Amref Health Africa’s Advocacy Response to COVID-19
by Lusungu Kacheche-Dzinkambani
The year 2020 started on a good note for the Amref Health Africa Advocacy team. It began with clear plans on advocacy priorities drawn around advancing recognition and remuneration of community health workers, ending female genital mutation, financing and access to family planning and advocating for sustainable financing towards universal health coverage amongst others.
To put the advocacy agenda in perspective the Amref advocacy team members from Europe and Africa, held a workshop in Nairobi, Kenya, during the last week of February 2020, to further unpack its corporate advocacy strategy into a detailed implementing framework.
The workshop was successful and came up with refined plans, updated strategies, new allies and a motivated team that was ready to influence decision makers for lasting health change in Africa.
However, within just two weeks of the workshop, the spread of COVID-19 across the world grew and it called for a global response.
As a health focused organisation, Amref was at the forefront of the response. To the advocacy team, this entailed many changes which included, adoption of new thematic priorities, revising focus in the existing thematic issues and a change in mode of operations.
Just like the programmes team, the Amref advocacy team had to shelve some of its plans and adopt new priorities in response to the pandemic.
The new priorities were focused on ensuring effective response to the pandemic by duty bearers. One of the key issues that Amref advocated on across its target countries is availability of Personal Protective Equipment (PPEs) for health workers. Advocacy around this mainly targeted government and health service provision partners.
Increased financing for COVID-19 also topped Amref’s advocacy agenda. Appreciating the challenges that low and middle-income countries (LMICs) face around public service delivery and the adverse effect that the pandemic has had on the countries, Amref in The Netherlands teamed up with other civil society organisations (CSOs) to engage the Dutch government.
With a number of letters sent to Members of Parliament, they advocated the Lower House to ring-fence 1% of the national budget for the COVID-19 response (about 900 million Euros) in LMICs for health issues.
Another advocacy issue that emerged was governance of the Covid-19 resources aimed at urging governments to have effective structures to manage the response professionally and transparently and efficiently use resources.
One example around this is where Amref in Malawi worked with other civil society organisations (CSOs) to influence the government to include CSOs and technocrats in the National COVID-19 Response Committee which initially comprised cabinet ministers only.
In the same spirit of advancing effective governance of COVID-19 response, Amref in Zambia facilitated the production of a documentary commemorating 100 days of the COVID-19 response which took stock of the progress made so far, gaps and presented asks around the response including the need for focused attention on addressing the needs of marginalised groups
Amref believes in generating evidence to influence the advocacy agenda. The coming of COVID-19 disrupted provision of health services from the both the service provision aspect and access mechanism. After noticing that the youth were not adequately accessing sexual reproductive health services, Amref’s Youth in Action Programme embarked on a study to understand the knowledge, attitude, practices and effects of COVID-19 on youth health seeking behaviour. This was aimed at generating information to inform programming and more importantly advocacy on youth access to health services during COVID-19.
The COVID-19 pandemic in some cases exacerbated the challenges that AMREF advocates faced. In response to this, Amref had to adjust its advocacy objectives within the thematic areas. Such thematic issues include sexual and gender based violence (SGBV) and access to sexual and reproductive health services among others. Ethiopia registered an increase in SGBV in the wake of COVID-19. In response to this, Amref in Ethiopia developed a paper that reviewed the COVID-19 response through the gender lens. It further advocated for the protection of women and girls from SGBV as an impact of COVID-19 and its resultant effects such as unemployment. In a similar manner, Amref Kenya and their allies made an appeal to the country’s judiciary for prioritisation of hearing of SGBV court cases during the semi-lockdown period as the courts were partially functional.
Amref has always championed formalising the role of Community Health Workers (CHWs) in the healthcare providers structure as they are crucial in the delivery of primary healthcare. Knowing how important CHW are in response, especially to provision of prevention information and contact tracing, Amref across its implementing countries advocated for their engagement. For instance, in Kenya, at the onset of COVID-19, Amref was invited to sit in a number of sub-committees within the Kenya national COVID-19 response committee. Amref Kenya used this opportunity to champion the need for effective engagement of CHWs and the process of developing guidelines for their training on their role in fighting COVID-19.
The COVID-19 response in Uganda was stretching resources in multiple sectors and for various services in the country. Amref in Uganda noted the growth of inadequate access to family planning (FP) during the lockdown period and escalating teenage pregnancies. Amref facilitated a series of inter-generational dialogues that were broadcast on radio on sexual and reproductive health and rights (SRHR), GBV and youths’ access to FP services in the wake of COVID-19. The dialogues enabled youth from the countryside to voice their issues around sexual and reproductive health live on TV and engage policy makers.
Amref is committed to ensuring inclusion of people with disabilities in its programming. As such, at the onset of the COVID-19 pandemic, Amref in Zambia prioritised translating the information, education and communication material on the pandemic into braille so that people with visual impairments would have access to credible infection prevention information. Amref noted the need to scale up initiatives on social inclusion and engage government and other CSOs on this.
New operational practices, allies
The changes had to be effected in strategies as well. Country COVID-19 response strategies included restricting travelling and physical meeting. Amref normally uses face-to-face lobby meetings, making physical presentation and other operational practices that include contact between people in advancing its advocacy agenda. With the restrictions, these practices could no longer be used and new ones had to be adopted. This saw Amref rely more on online communication. Webinars were one of the popular approaches that Amref employed in addition to petitions and having conference meetings with allies and advocacy targets.
Since Covid-19 is a new and different issue, it also called for new allies. Amref looked for new allies that were relevant to the advocacy agenda. It therefore developed new partnerships with different organisations for coordinated lobbying.
To coordinate the changing environment effectively, the advocacy Amref advocacy community of practice had to even scale up its meeting frequency from once a month to weekly. This enabled the team to share plans, coordinate activities and learn from each other.
As much as the changes derailed Amref Health Africa’s initial plans, it enabled Amref to contribute to positive health change in Africa.
Lusungu Kacheche-Dzinkambani is the former lead adviser policy and advocacy at Amref Health Africa. She provided strategic direction on policy and advocacy overseeing capacity building and coordinating specific international influencing and networking opportunities across the world. She describes herself as an activist at heart, passionate about social justice and women’s rights.