Healthcare is going through a time of great flux. Be it innovations in tech and digital, care delivery processes in hospitals, drug research, accessibility or leadership strategies, traditional practices and habits have never come under attack so scathingly. There is an increasingly growing voice to reboot old ways with fresh thinking. However, for new ideas to be well and truly ingrained within the healthcare system, they need the backing of policy, which comes after approvals at legislative and regulatory levels. And it all begins with policy advocacy, with individuals and groups pushing for changes to existing policies and the creation of new ones.
At its simplest version, advocacy is the act of endorsing, evangelizing or speaking up favour of something or someone – such as an ideal, a community or a system. When that something or someone happens to be the policy, plan or strategy of the state administration or government vis-à-vis the healthcare of the nation, it becomes policy advocacy. The term comes from the Latin word “vocare” which means “to call”, to which the term “ad”, meaning “for” or “towards” has been added. In combination, the term means to call, or to identify with. Healthcare policy advocacy is simply the process of policy advocacy that is taking place in the context or arena of healthcare.
In general, the broad goals of Healthcare policy advocacy are ushering in change in terms of laws, regulations, perspective (position or stance on a certain issue), awareness, processes, practises, habits, standards & benchmarks, funding and spending. Specifically, some of the goals of Healthcare policy advocacy are:
• Altering the policy, guidelines, criteria, standards or implementation systems that run and influence the state of healthcare of a nation by bringing about some change in them.
• Drawing the attention of the government, the community or decision-makers to an important issue with the goal of addressing it decisively and meaningfully. As a corollary, this also involves empowering or equipping the decision-makers with sufficient knowledge and data to take an informed decision.
• Presenting a challenge as well as a solution to that challenge, and then rallying for opinion and support for both the problem and the solution.
• Collective involvement and participation in processes and systems that run society, influence communities and affect lifestyles and livelihood.
• Protecting the rights and privileges of certain groups and communities.
• Winning the support and endorsement of influencers and decision-makers with the goal of disrupting the policy and spending status-quo with a new idea, and engineer social transformation at scale.
• The objects of policy advocacy must be specific and not generic. It must have well defined, realistic and an incremental step in the larger journey of attaining a broader goal or accomplishing a greater vision.
While there can be several challenges or roadblocks to a healthcare policy advocacy exercise, but amongst the central challenges is building consensus and unity by exploring common synergies and futures. Communication plays an important role here. The individual/s or group/s who are aiming to influence policy change by advocating a new idea or knowledge must be able to effectively communicate the benefits of the change. This helps when the advocate and the user-groups (groups who will be impacted by the new policy) share common interests and goals. However, that is often not the case, and the advocate usually has to ‘win over’ the user-group with the help of a well thought out advocacy strategy.
· Defining the problem
· Formulating the policy
· Setting the agenda
· Policy change
· Policy implementation
· Policy adoption
· Policy evaluation
· Policy impact
To move a healthcare issue effectively onto the public narrative and onward into the policy-making process, it is advisable to follow a sequential structure of steps. Here’s a broad framework or roadmap to follow:
Do the research
Healthcare policy advocacy is about ushering meaningful and purpose-driven change in the healthcare space, but we tend to forget that it may not be the only way to do so. So before you decide to begin a healthcare policy advocacy campaign, do the necessary research and dig up as much information as you can. Be certain that policy disruption is the best way to solve the challenge you are trying to address. Make sure you check out the latest developments in the spheres of public health, laws, regulations, technologies and industry practices to figure out pros and cons, and validate your conviction with the facts.
Set the objective
Your healthcare policy advocacy program must begin with a clear vision and goal in mind. The objectives must specific, measurable, achievable, relevant, and time-bound. The objectives must be mapped to current policy frameworks (identifying clearly where re-think is require d) and existing evidence. One must also factor in the current ecosystem of policy actors, decision maker(s) from all relevant angles.
