What is the activity?
Policy change is often the outcome of specific interventions that aim to inﬂuence people who make decisions that affect the lives of others, at local, regional and national levels.
Policies that help to reduce HIV prevention need among African people in England can cover a vast number of areas, including health, education, social care, housing, racial equality, criminal justice, welfare beneﬁts, immigration and employment. Policies that foster well-being, attend to human rights, and ensure appropriate access to services from the voluntary and statutory sectors will contribute to an environment where African peoples’ HIV prevention needs are better met.
Whether we work in the statutory or voluntary sectors, part of our mandate is to be involved in policy development processes that our democratic society affords, functioning as advocates for those whose interests we serve. That means becoming active within the policy environment that provides the context for our work.
The form that policy interventions take is inﬂuenced by existing structures for input. For instance, many signiﬁcant policy changes instituted by central or local governments are subject to a formal consultation, based on written responses to a draft document. Knowing about such consultations, and having the capacity to respond to them requires capacity with organisations, and supporting infrastructure between them. Informal policy development involves becoming familiar with the core documents that help to form a particular policy landscape, attending and introducing oneself at planning meetings or public events, exchanging emails, collating and sharing case studies, making phone calls, or preparing press brieﬁngs.
Whether policy interventions are local, regional or national, success requires a strategic, pro-active approach. It is impossible to inﬂuence all policy. This means that organisations should prioritise the issues they want to focus upon, devise a plan of action, identify and build partnerships, and review progress on a regular basis.
Sometimes, those responsible for making decisions (particularly those who are not specialists in migration, ethnicity, sexual health or HIV) will have signiﬁcant deﬁcits in information and awareness. One simple, yet direct means of inﬂuence is to offer oneself as an information resource to such individuals, helping them to gain a better understanding of the issues that are most pressing to African people at risk of HIV transmission.
Partnership-working on policy issues can be particularly powerful, as evidence can be collated across agencies, and innovative approaches to exercising inﬂuence can be strategically applied by different actors, with a diverse range of targets. These might include, but are not limited to those listed in structural targets and aims.
Whatever the activity or the audience, success will hinge not only on the persuasiveness of the argument, but also on the use of evidence. This means it is essential to be well-prepared with data and examples that help to support the change you wish to see occur.
Strengths and limitations
Policy interventions can result in change that dramatically alters the conditions of life for African people likely to be involved in HIV transmission. Their strength should not be underestimated, given that it has been widely argued that key players in policy have the greatest inﬂuence on and therefore greatest responsibility for HIV incidence (UNAIDS 2002, Barnett & Whiteside 2002).
Involvement in policy interventions requires understanding of connections between the HIV sector, statutory agencies and government. These connections offer opportunities to identify and establish partnerships that traditionally fall outside an organisation’s immediate contact base, thus helping to further develop the sector.
Intervening in the policy ﬁeld can require signiﬁcant effort for little immediate gain, making it difﬁcult to secure discrete funding to support these activities. Also, those in direct contact services will sometimes be forced to choose to prioritise the pressing needs of individual service users, or following up on the complex documentation that policy interventions can involve.
In the face of such pressures, it is useful to remember that achieving policy change improves outcomes for whole populations, not just individuals. Those with little experience of participation in policy interventions (perhaps due to experience of different forms of governance in other countries, or because of pervasive social exclusion experienced in this country) may ﬁnd such activities daunting. With appropriate support and guidance, those who are enabled to deliver a petition to a CEO of a Primary Care Trust, attend council meetings, write a letter to the editor of a newspaper, or make a visit to the Houses of Parliament will ultimately ﬁnd that familiarity with the ‘rules of engagement’ for each of these different activities improves their capacity to provoke change.
Issues to consider
At the moment, policy work within the HIV sector is signiﬁcantly under-valued, making it difﬁcult to prioritise its development in work-plans. The best means of circumventing this problem is to identify what core issues are most relevant to a particular agency’s work, and to begin devising a policy action plan with a few key targets in mind.
