encourage clients to say more than simply Yes or No.

• Avoid asking questions with “why”. “Why” can sound judgemental.

• Ask the same question in different ways if you think the client has not understood it.

• Avoid repeating questions that the client does not want to answer.

Summarizing and Paraphrasing: This means restating by the counsellor in her own words what the

client has said so far to check whether it has been correctly understood. This indicates to the client

that the counsellor has been following and understanding what she has said.

The Counselling Process

The ability to make decisions is an integral part of healthy personal functioning. Many problems that

the clients bring to a counsellor involve their inability to make decisions. Counsellors aim at giving

clients skills to solve their own problems. This approach facilitates client independence. The approach

may involve the following sequential steps:

Rapport establishment: Rapport is established by a warm greeting and a relaxed approach. The

counsellor should tell the client that her/his visit to the clinic will be kept secret.

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Problem identification. This step should include answers to problems such as: “What is the problem?”,

“What prevents solution?”, “When and under what circumstances does the problem occur?”, and so

on.

Identification of values and goals: During this phase a client’s values are examined so that the solution

will be consistent with the client’s values and long-range goals.

Identifying alternatives: A list of possible alternatives is formulated.

Examining alternatives: At this stage the advantages and disadvantages of each proposal are weighed,

based on factual information such as amount of time and money involved.

Make tentative decisions: A list of tentative decisions is made.

Take action on the decisions: If the decision is critical and the client is unsure about the choice, the

decision may be tested at this stage. Then further information can be gained and fed back into the

decision-making process.

Evaluate outcome: Evaluation should be a continual part of the process. The role of the counsellor

is not to make the clients’ decision for them but to give them the skills not only to deal with the

present concerns but also to deal effectively with future problems.

Follow-up: After having provided the information that the client needs, the counsellor should give a

date for a follow-up. Reassure the clients that they may return at any time if they have a question

or problem, regardless of the origin of the problem; ask if the client needs any additional information

and, if the answer is in the affirmative, provide it.

Family Planning Counselling

In family planning counselling, programmes that offer

client-centred care help people make informed

decisions about reproductive health and contraception.

To make an informed choice, clients need accurate,

clear, unbiased, and useful information and advice

about reproduction, family planning, and correct use

of contraceptive methods. Many people discontinue

using contraception because they lack accurate

information, while others never adopt contraception at all for want of information and guidance.

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The counsellor should inform the clients about both the advantages and the disadvantages of different

contraceptive methods. The providers should not discourage or promote particular methods at the

expense of others that might interest a client. Once clients have chosen a specific method, they also

need information about proper use, potential side-effects and complications and the follow-up services

that are available.

The Six Steps of Counselling

Family planning counselling has six steps, shortened in the mnemonic GATHER, to mean:

GREET each client warmly.

ASK the client questions about herself/himself.

TELL the client about each available family planning method; then tell her/him about the methods that

most interest him/her.

HELP the client choose the method that is best for her/him.

EXPLAIN how to use the method that the client chooses. Help her/him plan how she/he will use the

method.

RETURN for follow-up. Agree on a time to meet again.

GATHER Elaborated

Greet your client warmly:

• As soon as you meet the client, give her/him your full attention.

• Provide a comfortable atmosphere to sit and discuss.

• Be polite, introduce yourself.

• Use attending behaviour and positive gestures to indicate interest and attention.

Ask questions: When a couple visits a clinic they may want to talk about something other than the

purported reason for the visit. A sensitive counsellor leads the conversation to reproductive health

topics and asks questions that draw out the couple’s questions and concerns.

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• Ask questions to elicit information in a non-confronting way.

• Help the clients to talk about their needs, wants and any doubts, concerns or questions they

have.

Tell: Tell the new clients which methods are available and where. Address any anxieties or myths that

the client may have about any particular method.

Encourage them to ask questions: Tell them to come to you if they hear something bad about the

method they are using so that you can talk to them and give the correct information. Use correct words

and give all clients the same basic information about the specific method. Be honest about the

disadvantages, especially side-effects. If the counsellor is open and honest, the clients will know that

she/he is not hiding information, and they will not believe in false rumours.

Help the clients choose a method:

• Ask the clients if there is any particular method they would like to use.

• Ask them about their family circumstances and their reproductive intentions. For example, till

when does the client wish to delay pregnancy?

• Ask the clients which method their sex partner would prefer (in case the partner is not present).

Some methods are not safe for some clients. When a method is not safe, tell the client so and

explain clearly. Then help the client choose another method.

• Ask the client if there is anything she/he does not understand. Repeat the information, if

necessary.

