We have offered our Tuesday blog this week to Florida Uzoaru, an independent public health consultant. She reflects on some tough questions about the advocacy role of civil society in the health space.
A little over a fortnight ago, I was invited to participate in a meeting with civil society organizations (CSOs) working on governance in Nigeria. It was organized by UNDP’s Democratic Governance for Development Project. Through the course of my career in development, I had worked in a couple of international Non-Governmental Organisations (NGOs) that work in the “governance” space and they have all had to deal with the Nigerian government in one way or the other. This was however, the first time in my career that I was attending such an event as an independent consultant, and not a representative of an organization whose interest I had to look out for, I could therefore look at things with some refreshing freedom of perspective. My specific role at the event was to assess if the involvement of Nigerian CSOs in advocacy and governance had gone beyond being subservient to the tasks specified by donor agencies.
Firstly, lets establish common ground on the definition of advocacy;
“Advocacy is a political process by an individual or group which aims to influence public-policy and resource allocation decisions within political, economic, and social systems and institutions”
To do this I looked out for some indicators at the meeting. I tried to observe if there was good awareness among CSOs in Nigeria of their role as advocates for the health of the peole that they claim to serve. Also I was eager to see whether they were prepared to take positions that may challenge conventional wisdom, and whether they were willing to take the lead in steering governance and policy on significant health related issues. With the 2015 elections drawing close, now is the time for a shift in the discourse and an opportunity to include health and health care issues on the agenda of those competing for our votes. How do we give more voice to elderly, the impaired, women, young people, and the unemployed? How do we improve on accountability and sustainability of health sector interventions? These are the questions I hoped to hear asked and addressed at the meeting. But they never came up.
From my observations, my conclusion is that there is still a lot of work to be done to build the capacity of the CSOs, for whom advocacy is apparently their raison d’être. My views are aligned with the preliminary results from a study by Bill and Melinda Gates Foundationpresented earlier in April during a stakeholders meeting hosted in collaboration with the MacArthurfoundation, which showed that, of all the CSOs who claim to do work in advocacy in Nigeria, only 30% actually engage in significant advocacy and policy work.
Essentially, majority of CSOs in Nigeria are merely implementing projects whose terms of engagement they probably were not involved in drawing up. CSOs appear to have very limited understanding of what advocacy actually means. A representative of an organization at the UNDP meeting boldly defended his colleagues who were keen to continue with a practice of “advocacy” visits to state governors, while providing little evidence of impact of those already undertaken. Unfortunately, many in the room shared these views.
It is my impression that the third sector in Nigeria is very weak in their role as advocates. With more voices being lent towards stopping aid dependency, capacity building in terms of advocacy and policy has to come from within. We cannot afford to wait for “donors” and “development partners” to teach us how to engage with policy formulation and advocacy. We have to think of a bottom-up approach, and none too soon. The question is, after years of spoon-feeding, is this really something to hope for from our CSOs? Time will tell.
http://www.nigeriahealthwatch.com/Never doubt that a small group of thoughtful committed people can change the world; indeed it is the only thing that ever has…Margaret Mead