A document produced by the former Labour government, Communities in control: real people, real power (2008) contains a number of initiatives and ideas to help boost community development with the aim of increasing participatory democracy and direct advocacy. The coalition government’s proposed approach toward increased engagement through the notion of ‘Big Society’ has yet to be fully articulated, but this can be regarded as an opportunity for voluntary sector agencies to devise their own vision of the Big Society.
National agencies (such as the African Health Policy Network
In the same way that there is a need for information to ﬂow downwards with regards to campaigning strategies and support, there is also a need for a signiﬁcant ﬂow of information upwards. The documentation and sharing of information about policy interventions will increase success through sharing of best practice. This also helps to feed a dynamic process whereby those working on HIV policy issues at national level get to hear about the impact of their work, while those delivering services are better able to inform future policy interventions.
Given the huge range of individuals and organisations that can become targets of policy interventions, it is also important to have a means of identifying local and national partners who will be able to collaborate. This often means looking for potential partnerships outside of the African HIV sector and collaborating with other migrant, LGBT, and disability and equality interest groups.
Outcomes relating to policy interventions will be linked very speciﬁcally to the policy area that is targeted (see policy aims).
Examples of policy outcomes may include:
- Increased understanding of interventions and services offered by others (see section on partnership working).
- Written and fully implemented equalities and confidentiality policies (see associated needs).
- Improved service provider / commissioner relationships, evidenced by regular meetings and ongoing communication (see section on influencing local policy).
- Increased leadership profile promoting the well-being of African people at a local, regional or national level (see associated needs).
The following activities may help agencies unfamiliar with this type of work to begin to engage with local and national policy developments.
- Develop and maintain an up to date contact list of: local MP’s constituency ofﬁce and surgery times, key local councillors, PCT sexual health and / or HIV commissioning leads, Local Authority contacts regarding social services and housing policy, LINks contact details, and contacts in the local press.
- Maintain records of involvement in local and national policy consultations and their results, and share these with AHPN and NAT.
- Document participation in devising any local and regional sexual health and / or HIV strategies.
Monitoring and evaluation
Monitoring involvement in policy interventions (by keeping an up-to-date record of current and past activity) enables agencies to monitor their level of capacity to provide future delivery.
Evaluation of policy interventions can take on a number of forms. Document analysis can be undertaken with a discrete number of policy and other related documents (such as newspaper coverage, minutes of public meetings, or Hansard reports, for instance) covering a speciﬁed period of time. The purpose is to assess changes in the approaches or narratives used to address a particular issue before, during and following a speciﬁc intervention. Data can also be collected from those who commission, support, and deliver interventions in order to assess reasons for and impacts of shifts in particular policy areas. Finally, ongoing process evaluation undertaken throughout the life of a policy intervention can help those involved to determine the extent to which the intervention is worth continuing, what opportunities might have been missed, and to amend the intervention’s design and targets if necessary.
Page last updated: 22 July 2013
Policy network consultation updates
Knowing about policy consultations in plenty of time is key to preparation of a thoughtful response, a need which has largely been met by the National AIDS Trust’s policy network. Relevant government consultation documents and opportunities for the submission of joint responses are shared by email with the members of this network (who represent more than 80 agencies). Feedback from network members has resulted in NAT including information about the outcomes of consultations, so that members are able to follow-up and see the impact of their participation. To become a member of NAT’s policy network, send them an email.
On World AIDS Day 2008, AHPN organised a training event that aimed to familiarise participants with key issues and approaches to advocacy. This was followed by an Advocacy Day which focused on an AHPN campaign called Destination Unknown. Meetings were arranged between MPs and their constituents while others joined AHPN representatives to visit the Houses of Parliament and arrange future meetings with their MPs. The Advocacy Day was attended by religious leaders, the media, human rights advocates and members of the public. Afterwards AHPN received many more requests for assistance from MPs.