Explores some of the uses of information and communication technologies in health research advocacy and communication and draws on a research project managed by Healthlink Worldwide

2. Advocacy for health
and social change
The role of ICTs
By Andrew Chetley
Director of Programmes
Healthlink Worldwide
Global Forum for Health Research
October 2006

3. What is advocacy?
Process to:
 influence policy and decision makers, fight for social
change, transform public perceptions and attitudes,
modify behaviours, or mobilise resources. (GAVI)
 use information strategically to change policies that affect
the lives of disadvantaged people. (BOND)
 change attitudes, actions, policies and laws by influencing
people and organisations with power. (India HIV/AIDS
Alliance, 2002)
 change the policies, positions and programmes of any type of
institution and plead for, defend or recommend an idea
before other people.. (SARA Project)
 speak up, draw attention to an issue, win the support of key
constituencies in order to influence policies and spending, and
bring about change. (WHO TB Programme)
 Advocacy is about influencing or changing relationships
of power (World Bank)

4. Whose voices are heard?
 Representation: speaking on behalf
of the voiceless (for)
 Mobilisation: encouraging others to
speak with you (with)
 Empowerment: supporting the
voiceless to speak for themselves
(by)

5. What are ICTs?
 Definition: tools that facilitate
communication and the processing
and transmission of information and
the sharing of knowledge
 Types: radio, TV, internet, email,
websites, digital video and audio,
print, interpersonal communication

6. Communication is central
 Information
 Communication
 Technology

7. Using ICTs in the health sector
 Literature review, interviews,
discussion, scan of websites,
practitioner review
 More that 4000 articles and
50 websites
 Not much ‘reliable’ evidence
– 28 RCTs, most on
information systems and
biomedicine
 Review of more than 100
case studies found examples
of use of ICTs for advocacy

8. Examples of advocacy
and social change
 Women’s Voices in Kenya – empowerment,
confidence and government action
 Using multimedia in Nicaragua, South Africa,
Rwanda, Somalialand and Cambodia – awareness,
attitude change, policy action, mobilisation,
empowerment, social change
 Mobile phones in South Africa and the Philippines
– adherence to ARVs and TB medicines,
awareness, care, mobilisation, empowerment
 Combinations of media in Peru, Egypt and Uganda
– reductions in maternal mortality, improvements
to health systems, better interaction between
health workers and communities

9. Key findings
 Keep technology simple, relevant and local
 Build on what is there and being used
 Involve users in design (by showing benefit)
 Strengthen capacity to use, work with and
develop ICTs
 Increase M&E, particularly participatory M&E
 Include communication strategies in the design of
ICT programmes
 Continue to research and share learning about
what works and what does not.

10. Not just technology
 ‘many innovative ICT uses in the heath sector are
based on pilots and I would be very wary about
making any recommendations where evidence is
based on pilots, case in point being the Indian
Institute of Technology, which has lots of
interesting initiatives but their broader
applicability is a problem. For example, they have
an interesting telemedicine initiative, a remote
sensor that takes temperature, BP, ECG, and
stethoscope. The doctor at the other end of the
computer line can read the indicators and speak
to the patient, but the whole thing is let down by
the inability of the doctor being able to prescribe
a course of treatment.’ – Andrew Skuse,
University of Adelaide

11. A major challenge
 Too little priority has been placed using
ICTs to increase the voice of people
directly affected or threatened by health
issues in policy development, programme
review, critical thinking and programme
management roles.
 ICTs lend themselves to pushing
information to intended beneficiaries.
 Much less work has been done to enable
those most affected by ill health to share
their knowledge, understanding,
experience and ideas for change.

12. More information
 www.healthlink.org.uk
 www.asksource.info
(Source is an international information
support centre which strengthens the
management, use and impact of
information on health, disability and other
development topics.)