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Advocacy: Demanding Change

Throughout the year, both during National Actions and at other strategic times, you will have opportunities to help pass important legislation and influence policy. Here are a few advocacy tactics your Chapter can use – either individually or together.

Power Mapping

Be strategic when selecting the target of your advocacy.  You may want to provoke legislative change, demand corporate social responsibility, or shift public opinion.  This power mapping process will help you decide.

As your student chapter plans advocacy initiatives—and as you build your own capacity as an advocate—it is critical to analyze the power structures involved in the policies and processes you are advocating for or against. This kind of analysis will ensure your action is as effective as possible in both moving policy and in moving people:

  • Who has the power to make the change you want, and is most vulnerable to the kinds of pressure you can mount?
  • Who are your allies? Who could be your active supporters?
  • Who will actively oppose you?
  • How can we reach the people in power?

One process tool for this is called power mapping. Power mapping allows advocacy groups to systematically lay out power dynamics across your campaign so you can focus in on your main target—the one who can make the change you want to see—while also illuminating other potential connections and recognizing opposition so you can minimize it. Power mapping is used by organizations across the globe to: forge alliances; build support; do the most targeted actions; be politically relevant and strategic; and build awareness and legitimacy of your group.

Step One: Setting the Stage

To begin the process of power mapping, identify all of the stakeholders and actors involved in your particular issue. One helpful matrix to do this mapping is the power mapping table included below—it helps you map out your campaign allies, beneficiaries, opponents, decision makers, and those who influence the decision makers—all key power relationships to win a campaign.

  • Allies: People who are “on your side” either because they will benefit directly or because they share the same objectives and want to help bring about these changes as part of a broader movement. These are the people and groups who are already active on your issue or those you want to enlist and you think you can get on board. Ask yourself: who can you bring into this campaign as stakeholders and supporters?
  • Beneficiaries: People whose lives will be improved by the successful achievement of your advocacy goals. They can also be called “allies” but without additional organizing, a beneficiary is often a more passive stakeholder than an ally.
  • Opponents: People who are opposed to what you’re trying to do and are likely to actively oppose you. Some of these people could become allies in time, with greater understanding of the issues, or could be standing in the way of what you’re trying to do. Adversaries can become targets of your advocacy project if you are planning a series of activities to “win them around.” Also, it is useful to not allow your campaign to get distracted by passive opponents—those who will not actively oppose you, or who do not have the ear of your targets. Ask yourself: how can you ensure the opposition stays at least neutral—and that your actions do not necessarily inflame them to put opposing pressure on policy makers? Can you make any opponents into allies with specific outreach strategies?
  • Decision Makers: Those with the authority or power to make the desired change. Look at your list of decision makers and compare it to your objective and the policy/budget you are trying to change, and find the targets you have the greatest number of routes to reach. Ask yourself: are they vulnerable to influence? Accessible or accountable to your constituency or allies?
  • Influencers: Those who through their position, relationship, knowledge, or status are able to influence those with the power of decision making, or the direction of policy changes. Ask yourself: who do you know who has the ear of your target? How can you influence them to move the target towards your position?

Step Two: Identifying Targets

Now that you have mapped out the overall power dynamics in your campaign, it is time to focus on mapping out your targets. A “target” is the person who has the power to give you what your group wants in your campaign. A target is a person, not a faceless institution. Your constituency can easily imagine and express power over a person—but how can anyone have power over “the government” or “the International Monetary Fund”? In addition, individual decision makers have more incentive to respond to actions targeted at them directly, versus at a committee, or a larger government body—their names and their position are on the line, so they are more likely to respond.

There are two kinds of targets: primary targets and secondary targets. The primary target is the person or institution with the ultimate power. This may include Senators and Congressmen, Medical School Deans, local elected officials, or others who hold the power to make the change you want to see.

Secondary targets are people who can influence your primary target. The opinions and actions of these “influencers” are important in achieving the advocacy objective in so far as they affect the opinions and actions of the decision makers. Some members of a primary audience can also be a secondary audience if they can influence other decision makers. For example, the President and the Secretary of State might influence one another’s opinions. Therefore, they are both a primary audience (“targets”) and a secondary audience (“influencers”). In addition, your secondary audience may contain oppositional forces to your objective. If so, it is extremely important to include these groups on your list, learn about them, and address them as part of your strategy.

Some secondary targets may include:
  • Relatives
  • Leaders of target’s party
  • Business associates of the target
  • Personal Assistants or staff
  • Formal/informal advisors to the target
  • National opinion leaders
A special note on targets

What does it mean to say target? The term “target” does NOT always imply that we are attacking them—but that they are the decision makers who are key and around whom you should focus your efforts. Advocacy can often be most effective when you approach your targets as colleagues versus adversaries: you are still targeting them and their power, but in a collaborative light. Or, to make change, you may have to use more aggressive tactics towards your target—either way, the target is the person who has the power to give you what you want, and it may or may not be strategic to treat them as an adversary.

You can have more than one target for a campaign, although in general, fewer are better and allow you to be more focused. There will often be a progression of targets on the way to victory in a complex campaign. If a “primary target” is determined too hard to reach, but critical for your issue, you can make your secondary target your main target—so if you can’t reach, say, the President, but you know he listens to a certain cabinet member, target that person primarily to reach the President.

