Power in the hands of local advocates: what does it take?

Advocacy for health sector changes in low- and middle- income countries (LMICs) should be locally driven. Our team has therefore been working to increase the power that local advocates have over policy decisions. Through discussions with the advocates that we support and with sector partners, we have started to make practical sense of how the colonial legacy of development affects our small but important project. Helen Ekpo, our Senior Impact and Sustainability Advisor in Nigeria, shares her ideas on our learnings and how projects should change how they support advocates.

“We don’t have strategic plan for our organisation because we only respond to request for proposals from donor organisations based on the donors focus and requirements…. the important thing is getting funds to address gaps identified in their request for proposals…”

I was startled when I heard an advocate speak these words during a workshop hosted by my team under the ‘Evidence for Action (E4A)-MamaYe’ project in Nigeria. If civil society in my country do not set the agenda, but are only implementors for donor agencies, what does this mean for health governance? This is one of the effects of “colonisation in aid” where civil society advocates are used to respond to what international donors think are the needs of the population.

Decolonisation of foreign aid

Colonisation “refers to the idea that western researchers and practitioners impose their ideas on countries with low resources, without involving people from those places and while controlling key resources such as money”. This is especially the case in post-colonial countries that receive conditional loans from the rich ‘developed’ and often ex-coloniser countries. Foreign aid has been seen by some, as an extension of colonialism.

This has paved the way for calls from activists, scholars, and practitioners, especially in the global South, to ‘decolonise foreign aid.’ However, as this term is gaining new popularity, many struggle to articulate the structural issues of the colonial legacy of development assistance, how these structures shape development assistance today and the practical steps that we working in the sector can take to address these.

Development assistance’s colonial legacy

As a Nigerian public health expert, I have experienced first-hand how the colonial foundations of official development assistance shaped donor-funded health programmes. I have worked for several international organisations where projects for Nigerian communities are developed by project leads based in the global North, while local staff are relegated to the side-lines during the process. I struggled to interpret these foreign project designs, trying to implement them in a way that translated to improved health care services.

The de-facto experts often travelled down on short-term trips to provide trainings which were sometimes insensitive to the socio-cultural needs of the people. I have also seen project results developed into abstracts and presented in international conferences (mostly held in the West) by our global North project leads. Projects would have been more effective if truly driven by those with a deep understanding of the context that shapes the problems that projects aim to solve.

  • Civil Society leader speaking in a forum
    Civil Society leader speaking in a forum

Resourcing local civil society initiatives

The push to reform foreign aid comes as the coronavirus pandemic has showcased the capabilities of local people who continued working long after their American and European bosses flew home to the relative safety of their own countries. However, the effort to put more money and power over aid into the hands of the communities it is meant to benefit is not new. In 2010, USAID’s administrator, Raj Shah, committed to ramping up the amount of American aid that goes directly to local and national groups and local government entities, to 30 percent from about 10 percent. That target has never been met, partly because government funding comes with burdensome paperwork requirements that large American aid contractors are used to handling, but that tend to strangle smaller organisations.

However, a rapid shift in funding to local organisations and communities will be futile unless they have the financial management systems and capacity to receive these funds. Donor funding requirements should be made flexible to enable local organisations to access these funds to drive their own agenda. As discussions and steps towards decolonisation of aid to African countries gains traction around the world it is important to ask ourselves how development aid organisations can play an interim role by supporting this transition in a way that enables local organisations and networks to lead development and policy agendas. This needs to be done in a way that does not reinforce or continue current power imbalances, requiring shifting existing norms, redesigning our approaches to providing technical assistance, and unlearning existing ways of working that perpetuate power imbalances.

What can projects do?

During recent years our project team started to ask ourselves: what can we do to shift the power imbalances that grip the sector in which we work? While recognising that we are managed by an organisation that has its headquarters in the United Kingdom and funded through a US-based donor, what can we do to serve as a ‘transition vehicle’ that prepares advocacy coalitions and CSOs to take power in the own hands?

In response to these questions, we redesigned our support to civil society advocates in a way that puts them in the ‘driving seat’ to independently advocate for the maternal, newborn, and reproductive health issues that are a priority to them. Based on this work, lessons that I would like to share with development partners and donors are:

  1. Shared meaning of sustainability: Sustainability is a word that is used frequently in our sector. International agencies are often tasked with making their project interventions ‘sustainable’. However, sustainability cannot be achieved through a one-way process (from donor to recipient). When E4A discussed with advocates what “sustainability” really means, this concept evolved into a much more complex definition, which interrelates with movements towards the decolonisation of aid, ethics of what voluntary coalitions can be expected to do and where they can be expected to source for funds. It is therefore important to discuss and agree with project counterparts what sustainability means for them and what steps needs to be taken to achieve this before introducing systems and approaches that are not sufficiently in line with future goals, or too complex, costly or time intensive to continue without external resourcing.
  2. Flexible funding: it is important to recognise that some advocates operate in formal CSOs whereas others operate through collaborative groups that function in different ways depending on the context. Therefore, not all advocates or advocacy groups are set up to mobilise or receive funds from external partners. Supporting advocates requires flexible funding methods that are customised to meet their specific context and needs.
  3. Be conscious and intentional about preventing ‘elite-capture’: Development agencies often select CSOs or advocates that are already well-resourced and are part of the establishment. Such coalitions are often male dominated and are not representative of those most affected by poor health services. Development organisation need to be intentional about supporting civil society organisations and advocates that are truly representative of those affected by poor quality health services.
  4. Demand-based approach to development assistance: Development organisations should be accountable to providing support that is responsive to local demands, rather than global agendas. Local CSOs should be supported to assess their own needs and capacity, develop capacity strengthening plans, and reach out to partners to provide them with the support they need. This approach increases ownership, placing them in the driving seat of change. CSOs should be provided with mechanisms for complaint in case support does not meet agreed standards.
  5. Capacity support by those who ‘speak your language’: Training and mentoring is less effective if this is provided by those that do not share your lived experience. Most effective support is provided through ‘peer-to-peer learning’ or use of foreign training materials that have been adapted to fit local context.

Development aid organisations need to position themselves as allies, helping and supporting local advocates to achieve their desired change. They should support the transition to more effective forms of support to local organisations and by intentionally working to take practical steps to dismantle colonial power dynamics. This is key to building a strong and resilient civil society that can perform its crucial role in holding those in power accountable for providing quality health services.

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