HEALTH PROMOTION &

HEALTH ADVOCACY

Dr. Komel zulfiqar

Professor
Community Medicine
What is Advocacy
Advocacy means getting support from
another person to help you express
your views and wishes, and help you
stand up for your rights.
Definition
Advocacy is a strategic approach to
influencing outcomes and driving
change on behalf of your community. It
involves representing your community's
rights and needs to the level of
government best able to respond.
What is advocacy?
Actively working to change the social,
political, legal, economic, and medical
environment.
Derived from Latin word advocatus,
which means one who gives voice.
World Health Organization
definition
Any combination of individual and
social actions designed to gain
political commitment, support, social
acceptance, and systems support for a
particular health goal or program.
What Comes to Mind When You
Think of Advocacy..
There Are Many Ways to Shape Policy
Are YOU an Advocate?...
Have you worked on implementing a
health-related policy at your workplace or
community?
Have you helped draft or pass a resolution
on behalf of a professional organization?
Have you had a class project where you
worked on advocacy related activities?
Are YOU An Advocate?.....
Have you ever met with administrators
regarding the importance of school health?
Have you ever provided public testimony at a
school board meeting or legislative meeting?
Have you voted in an election or forwarded
health policy information to another student
or colleague?

You must be the change you wish to
see in the world.

 Gandhi

Definition of Physician
Advocacy
“Action by a physician to promote those
social, economic, educational, and political
changes that ameliorate the suffering and
threats to human health and well-being that
he or she identifies through his or her
professional work and expertise.”
Issues identified through professional
work
Example topics
◦ Health insurance coverage
◦ Access to healthcare
◦ Women’s health
◦ Human trafficking
◦ Gun violence
◦ Vaccine mandates
Identify an issue of concern
Gather information
Commit to action
Collaborate with others
Mobilize resources
Sustain the effort
Advocacy and Health Educators
Responsibility By Assessing Individual And
Community
Needs For Health Education.
Responsibility Ii Planning Health Education
Strategies
Interventions And Programs.
Responsibility in Implementing Health
Strategies, Interventions, And Programs.
Responsibility for Conduct Evaluation
And Research Related To Health
Education.
Responsibility: Administer Health Education
Strategies, Intervention, And Programs.
Responsibility : to Serve As A Resource Person
In Health Education.
Responsibility: Communicate And Advocate
For Health And Health Education.
Lobbying vs. Advocacy
People sometimes confuse the words
lobbying and advocacy.
Lobbying is one form of advocacy,
comprising efforts to influence specific
legislation with legislators and their staff.
.
Advocacy covers a much broader range
of
activities such as influencing executive
branch actions to implement the laws and
public education.
One way of differentiating between the
two terms is to understand that lobbying
always involves advocacy but advocacy
does not necessarily involve lobbying
Levels of Engagement
Interpersonal
Organizational
Health System
Policy
Public health advocacy
The term “public health advocacy” refers
to educating, organizing, and mobilizing
for systems change in population health.
Need for advocacy
Current and future threats to the health of
the community are identified and public
health advocates work to inform, create,
and influence legislation and change the
environment in order to create
circumstances in which optimal health
is possible.
Continued
 Public health advocacy occurs through
media, legislative, and grassroots efforts.
Although individual health advocacy for
patient and client can be practiced, it
should be stressed that public health
advocacy, like the core discipline of
public health, is undertaken to enhance
the health of communities through
improved health policies and programs.
Public Health Advocacy
Advocacyis a catch-all word for the set of
skills used to create a shift in public
opinion and mobilise the necessary
resources and forces to support an issue,
policy or constituency.
Advocacy is not just about lobbying
Advocacy can be part of your day job!
Public Health Advocacy
Refers to the process of overcoming major
STRUCTURAL barriers as opposed to
INDIVIDUAL barriers to Public Health
goals.
Advocacy seeks to increase the power of
people and groups and to make institutions
more responsive to human needs.

