Social Capital approaches September 5, 2012 HPP Field Programs

The Social Capital Process The process includes three steps—bonding, bridging, and linking: Bonding social capital. Approaches that build social capital first aim to create bonds of mutual trust, support, and reciprocity among groups of people who share a common identity, issue of concern, social status, or interest to provide support and safe spaces in which to build social cohesion, self-confidence, leadership capability, and advocacy skills. Bridging social capital. The social capital resources engendered at this level have the capacity to expand primarily when these bonded groups build bridges to create a network with other groups who share a common goal, purpose, or vision, which lead to collective Linking social capital. The expanded sphere of influence generated through bridging social capital is further developed when these bridged networks create linkages with groups that have different levels of power and authority (i.e., community networks may link with political or professional groups or networks to achieve greater voice and access to decisionmaking); likewise political or professional groups may link with community networks to engage their participation and partnership in policymaking and program or service design, implementation, and monitoring.

Social Capital and Systems GFATM identifies (and supports) six core components of community systems(GFATM, 2010b). These include ways in which social capital can be influential in strengthening health systems. The relevant types of social capital have been added in italics: Enabling environments for advocacy (linking social capital) Community networks, linkages, partnerships, and coordination (bonding, bridging, and linking social capital) Resources and capacity building (all three forms, with an emphasis on linking social capital) Community activities and service delivery (bridging and linking social capital) Organizational and leadership (bonding, bridging, and linking social capital) Monitoring and evaluation and planning (primarily bridging and linking social capital).

Objectives and Strategies From the Draft HPP Discussion Paper 1. Improved Understanding of Social Capital and its Effects on Health, Health Systems, Advocacy, and Policy Invest in social capital building programs and action research Foster an appreciation of evidence and local contexts Support systematic civil society involvement in policy dialogue 2. More Effective Programming Build social capital in marginalized communities and/or those facing specific barriers to health and health-seeking care Facilitate a shift from coalition building to linking for policy Strengthen systems and build institutional capacity Foster evidence-based advocacy 3. Improved Monitoring and Documentation Systems Develop indicators for measurement Monitor and document progress and impact

HPP Caribbean and Social Capital: the example of Dominica Ken Morrison and Ayana Hypolite Health Policy Project August 2012

 Bonding: Building social cohesion  Cohort of trained facilitators  Advocacy training for MSM group  Bridging: Working together in collective action  Training of health care workers by health care workers and key population community representatives  Linking: Linking service providers and key populations to policy makers  Development of a National HIV Policy through participatory methodologies How program is engaging social participation principles?

Achievements to date Cadre of 21 facilitators trained in 5 day Caribbean S & D ToF Includes representatives from health care, civil society, educators, FBOs To train health care facility staff across the island To facilitate outreach and consultations with different sectors of Dominican society Movement on development of a National HIV Policy Formation of a Steering Committee to oversee policy development 2 national consultations to discuss policy issues 4 discussion groups with key populations to discuss policy development Advocacy 101 training with MSM Movement on Facility level policy development Proposal for health facility personnel survey Plan for health facility personnel training & facility level policy development Key population trainees will participate in stigma awareness & monitoring process National cohort of trained leaders/facilitators in stigma and discrimination reduction

 High levels of stigma related to key populations makes coming together very challenging  High levels of perceived stigma and lack of privacy makes accessing public health care less attractive  Limited human resource capacities related to policy and advocacy  Ethical review process time consuming Challenges

 Problem Identification  Consultations and discussion groups  Policy Development  Multi-sectoral steering committee for development of National HIV Policy  Facility level policy development  Policy Implementation  Stigma reduction programs in health care facilities  Advocacy and monitoring in civil society  Policy Monitoring and Evaluation  Training of key populations (first step on policy and advocacy) for civil society monitoring Links to policies, policy process

Citizens’ Alliance Priya Emmart September 5, 2012 HPP India and Social Capital

 Bonding social capital  Formation of alliance of like-minded Parliamentarians  Providing younger parliamentarians with a social agenda on which to take action  Bridging Social Capital  To family planning experts and stakeholders  To Religious leaders in their districts  To state level decision makers  To civil society – ARC, YP  Linking social capital  Increasing power and influence at the community level – JSK 20 district joint work plan  Linking upstream to Parliament and NIHFW Engaging Social capital

 Technical support team formation  Five-point action plan for parliamentarians in alliance  Meetings with ARC to engage civil society and MPs Achievements to date

 Currently a single parliamentarian’s focus  Will take time to build champions, not yet an alliance  Funding from Naveen Jindal’s office to build alliance  Political aspirations can be both a burden and an asset Challenges