Create the partnership
When we already have the support of a key section of the healthcare community - such as healthcare influencers, healthcare decision makers, healthcare role models as well as core healthcare groups from domains like politics, business, research, education, minority demographics and so on - the idea naturally gains in weight and credibility. Going forward, it becomes easier to garner support and goodwill for the proposed disruption in policy. So take the time and effort to nurture bridges and develop bonds with such individuals and groups with the underlying goal of turning them into loyal partners and effective champions. Meet up with them regularly, listen to their concerns intently, share helpful information and resources with them freely – thus building a stature of thought leadership who inspires trust.
Know the political landscape
A change at the policy level in healthcare is usually deeply interconnected with the political landscape, and therefore it is important to gain a reasonably in-depth understanding of it. Figuring out the key processes and players (which will include their own stance and view on the issue) in the current political terrain can help us successfully approach, engage and influence them.
Create the framework
It is a good idea to draft a broad or rough framework of how you want the new healthcare policy to look like. This will clarify your goal clearly, and also help healthcare policy-makers identify the right legislations and regulations for the exercise quicker. This involves doing substantial ‘homework’ (involving analysis and research on gaps and opportunities in current policies) and also taking the help of lawyers and experts from healthcare if required – all of which deliver the additional benefit of positioning you as an ‘insider’ or ‘expert’ who knows exactly what s/he wants – and not a novice who can be taken lightly.
Identify what is non-negotiable
Negotiations – and as an extension compromises – are a natural part of the healthcare policy advocacy process. However, it is important to set limits on how far one is willing to recede or yield. Some cornerstones and fundamentals of your proposed ‘new world’ must be sacrosanct and non-negotiable. Remaining inflexible on these core aspects won’t make you appear as much headstrong or bigoted as it will portray you as strong willed and passionate towards the cause (which is the most important ingredient in the recipe of creating change), and earn you valuable support – both tangible and moral.
Prepare the Plan of Action (strategy)
It’s important to healthcare get decision-makers to take action to make the healthcare policy advocacy strategy successful. How does one do that? 1) Interact with healthcare influencers and decision-makers on a one-on-one / personal level by approaching them directly 2) Leverage the reach and power of media – both traditional and social media – to reach out to healthcare influencers, decision-makers and even the public, 3) Mobilize voices at the grassroots by engaging a strong base of supporters and allies who can push the movement forward and also be an effective anti-dote for opposition or indifference.
Prepare the message
We have touched upon the criticality of communication at the beginning of this article, but it deserves double mention. Advocacy is all about transferring the conviction and spreading the passion with target groups and communities. And that will never happen without an effective communication strategy. Define and segregate your audience or market, understand the emotion drivers and motivations of each bucket, and use the best forms and formats of communication channels to reach, influence and convert them. The message or logic you will use to change their thinking must carry a healthy mix of emotion and facts. Use traditional and new forms of media to spread the word, monitor the conversations that are happening around your message online, and be ready with answers since you must continuously respond and engage.
Formulate the campaign
You may have the micro-details in place, but it is equally important that they come together without hiccups. So spend time perfecting the macro-picture as well, finalizing the exactly milestones you plan to cross along the journey, the timeline you are setting for the entire course, the resources, manpower and support you will need along the way, and the potential challenges and resistance you may face. Discuss your roadmap with core group members and partners. This Plan of Action becomes a dynamic (inclusive, flexible and editable) document that must be referred to at each step to ensure you don’t stray from the path.
There are various ways to be a healthcare policy advocate. Below are some of the categories :
Much like a citizen journalist or citizen activist, an individual – who may or may not be the recipient of the benefit of policy change – can be an ‘champion of transformation’ and take up the cause.
There are individuals, organizations and agencies who take up advocacy projects and causes against a professional fee.
Central or state agencies that oversee HCPs are responsible for certifying and recertifying healthcare professionals and healthcare institutions. The reports they generate can help patients on all providers within their area of oversight.
HEALTHCARE COMMUNITY ADVOCATES
Some organizations who are active in healthcare – be it hospitals, insurance companies or others – engage people (for example, ‘Patient Representatives’) on their payrolls specifically for the objective of spearheading policy advocacy assignments.
Patient advocacy groups
There are the organizations, generally non-profit, that focus on specific diseases or aspects of healthcare. They may be differentiated from Patient Advocates and referred to as Health Advocacy Organizations.
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