• Confirm whether the client has made a clear decision. Ask: Have you decided to adopt a

contraceptive method? If yes, which one?

Explain how to use a method:

After the client has chosen a method:

• Explain how to use the method. Show samples.

• Give supplies, if appropriate.

• If the method cannot be provided immediately, tell the client how, when and where it will be

provided.

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• Ask the client to repeat the instructions, listen carefully to make sure she/he remembers and

understands.

• Tell the client when to come back for a follow-up visit.

Return for follow-up:

Good follow-up is essential for maintaining continuity of use of a family planning method. At the

follow-up visit:

• Ask the client if she/he is still using the method.

• Ask how the client is using the method. Check to see that it is being used correctly.

• Ask the client if there are any side-effects, mentioning them one at a time and cross-checking

with the client. If so, find out how severe they are. Reassure clients that minor side-effects are

not dangerous. Suggest what they can do to get over them. If side-effects are severe, reassure the

client and refer for further treatment. Do not dismiss the problems off-hand.

• If the client is still reluctant to continue using the method, counsel her/him about switching to

another method.

• Ask if the client has any questions.

To counsel clients about family planning, the counsellor needs:

Information on family planning:

Communication skills: (a) understanding how the clients feel; (b) talking to the clients in a way that

they understand; (c) encouraging clients to talk and ask questions; (d) using open-ended questions that

draw out more information; (e) asking clients what information they have about the methods that

interest them.

The history of a new client, including: (a) age; (b) marital status; (c) number of pregnancies; (d)

number of live births; (e) number of living children; (f) family planning methods used currently and

in the past; and (g) relevant information on general and reproductive health.

Counselling Adolescents and Youth

The counsellor may come across adolescent clients occasionally. Adolescents need a special approach

as this is the period when they are discovering their sexuality, feeling curious and at the same time

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feeling embarrassed about many areas of sexual function. They need accurate information about the

reproductive system, the function of various organs and changes due to puberty. They have misconceptions

about menstruation, masturbation and nocturnal emissions, all of which are natural processes. In

many cases, their only source of information is their peers, who are likely to be ill informed. Under

family education programme they should be informed about:

• biological facts about reproduction

• coping with sexual development

• different kinds of birth control methods

• preventing sexual abuse

• facts about abortion

• where to get contraceptives, and

• prevalent dangers of STIs.

The counsellor needs to be approachable, non-judgemental and non-threatening when dealing with

adolescents.

• Impart timely and proper sex education to adolescents.

• Encourage them to interact with the opposite sex.

• Keep a close eye for signs of trouble.

• Divert their energy in hobbies and sports as far as possible.

What the Corporate Sector Can Do

The corporate sector needs to:

• recognize the importance of counselling both in the clinical and non-clinical settings;

• ensure that its key staff members are trained on the importance of counselling;

• ensure the availability of informed choices and availability of basket of choices with good

quality of care in family planning programme.

References

Adapted from Training Module : Reproductive and Child Health, Population Foundation of India.

September 1999.

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chapter 20

ADVOCACY

At its simplest level, advocacy is any act of giving support to a cause. In its broadest sense, advocacy

ensures that the cause for concern or idea to resolve an issue dominates public consciousness. In our

context, advocacy is an organized, deliberate, systematic and strategic process intended to bring about

a positive change towards fulfilling, respecting, protecting and promoting human rights, especially

those of marginalized individuals and groups. It is about increasing the voice, access and influence

of the community, especially marginalized individuals and groups in all decision-making processes

that affect their lives, towards changing existing power hierarchies and relations.

Legislative or legal advocacy is aimed at changing laws or bringing about legal reform. Media advocacy

is directed towards getting print and/or electronic media to understand and become interested in

covering a particular issue. Social advocacy aims to change the mindsets of various sections of society.

Policy advocacy is about bringing in policy change through (a) creating policy where they are needed

and none exist; (b) reforming ineffective and harmful policies; and (c) improving policy implementation.

Human rights-based advocacy subscribes to values of non-violence, non-aggression and avoids coercion

and intimidation. Value-based advocacy places emphasis on the means as well as the ends, i.e. how

we do our advocacy is as important as what we want to achieve through our advocacy. Most advocates

agree that transparency, no corruption, respect for human rights, gender sensitivity, democratic means

of functioning and accountability are norms and values that should be upheld.

Effective Advocacy

Advocacy can be likened to a long-distance race. There is a need to develop necessary resources, skills

and systems to sustain the effort. Resources required are wide-ranging: managerial, mental/psychological

and social in addition to the usual material, financial and human.

