A three-pronged approach to advocacy for sustainable national funding

By and large, the financial commitments 179 nations made to the family planning and reproductive health components of ICPD in 1994 were not kept. While donors ramp up support for civil society advocacy in developing countries, in hopes of improving national funding and outcomes, recent trends in advocacy evaluation leave unanswered the broader question of whether/how international campaigning can appropriately and effectively strengthen national-level decision-making. This article provides background regarding the challenges in monitoring developing country contributions; summarizes current donor initiatives to strengthen civil society advocacy; and reviews theoretical approaches to assessing advocacy. The author identifies major advocacy limitations and proposes a three-pronged approach to harmonize international and national advocacy messages for improved, sustained increases in health funding and outcomes, namely, that local accountability is paramount, that national health programmes must be designed as legally binding entitlements, and that pro-health values and norms must be strengthened.