A Guide for Public Health Advocacy: Tools and Lessons Learned from Successful Infant and Young Child Feeding Advocacy in Southeast Asia

"[I]n the case of maternal and child nutrition, advocacy can create permanent shifts that forever change the type of support and opportunity a family has to choose the best feeding practices."

This guide draws from lessons learned and best practices from Alive & Thrive (A&T), a multi-year regional nutrition advocacy initiative in Southeast Asia funded by the Bill & Melinda Gates Foundation and the governments of Canada and Ireland and managed by FHI 360. A&T has focused on improving infant and young child feeding (IYCF) policies specifically, but the results and lessons learned are relevant for a broad range of public health advocacy efforts.

The approach to advocacy involves a 4-part Process for Policy Change (shown on page 4). In brief, it entails:

• Establishing and sustaining partnerships - e.g., with media agencies
• Developing the evidence base - e.g., thruogh socio-cultural evidence, which establishes the current landscape for a given health behaviour or helps make the case that a policy shift can help address a health behaviour in a specific context
• Creating compelling messages and materials - e.g., policy briefs
• Building consensus - e.g., by finding and deploying champions

The approach is methodical and iterative, while also adaptive. This guide uses the Process for Policy Change, as well as specific tools established by the initiative in Southeast Asia, to illustrate a number of universal best practices for developing and implementing advocacy strategies for any issue or context. Each section provides a high-level overview of the approach and activities undertaken, followed by reference materials that can be adapted by advocates working on similar efforts in public health.

Throughout the guide, examples from A&T's experiences and best practices are highlighted to illustrate strategies, such as for making your consensus building efforts and events as impactful as possible, including:

• "Find the right message - and the right messenger. One of the most essential components of building consensus is identifying spokespeople that will capture the attention of target audiences, whether because they are well-known or because they are effective at delivering compelling presentations.
• Provide spokesperson and champion trainings. One of the most effective ways to ensure spokespeople deliver impactful presentations is to provide them with support to do so. Agenda items can include a review of key messages and talking points on the issue; how to address tough questions; and technical skills for strong delivery both on-camera and with in-person audiences.
• Amplify with earned and social media. Many events, even those with smaller audiences, can present an opportunity to broadcast information to larger audiences. Consider distributing a press release and inviting journalists to participate in any event that may have a newsworthy angle, especially if there is participation from high-profile individuals. Sharing key outcomes and even photographs by social media can also be an effective way to reach more people, more quickly.
• Be opportunistic. Ultimately, it is essential to be opportunistic throughout the process for policy change and consensus building in particular. New information emerges regularly, unpredictable events drive interest in specific issues, and windows for more direct policy dialogue and engagement can appear - even if only briefly. This approach is intended to be adaptable, to take advantages of new opportunities as they arise and prioritize activities accordingly."

According to A&T, over the past several years, advocacy for stronger nutrition policies and programmes in countries throughout Southeast Asia region has yielded significant outcomes, such as stronger regulations on the marketing of infant formulas to ensure that mothers receive accurate information about how to feed their children. The efforts were the result of coordinated action on the part of numerous actors who united their resources and expertise to execute sustained advocacy.