Effective advocacy is based on an integrative approach, using various components such as legislative

advocacy, media advocacy, judicial devices, dealing with bureaucracy, forming coalitions, strengthening

grassroots mobilization, and so on. This highlights the integrative and composite nature of advocacy

as a process, as against advocacy as an event.

Effective advocacy can also be seen as a bridge between micro-level social activism mobilizing

affected people to demand change and macro-level policy interventions. It deals with the system at

various levels – from the village to the district and the state and central government.

The Advocacy Institute lists some elements of a successful advocacy campaign as follows:

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A strong organization: (a) a carefully nurtured organization – may be formal or informal (both have

relative advantages and disadvantages); (b) working simultaneously at the apex and the base; (c) clear

goals; and (d) committed people.

Information and knowledge: (a) authoritative sources of information; (b) knowledge of the procedures

and processes of institutions and power centres that we are working with.

Networking constantly: (a) seeking strong champions and supporting them; (b) knowing whom the

advocacy initiator is supporting – following their record of public and private actions and positions;

within other sections including within centres of power.

Strategy development: (a) ability to identify opportunities and use them; (b) developing new tactics

constantly; (c) mastering the rhythms of the process – sometimes it is wiser to do nothing, remain

silent or move quietly; (d) rebounding quickly after losing a battle; (e) being committed but also

flexible, not righteous.

‘A’ Frame for Advocacy

Effective advocacy calls for being proactive, responsive

and flexible and not being merely (or constantly)

reactive. With this perspective, effective advocacy

incorporates several stages and activities. The ‘A’ Frame

for Advocacy, developed by Johns Hopkins University,

Centre for Communication Programs (JHU/CCP), lays

down the different stages for systematic advocacy

(available at <http://www.jhuccp.org/pubs/sp/13/

13.pdf>). These inlcude Analysis, Strategy, Mobilization, Action, Evaluation and Continuity.

Analysis involves in-depth understanding of the problem, the people involved, existing policies,

implementation or non-implementation of these policies, and channels of access to influential people

and decision-makers.

Strategy entails directing, planning, and focusing on specific goals; designing clear paths to achieve

goals and objectives.

Mobilization implies networking, alliance building, coalition building through events, activities,

messages and materials suited to different audiences; grassroots mobilization and support to bring in

grassroots voices.

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Action entails planned and continuous activities; keeping coalition members informed; media advocacy;

holding policymakers accountable for commitments; keeping a record of successes and failures. Action

is also required to respond to opposition and developments quickly; to monitor public opinion and

publicize positives.

Evaluation establishes impact, process and intermediate indicators. Specific events and activities need

to be evaluated and changes based on objectives and also unintended changes documented. The results

of evaluation are to be shared with the stakeholders.

Continuity involves moving onto the next stage after advocacy results in a new policy, while monitoring

the implementation of the policy to keep reinforcing change.

Effective advocacy work is characterized by the following values:

• developing an “information culture”. Right to information is demanded not only of the centres

of power but the work of the advocacy initiator has to be fact based and transparent. Systematically

organized and disseminated information is a hallmark of advocacy efforts.

• a “political culture” that demands and works for accountability and responsibility in every sphere

and at every level, including accountability and responsibility from one’s own self and one’s

own sector. An important element of the political culture is decentralized leadership.

• “participation” not only as a programmatic element but also as an attitude of learning from the

people that one is working with – an openness to their knowledge and the manner in which

their knowledge is produced.

• a “constructive approach” – the articulation of viable alternatives. Advocacy is about alternatives

and not merely opposition to the existing situation.

For effective advocacy it is necessary that it should carry credibility. Box 20.1 presents some means

of establishing credibility.

Box 20.1. Ensuring Credibility

Advocacy is an act of creating pressure on the policymakers or decision-makers so that decision-

making is not only in the interests of the marginalized but that the marginalized themselves get

a greater role in decision-making. To get the decision-makers to listen to the arguments and

messages it is necessary to ensure their credibility. Credibility can be ensured through (a) expert

credibility, (b) institutional credibility, (c) celebrity endorsement, and (d) grassroots mobilization.

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• Expert credibility – The arguments and messages can be made by recognized experts in the

field who act officially as spokespersons or indirectly as supporters.

• Institutional credibility – arguments and messages based on data from recognized institutions,

such as the census, have immense credibility.

• Celebrity endorsement is a tactic often used in advocacy campaign to gain supporters. An

advocacy campaign against violence against women used the cricketer Sachin Tendulkar’s

message for speaking out against violence.

• Grassroots mobilization provides strong credibility to any advocacy effort as the affected

themselves are at the forefront of advocacy. However, even such advocacy must be backed

by evidence and clear advocacy messages.