 Technical briefings to Parliamentarians and their technical advisers on contraceptive choice  Linkage with NRHM’s focus on strengthened community systems  Monitor district level activities on FP priorities including funds, methods and access to services  Use district vigilance committees as forum for Parliamentarian action at the community level  Using deliberations within Parliament to influence policy actions of NIHFW relating to contraceptive choice Links to policies

Building Social Capital with Religious Leaders in MALI Famory Fofana & Sandra Duvall September 5, 2012

Why Build Social Capital with Religious Leaders in Kita? Successful outcomes under POLICY Project & HPI developing social capital with religious leaders & parliamentarians at the national level HPI evaluation of Mali national reproductive health law implementation: Advocacy at the community level essential to translate policy & law into action at the local level World Bank Report (2010): Advocacy on population & reproductive health issues needed in Mali to increase implementation of policies IRH Research: Social Networks influence FP uptake & unmet need  Barriers to FP use cited:  Spousal disapproval  Community disapproval  Rumors and misinformation from members of social network  Religious opposition  Age hierarchies direct flow of information

HPP Mali Engages Social Capital Principles Social Capital for Conducting Advocacy: Boosting Policy Implementation at the Community Level Bonding Social Capital  Reinforcing bonding social capital of Imams & constituencies  Creating network of religious leaders in Kita Bridging Social Capital  Between Muslim & Christian networks & groups  Between Imams & Health Center Staff: for RH law dissemination & FP uptake Linking Social Capital  Linking Parliamentarians Network on Population & Development (REMAPOD), national level religious leaders & religious leaders in Kita: Dissemination of RH law The Parliament of Mali hosts REMAPOD, network established under HPI

Policy Links: Translating Policy into Action Religious Leaders’ advocacy promotes implementation of GoM policies & laws Examples of these policies & laws: 2002 Reproductive Health Law (elaborated & disseminated with HPI assistance):  Reproductive health care to reduce maternal & child mortality & morbidity & promote the well-being of all individuals  Preserving the health of the pregnant woman & the newborn Mali National Population Policy (1991, revised 2003)  1 st objective (revised version): Contribute to the rise of the level of schooling and functional literacy, particularly of young girls and women  2 nd objective (revised version): Reducing maternal & infant mortality, & improving population health, especially reproductive health  Advocating birth spacing & increasing modern contraception use to improve maternal & child health  Encouraging breast feeding  Heightening the awareness of men about the benefits of family planning

Religious Leaders in Kita: Achievements and Challenges Religious Leaders & Parliamentarians field visit to Kita, March 2012 Achievements (2011 to 2012)  176 Muslim & Christian leaders in Kita trained on advocacy tools  Trained religious leaders reached more than 131,205 people (male and female) with MNCH messages through policy dialogue  Religious leaders & REMAPOD  worked together to disseminate RH law  met with District Health Reference Center RH staff to verify the law’s application  Field visit broadcasted on national TV  Imam Dembele becomes RH/FP champion Challenges  Continuing education of networks  Keeping advocacy tools up-to-date: new data  Scale up of networks throughout the country using best practices  Network sustainability Imam Dembele & his wife

Revisos HEPP Guatemala and Social Capital

21 Municipal Social Watchdog Networks (REVISOs) engaging in social participation principles  BONDING: 30 REVISOs created in priority munici- palities; five to more than 20 member organi- zations per REVISO  BRIDGING: REVISOs receive capacity development with focus on human rights-based health and quality education  LINKING: REVISOs monitor local health and education services and advocate for change through policy dia- logue

22 Achievements to date Healthy Motherhood Law and Regulation implementation  Networks developed and are using a detailed monitoring instrument that verifies elements of new law  “Casas Maternas” are in the planning phase in some municipalities Quality Education  Parent groups have a monitoring tool and are visiting schools In Year 2 the REVISOs will undertake advocacy and policy dialogue with the municipal councils in support of; a)putting health and educational themes on their political agendas and b)making the decision to invest their funds in health and education.

 Inactive health and education committees within municipal governments  Resistance on the part of some mayors  Cultural reticence to discuss reproductive health and family planning  Long term sustainability of networks  Challenging terrain and widely dispersed populations Challenges

REVISOs have direct links to health care and educational service providers Networks will establish links to municipal-level health and education committees once they are re-activated Networks have established relationships with HEPP’s department-level and central advocacy networks through which they can access the central government REVISOs linking to policies & policy process

Thank You! The Health Policy Project is a five-year cooperative agreement funded by the U.S. Agency for International Development (USAID) under Cooperative Agreement No. AID-OAA-A , beginning September 30, It is implemented by Futures Group, the Centre for Development and Population Activities (CEDPA), Futures Institute, Partners in Population and Development Africa Regional Office (PPD ARO), Population Reference Bureau (PRB), Research Triangle Institute (RTI) International, and the White Ribbon Alliance for Safe Motherhood (WRA)