Social Capital approachesSeptember 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 StrategiesFrom 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 HypoliteHealth 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 EmmartSeptember 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) 1st objective (revised version): Contribute to the rise of the level of

schooling and functional literacy, particularly of young girls and women 2nd 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 toolsTrained 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

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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 withfocus on human rights-based health and quality education

LINKING: REVISOs monitor local health and educationservices and advocate for change through policy dia-logue

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Achievements to date

Healthy Motherhood Law andRegulation implementation

Networks developed andare using a detailed monitoringinstrument that verifies elements of new law“Casas Maternas” are in the planning phase in some municipalities

Quality EducationParent 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 mayorsCultural reticence to discuss reproductive health and

family planningLong term sustainability of networksChallenging 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

www.healthpolicyproject.com

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-10-00067, beginning September 30, 2010. 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)