Different Kinds of Advocacy Action

Media advocacy: Print media – press releases; media advisory, letters to the editor, writing Op-Ed

pieces, inviting media persons to events, exclusive stories, etc. Electronic media – coverage of events,

human interest stories, participating in discussions and talk shows, etc.

Public education: Public meetings and film shows; signature campaigns, banners, posters, street plays

and other popular or folk media, etc.; preparing reports, briefing kits, booklets, fact sheets and other

written material; opinion polls and focus groups.

Dialogue and Negotiation: Individual meetings and face-to-face interaction; consultations; written

memoranda.

Policy/Programme Monitoring: Facility visit; interviews with clients and community; implementation

mapping; social audit.

Legislative Advocacy: Meeting with leaders of political parties, preparing and presenting briefing kits;

asking politicians to put questions in the legislature; meeting with leaders of political parties around

their election manifestos; meeting and briefing politicians associated with committees with the

legislatures or during a law-making process.

Legal Advocacy: Filing cases about violation of human rights in the court of law; filing public interest

litigation in state high court or the Supreme Court; public hearing, tribunals and commissions.

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Internet based Advocacy: E-mailing, action alerts; Email signature campaigns; building issue-specific

websites and portals.

Direct Action: Protest march and rally; sit-in and demonstrations; hunger strike.

Tools for Advocacy

The optimal mix of the various tools that can be used for advocacy should be decided based on an

analysis of the target audience and what would be the best way to reach them. Some tools for

advocacy through the print and electronic media, Internet and legal advocacy are presented here.

Printed Material

Advocacy-related publications may be for generalized

public education or targeted for specific audiences.

These publications allow the advocacy issue to be

presented as briefly or as elaborately as desired and

can thus be in different formats.

• Flyers are one-page information sheets which

succinctly describe the what/why/who/where/

when of advocacy issues, activities and/or events.

• Pamphlets give more attention to both form and content than flyers. Pamphlets can be used to

introduce the advocacy effort describing the essence of the advocacy campaign, highlighting the

main issues, the solutions as well as the people who are involved in it. Thus pamphlets should

remain relevant for longer periods of time as well.

• Booklets cover different aspects of the advocacy issue and should be well researched. Because

booklets usually contain more substantive documentation and research, they can be used to

establish greater credibility and visibility with the media, scholars, educators, and other advocates.

• Newsletters are useful in providing periodic updates. Newsletters provide progressive and up-to-

date information; however, they also require resources especially in terms of human resources

and time on an on-going basis. Newsletters can include articles, interviews, news and reports

and can also announce forthcoming events. It is most important that a newsletter is published

regularly.

• Fact sheets are one- or two-page summaries of relevant information about the advocacy issue.

This could include state-wise data on a subject that can be extracted from large surveys. A fact

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sheet could include summaries of qualitative research studies and also have short quotes from

newspaper reports. Fact sheets are valuable for summing up the issues succinctly, provided they

present the most current data available. Fact sheets may need to be updated from time to time.

• Briefing kits can be thematic or event-specific. An event-specific media briefing kit for a press

conference, for example, would ideally include the press release for the event, a short summary

of the research report which is to be shared (if that is the case); a brief biography of the celebrity

speaker (if a celebrity is addressing the press conference), and so on. The kit should also include

copies of the advocacy-related pamphlets, the latest edition of the newsletter and any fact sheets.

Thematic briefing kits aimed at policymakers as well as potential supporters are more deliberately

prepared and can be used generically. Thematic briefing kits can include fact sheets, position

papers, summaries of reports and studies, calls for action and so on.

Effective use of the media can result in increasing the visibility and credibility of the issue being

advocated. Planners for media advocacy need to note that: (a) in the absence of adequate planning

for media advocacy, there are risks that the reportage on the issue can do more harm than good; (b)

the media can sensationalize an issue, which may not be useful from an advocacy point of view; and

may reflect in their coverage.

Identify media persons and develop contacts – A useful first step is to follow reportage on health-

related issues in the local newspapers and journals. This can lead to the identification of specific

media persons who report on these issues. Media persons, especially those associated with daily

publications, need information on a very regular basis, and would like to be in touch with reliable

and credible sources. It is necessary to build a relationship of respect and mutuality with some media

persons. They can be provided with information about the advocacy issue and key messages by inviting

them to events, providing them with press releases, briefing kits, human interest stories, and so on.

Press releases – Press releases are concise news items describing an event or issue of significance.

When there is a good relationship with the media persons they start looking forward to such press

releases, because it gives them a news item without having to work too hard to get it. However, press

releases should be prepared for newsworthy items and not all activities undertaken as part of advocacy.

