Regional Workshop on RHCS Advocacy
28th January 2008
"How long can we be a silent watcher of half a million maternal deaths of our mothers and sisters every year, year after year?" These compelling opening remarks by Mr. Jagdish Upadhyay, UNFPA, set the scene for a workshop held in Bangkok on 11-13 December, on Strengthening National Capacity for Achieving Reproductive Health Commodity Security (RHCS). The workshop brought together in one forum a unique gathering of members of parliament, senior government officials, media representatives and UNFPA officials from the East and South East Asian Region.
RHCS is achieved when all individuals can obtain and use affordable, quality reproductive health commodities of their choice whenever they need them. In practice, Mr. Jagdish Upadhyay explained that "RHCS involves making sure everyone-especially women and young people-face no obstacles accessing and using these life-saving supplies" Mr. Chris Wright, Senior Technical Advisor, John Snow Inc, emphasized that reproductive health commodities refers not just to contraception and family planning, but to a range of health supplies required for reproductive health, as well as the availability of skilled birthing attendants. The availability of these supplies helps to prevent unintended pregnancies, life endangering abortions, and a range or pregnancy related complications which could easily be avoided, such as high blood pressure or post-delivery hemorrhage.
Inadequate funding was one of the key issues discussed at the workshop as it contributes to the large gap between demand and supply for reproductive health commodities. Mr. Jagdish Upadhyay, UNFPA provided figures which showed that donor support for condoms and contraception had fallen from US$217 m in 2005 to US$196 million in 2006, while the cost to meet the need in all developing countries was over US$1.3 billion. The issue of shortfall in resources is compounded by the growing youth cohort, with contraceptive users expected to increase from 571 million in 2000 to 731 million in 2015.
However, lack of funding is not the only impediment to RHCS. Health care delivery and supply logistics can also play a critical role. Through presentations, participants identified country specific examples of weakness and challenges in this area. These included: meeting WHO specification standards for the manufacture of contraceptives and condoms; lack of effective procurement systems including storage and transportation supply chains; insufficient forecasting and reporting systems leading to stocks running out; unregistered sale of potentially inferior quality of contraceptives; a large number of private companies procuring and distributing health supplies with insufficient coordination; opposition by religious groups; and to few logistical staff.
Following awareness raising on challenges each country faces in achieving RHCS, the focus of the workforce shifted towards what actions can be taken to address these issues. Ms. Margaret N. Thuo, Adviser BCC and Advocacy, UNFPA/CST Addis Ababa, facilitated a number of sessions to build participants advocacy skills in support of RHCS. Ms. Margaret Thuo commenced these sessions with the message that "Advocacy is speaking up on behalf of someone who is marginalized or suffering you are leaders because you can give people a voice who can not speak for themselves." Topics covered included why leaders must be involved in advocacy; advocacy as strategic communication; processes for building support for RHCS; and media advocacy.
Ms. Margaret Thuo emphasized the importance of building partnerships in advocacy campaigns, as well as stakeholder analysis and knowing the best way to tailor messages towards policy actors so that they are sensitized and mobilized into action. Mr. Jagdish Upadhyay drew attention to the importance of evidence in advocacy campaigns, citing the strong returns from investment in RHCS as an example of the type of information that could be used to win the support of ministries of finance.
Media representatives from each country spoke on ways in which the media can be engaged in advocacy efforts. Ms. Rina Jimenez David, a Columnist for the Philippine Daily Inquirer explained that the media does not have expertise on issues, so it was important for their contacts to be available and accessible at all times. She also discussed the need to make information colorful and controversial for readers to be come interested, as well as the value of including personal testimonies of those affected by lack of RHCS. Ms. Rina suggested that those leading advocacy campaigns study the media to know who writes favorably on their issues as they will be the best people to contact, as well as editors, who are the gatekeepers to what is written.
Participants then worked to develop country specific advocacy plans and next steps for improving RHCS that they would refine and implement in partnership with UNFPA on their return home. Participants also agreed on an Appeal, which outlined their commitment to improving RHCS and the key actions, which they would be urging their national, state and local governments to take.