Types of Barriers
Political philosophies that devalue health
and quality of life at the expense of
economic outcomes
Political or bureaucratic opposition or
inertia to health promoting legislative
provisions
Political or bureaucratic opposition to the
participation of consumers in healthcare
planning
Marketing of unsafe and unhealthy
products
Targets of Advocacy
Policies and practices of Governments
and Institutions
Government laws and regulations
Commercial marketing practices of
industries
Activities of counter health lobbying
groups
Being an Advocate
Advocacy is an integral part of any
prevention strategy
It is issue and policy orientated
It is not primarily about changing
individuals behaviour
Upstream/downstream

Causes of ill-health the risk factor
reduction!
Smoking - education, cessation supports, etc
Alcohol - education, sensible/safe limits, etc
Exercise - education, advise, etc
Nutrition education, Diet, the pyramid, etc
RTAs - education, driving schools, speed
limits
Etc etc etc etc

Key issues to consider
The use of evidence
Using data to support argument
Setting targets short to long term
Power assessment
Tactics
Continuous evaluation
Media Advocacy
Evidence is crucial
Supported by systematic empirical
evidence
Supported by cogent argument
Scale of likely health benefit
Likelihood that policy would bring
benefits other
than health benefits
Fit with existing or proposed government
policy
Possibility that the policy might do harm
Ease of implementation
Cost of implementation
Data are important
strong and credible data base
gives a clear analysis of the issues to be
addressed
be user friendly with the data

Health policies can be made in the
absence of evidence, or despite evidence
Targets
Goal setting is critical
sense of direction, unifying theme, end point
long range - short term
what steps are needed to achieve each goal
helps long term thinking and focuses on the
real issues

Advocacy can be threatening
If there is no struggle there is no progress.
Power concedes nothing without a
demand.
challenges staid notions, vested interests
upstream forces might not like it
Advocacy requires assessment
what about your own organisational
health
can I win, can we afford to lose
assess assets and liabilities and plan
strategies building broad, cohesive
coalitions
- resources, strengths and weaknesses.

The media connection
In our mass-mediated democracy public
health battles are fought not only in the
clinics and the courts, but also on the
10pm news, the front pages, financial
section and even on 24 hour all
talk radio

The mass media constitute an important
part of the environment in which the
selection, presentation, definition and
discussion of public issues occur
Media advocacy
Seeks to influence the selection of topics
by the mass media and shape the debate
about these topics
Ensures that the story is told from a
public health perspective
If you don't exist in the media, for all
practical purposes you don't exist

Understanding media advocacy
More an art than a science
Improves with practice
understand the needs of journalists
set media objectives that relate to your goals
be on the alert for stories that help your issue
Never do anything that would compromise
your credibility

Key issues
Smoke-free workplaces introduced 29th March
2004
Campaign did not start on the 28th March 2004
Capacity building for years
Part of a comprehensive tobacco control package
price, advertising, sales to children, tar and
nicotine levels etc

The 70s era
Active smoking harmful
Smokers rights universal
Environmental tobacco smoke (ETS),
passive
smoking, involuntary smoking what is
that?

The 80s
Increasing awareness of tobacco control
issues
Advertising bans
Health warnings on packs
Sales to children
ETS could it be bad for you?

 Passive smoking: The evidence
emerges
1982- US Surgeon General. The health
consequences of smoking cancer.
Reviewed 3 studies showing an increased
risk of lung cancer in non-smoking
women whose husbands smoked

Conclusion - cautious
1986 - US Surgeon General. The health
consequences of involuntary smoking.
Reviewed 13 spousal studies
Conclusion Involuntary smoking is a
cause of disease including lung cancer, in
healthy
non-smokers.
he 90s
Increasing awareness of adverse health
effects of ETS
Irrevocably changed balance of smokers
rights versus non smokers rights
Irish Legislation

Restrict consumption (non smoking areas)
in specified locations
e.g. Public offices, schools, colleges,
cinemas, theatres, taxis, health and child
care facilities, restaurants
Voluntary code for the workplace
Assignments
Preventative Medicine and Healthy
Living for Senior Citizens. ...
Obstacles to Smoking Cessation. ...
Causes of Youth Inactivity. ...
Mental Stability and Obesity. ...
Educational Strategies and Social Media.
