This document discusses advocacy and policy development in maternal and child health (MCH). It defines advocacy as supporting a cause or proposal, which can occur at the individual, organizational, or community level. Advocacy is important for MCH to address inequities and ensure the needs of vulnerable groups like women and children are heard by policymakers. Advocacy strategies can include legislative, interagency, and judicial approaches. Successful advocacy requires assessing problems and solutions, clear messaging, and coalition-building directed at appropriate decision-makers. The example of the Maternal and Child Health Coalition that advocated for the Children's Health Insurance Program demonstrates long-term advocacy strategies.

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Week 13
Chapters 21 & 22
Instructor: Gina Crosley-Corcoran, MPH
PBH 805 – Maternal & Child Health

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Introduction
 Advocacy is an essential tool for MCH and is closely tied to policy
development.
 Governmental employees may be restricted from direct advocacy,
relying on outside partners to advocate on their behalf.
 Policy development is one of the three core functions of public
health.
 The field of MCH has its roots in evidence-based advocacy and
policy development.

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What is Advocacy?
 The act or process of supporting a cause or proposal
 Advocacy can happen on three levels:
1. Individual or case level: a person acting on behalf of another
individual, challenging an organization or institution
2. Organizational level: a person or group attempting to alter or
monitor legislative, budgetary, and administrative processes
3. Community level: a person or group seeking to reform a system to
benefit a specific community

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Why is Advocacy Important in MCH?
 Inequities in decision-making authority, resources, and
information require that individuals and organizations advocate for
children and families.
 MCH population often includes those who are marginalized,
vulnerable, and lack representation (e.g., children, women).
 Advocacy is needed to ensure health equity and address ongoing
racism and other injustices.
 Helps ensure that needs of women, children, and families are
brought to policymakers

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Types of Advocacy
 Legislative advocacy: working through the legislative process to
create the foundation, authorization, and appropriation of funds
for specific programs; contributes to policy development
 Interagency or systems-level advocacy: building partnerships
across programs that help lessen administrative barriers and
improve opportunities and resources for children and families
 Judicial advocacy: advocacy through the courts, typically to clarify
the interpretation of statute or regulation, to enforce
implementation of the law, and to promote personal or group
constitutional rights

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Who are Advocates?
 Anyone can be an advocate, and everyone in the field of MCH
should be an advocate.
 Advocates can include parents, grassroots coalitions, and national
organizations.
 Advocacy can be a short-term, temporary role or a long-term or
lifetime commitment.

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Organizations that Advocate for MCH
 Trade associations: membership organizations consisting of individuals or
agencies (e.g., American Academy of Pediatrics, American Public Health
Association, Association of Maternal and Child Health Programs)
 Voluntary organizations: volunteer-based organizations, but tend to have
narrow focus (e.g., The Arc, March of Dimes)
 Advocacy organizations: established for the sole purpose of advocacy (e.g.,
The Children’s Defense Fund, Moms Rising, Black Mamas Matter Alliance).
 Public and governmental agencies: may be limited in formal advocacy but can
compile data and work with families and consumers to promote internal and
external policy development

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Where are Advocacy Efforts Directed?
 This depends on who has the power to make change and who can influence
those with that power.
 Can be targeted at national/federal level, state, or local/community levels
 Identifying appropriate target can be facilitated by clarifying objectives,
assessing the likelihood of success, and securing helpful allies.
 Advocacy efforts must continue through legislative process to rule-making
and implementation.
 Grassroots, or local, support and involvement of professionals and
constituents is important for success regardless of target level.

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How is Advocacy Conducted?
 Blend of education and action: linking education with policy change at
legislative or regulatory levels
 The best advocacy is based on knowledge, grounded in scientific data, that
leads to a shared understanding of the problem and honest dialogue about
the best approach for a community.
 Forming or joining coalitions and partnering with others can greatly increase
chance of success, offer additional expertise, and enhance credibility.

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Common Elements of Successful Advocacy
 Sound assessment of problem and potential solutions
 Clear articulation of problem and program or policy strategies
 Identifying key decisions makers and stakeholders
 Developing a strategy to achieve advocacy goals
 Identify existing coalition or form new one
 Develop a communication strategy
 Follow-up!

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Advocacy Example: The Maternal and Child
Health Coalition
 Large coalition with leaders representing major MCH organizations (e.g.,
Children’s Defense Fund, American Academy of Pediatrics) formed in the
1980s to advocate for programs providing health care coverage and
access (e.g., Title V, Medicaid, and Community Health Centers)
 Advocated for special needs children during early, failed health care
reform efforts in the early 1990s
 Regrouped to form Children’s Health Group with clear objective to secure
federal legislation to increase the number of children with health care
coverage
 Resulted in the 1997 enactment and 2009 reauthorization of the
Children’s Health Insurance Program (CHIP)
 Strategies included coalition building, education, information sharing, and
developing and adjusting strategy.

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How does Advocacy Relate to the Policy
Development Process?
 Public policy process is messy, but must be engaged for effective change.
 Advocates must understand their state’s policymaking process: learn the
structure of the legislature, identify important committees, learn background
information of key policymakers and staff infrastructure/structure
 Important to know the calendar for budget preparation and process by which
agencies develop legislative agendas
 Advocacy is important year-round!

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Rules to Improve Chance of Success in
Advocacy
 Be prepared: do your homework and bring science-base.
 Never raise a problem without offering a solution: solution should be
effective, cost-efficient, and acceptable to public.
 Be inclusive: various points of view strengthen a position.
 Be prepared for the long haul: engage in critical self-assessment.
 Be consistent: stay on message to avoid confusion and keep it simple.
 Be respectful: thank all who contribute, respond to others, and follow-up.

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Defining Leadership
An expanded definition of leadership includes:
• those who have the ability to influence change, make a
meaningful impact, and shepherd through the changes our
systems so greatly require. In this sense, we can all be
leaders in our own right, no matter what our title or
administrative responsibility.

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Equality vs Equity

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Conclusion
Anyone and everyone can and should be
an advocate.
How you advocate and strengths and
weaknesses vary by position, type of
advocacy, and context.
MCH professionals should advocate as
private individuals regardless of advocacy
efforts conducted in the context of their
work position.
There are many advocacy achievements in
the field of MCH, and the future will be
shaped by today’s advocacy efforts to
promote MCH and support an agenda that
values women, children, and families.
MCH ADVOCACY and
LEADERSHIP

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Week 13 Assignments
Discussion Board Post
Quiz on Chapters
Extra Credit Assignment