It is also necessary to be careful about the newspaper deadlines.

Press Conference – A press conference can be organized to share information about an issue like the

release of a report, to respond to some government announcement or a judgement from the Supreme

Court or if there is a celebrity who is willing to endorse the issue. On the positive side, a press

conference allows for greater interaction with members of the media, leading to greater elaboration

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of the issue and possibly a better articulated news item. On the negative side, if the preparations are

inadequate and questions posed by the media cannot be handled with appropriate data and consistent

messages, damage can be caused to the advocacy effort. It is useful to prepare printed handouts and

briefing kits for the media persons, and also have space for one-to-one interaction between the

spokesperson and any media person who would wish to do so. Preparation is paramount in a press

conference.

Letters to the editor – To improve the chances of a letter getting published it helps if it is clear, precise

and short. It is useful to respond to articles and features that have raised issues similar to or affect

the advocacy issue in question. These responses need to be sent in quickly in order to keep them

relevant as far as the publication is concerned. Adding the organization’s name and the writer’s

position in it may increase the possibility of the letter getting published.

Writing opinion pieces – If the advocacy effort one is involved with has been able to gather the

support of acknowledged subject-matter experts, it may be useful to ask them to write a short opinion

piece on the issue. The opinion piece should be in simple language to explain the problem, have clear

messages and provide specific solutions.

Working with the Electronic Media

The electronic media require images and “sound bytes”. As with the print media the electronic media

should be invited to press conferences and other events and they may prepare brief news items on

the issue. With regional and state-specific news channels coming up it may be easier to get coverage,

but the smaller coverage limits the reach of the advocacy message. With human interest stories the

electronic media have the advantage of relaying the image and the voice of the persons involved into

thousands of homes. At press conferences articulate spokespersons can deliver creatively crafted

messages which can become “sound bytes”. Giving individual interviews is another method of

reaching out through the electronic media. Here again, the spokesperson needs to articulate the

message very clearly and in the shortest possible time. After editing, only a few seconds of the

interview will possibly get broadcast. While replying to a question it is useful to weave in the

question within the answer, otherwise the answer loses context and this may happen during the

editing process.

Advocacy through the Internet

• Email action alerts or mass mailing can help relay information to many people very fast and with

very little expenditure on printing and postage.

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• E-groups and list-servs can create a virtual community of like-minded persons who may be

located at great distances from each other. However, people need to keep posting to the e-group

to keep the discussion alive.

• E-newsletter and updates help in sharing information about an issue among those who choose

to remain informed. It can be a valuable tool for public education.

• Internet-based signature campaigns – Once the appeal has been created the link needs to be

forwarded to as many people as possible for signature. Once the signatures have been obtained

they need to be forwarded to the person(s) to whom the appeal is addressed through email, fax

or by post.

• Websites – While for-profit entities have different and often intrusive ways of directing traffic

to their websites, advocacy groups face the challenge of getting the casual browser to visit the

website and then keep up her interest. One way forward is to design interactive websites and

build links with other similar websites.

Public Hearings and Tribunals

Public hearings and public tribunals are public fora

for sharing information on rights violations. In a

public hearing the rights violations are usually shared

in front of an official panel of empowered officials

such as the National Human Rights Commission

and its state counterparts or the National Commission

for Women and its state counterparts. The hearing is

a quasi-judicial proceeding in which the members

of the panel provide instructions and directions to

the responsible officials to take administrative action

to rectify the situation. In the case of a public tribunal the panel is not official. However, in order

to give the panel credibility it usually comprises eminent citizens. The panel hears the testimonies

and experiences of the persons whose rights have been violated and then makes its recommendations

and observations which are usually directed towards the state agencies responsible for action on the

subject. The National Human Rights Commission and the National Commission for Women have

started a process of hearings and consultations on health and reproductive health in different parts of

the country.

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Advocacy planners may find the Smart Chart 3.0TM, developed by Spitfire Communications, a helpful

guide for developing an advocacy strategy (available at <http://www.smartchart.org/>).

References

http://www.jnuccp.org/pubs/sp/13/13.pdf.

Advocacy Institute, 1990. “Elements of a Successful Public Interest Advocacy Campaign”, Washington

DC: the Advocacy Institute.

Das, Abhijit, 2004. “Ensuring Quality of Care in Reproductive Health: An Advocacy Handbook”. New

Delhi: PFI.

National Centre for Advocacy Studies, 1995. “What is Advocacy?” Understanding Advocacy Series (1),

Pune.

Srinivasan, S., 1990. “Content and Context of Advocacy in India”, mimeo.

4.5 Page 35

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