Power mapping is an art, not a science. And things change. So think about the criteria listed in this power-mapping worksheet [1], but know they can be flexible. Targets totally depend on your objective, so targets in one campaign might be allies in another. Be flexible and ready to shift your targets and allies as the situation changes.

NSP National Actions

Three times a year, the PHR National Student Program leads a nationwide advocacy event known as a National Action. National Actions are opportunities for coordinated action on one of PHR’s key campaigns. National Actions generally seek to change U.S. policy to address an urgent human rights concern. Chapters that choose to participate are part of a coordinated nationwide advocacy effort that magnify the voice of health professional students and help change the health and human rights landscape.

Previous National Actions have introduced advocacy in tandem with an internationally observed day, like World AIDS Day and Human Rights Day.  The Global Health Week of Action is linked to World Health Day.

Current or upcoming National Actions:

2011 Global Health Week of Action – May 1-7, 2011

Engage Your Congressional Representatives

Extend the fight for health and human rights by speaking with your congressperson.  Call your congressperson’s office to set up an appointment. When scheduling a meeting, underline the magnitude of your issue(s), and say that it is important to you (and your officer team) as future health professionals.You can achieve a number of goals through interacting with your representatives:  you will be letting the policymaker know that his or her constituency cares about the issue at hand; you can educate the policymaker about the issue and explain why his or her support is important; you may be able to gain a commitment for some specific action, such as voting for a piece of legislation, and you can thank participants for prior support.  Even if you are not successful gaining a commitment, you will have established a dialogue, raised awareness, and set the stage for follow-up communication.

To identify your local and state representatives, go to USA.gov’s website. [2]

Letters to Congress

A letter-writing campaign can be a great way to urge your representatives or senators to back a major legislative issue or champion a cause crucial to health and human rights. Gather your chapter members, as well as faculty, classmates, and local community members, to write letters on a given issue. Bring sample letters for everyone to replicate or use as a draft. Then, send the letters out to your representative or senator. Follow-up the letter writing campaign with a phone call to your representative’s or senators’ offices.

Petitions and postcard campaigns demonstrate to your representatives, university president, or other official that there is substantial agreement in your PHR chapter, campus, or larger community on an issue. Collect signatures on issues ranging from implementing HHRE on campus to health care issues in Congress, and submit them with a cover letter explaining your position. If you collect signatures for a PHR campaign, mail them to the National Student Program Coordinator.

To learn about the process by which a bill becomes a law, see this chart [3] or view this highly educational film [4].

District Meetings

Schedule a meeting with your local representatives and senators by calling their national or district office and speaking with the scheduler. Call the Capitol Switchboard at (202) 224-3121 and ask to be connected to your Member of Congress’s office. Allow sufficient lead time when calling for an appointment. The more advance notice the office has, the more likely that a representative will attend.  Try to schedule your visit to coincide with a milestone: a report that has just been released, recent media coverage of an issue, a bill that is being deliberated, etc. Don’t bring a large group—three or four people should suffice.  Be sure your group includes people from the legislator’s district, are from constituencies the member cares about (religious or civil groups, for example), and are articulate and confident. Practice what you will say beforehand, and keep your presentations brief and to the point.

Town Halls

An informal public event with the community, where attendees can voice their opinion and ask questions of their elected officials. Ask your representatives if they would be willing to meet with members of the community regarding a topical issue. This is also an excellent format in which to hear the viewpoints of community members without a representative present, and a way to form coalitions and decide on further action.

House Parties

Many house parties are organized around televised debates during election season. Alternatively, some representatives are too busy to meet in person, but would be willing to have a call-in meeting with a group of constituents. House parties are also excellent vehicles when lobbying for a local or regional candidate, who may be willing to come speak to those assembled.

After any interaction with a representative, write a thank you note to all meeting attendees and send them follow-up materials from PHR to respond to any questions that came up during the meeting. If the policymaker was unsupportive or noncommittal, ask constituents to write letters on the issue; if the member is supportive, urge constituents to send thank you notes.

Hosting Call-In Events

Organizing a Call-In Day can be a very effective way to advocate to policy makers and to engage your campus. Congressional staffers keep track of who calls in to their offices every day, and what issues are on their mind. Make sure your issue rises to the top by getting 20, 50, or hundreds of your classmates to call your Senators’ or Congressperson’s office in one day.

Organizing a Call-In Day is easy.  First, create materials about your issue. You’ll need a call-in script for people to follow, so they have the facts right there in front of them. These scripts should be short, just a few sentences–calls to offices usually last less than 2 minutes, so the script should be concise and powerful. You may also want to prepare a one page fact sheet. A fact sheet will teach potential callers more about your issue, and why they should care—and what impact their action can have on health and human rights. Finally, you need the phone number to the office–DOUBLE CHECK to make sure it works before you move forward.

Once you have the phone number, script and facts, its time to plan an outreach strategy. Got an active email list? Send out an elert. For more immediate impact, set up a table in a busy area of campus, and ask everyone to pull out their cell phones and make a call. Have PHR chapter members make the same ask in every class they are in on the call-in day–this will generate many calls. Work with other groups: reach out to AMSA or other campus groups and see if they want to join the call in day. Blog about it. Be creative—there are many ways to publicize a call-in day to ensure maximum exposure and impact.

Follow-up is important too. Within a few days of the call-in day, make official contact with your target policy maker’s office. See if they want or need more information. You will be on their radar screen—offer yourself as a resource and help make sure your issue remains at the top of their list!