WEBVTT 00:00:00.000 --> 00:00:02.385 align:middle line:90% [MUSIC PLAYING] 00:00:02.385 --> 00:00:07.632 align:middle line:90% 00:00:07.632 --> 00:00:09.300 align:middle line:90% ANNA KALBARCZYK: Welcome back. 00:00:09.300 --> 00:00:12.890 align:middle line:84% In this section, I will describe the health policy triangle, 00:00:12.890 --> 00:00:16.280 align:middle line:84% a framework that outlines key considerations for good health 00:00:16.280 --> 00:00:18.860 align:middle line:84% policy making and the different factors 00:00:18.860 --> 00:00:22.800 align:middle line:90% that may affect policies. 00:00:22.800 --> 00:00:25.800 align:middle line:84% Most often, emphasis is placed largely 00:00:25.800 --> 00:00:29.190 align:middle line:84% on the content of policies for health care programs, 00:00:29.190 --> 00:00:33.500 align:middle line:84% which is shown here on the bottom left of the triangle. 00:00:33.500 --> 00:00:36.220 align:middle line:84% The health policy triangle also draws attention 00:00:36.220 --> 00:00:39.310 align:middle line:84% to the actors involved in policy reform 00:00:39.310 --> 00:00:42.940 align:middle line:84% at the international, national, and subnational levels, 00:00:42.940 --> 00:00:45.580 align:middle line:84% in addition to the processes in which policies 00:00:45.580 --> 00:00:49.000 align:middle line:84% are initiated, developed or formulated, negotiated, 00:00:49.000 --> 00:00:52.360 align:middle line:84% communicated, implemented, and evaluated, 00:00:52.360 --> 00:00:56.080 align:middle line:84% and the context within which policy is developed. 00:00:56.080 --> 00:01:00.280 align:middle line:84% These aspects together allow for more effective implementation 00:01:00.280 --> 00:01:03.900 align:middle line:84% than just considering the content itself. 00:01:03.900 --> 00:01:06.360 align:middle line:84% The triangle promotes a better understanding 00:01:06.360 --> 00:01:10.560 align:middle line:84% of the interface between context, process, and content, 00:01:10.560 --> 00:01:14.220 align:middle line:84% power relations among actors, potential alliances, 00:01:14.220 --> 00:01:16.620 align:middle line:84% and conflicts among stakeholders, 00:01:16.620 --> 00:01:18.930 align:middle line:84% and also provides the foundation for planning 00:01:18.930 --> 00:01:21.040 align:middle line:90% stakeholder engagement. 00:01:21.040 --> 00:01:23.910 align:middle line:84% Now this, of course, is a highly-simplified model 00:01:23.910 --> 00:01:27.240 align:middle line:84% of an extremely complex set of interrelationships. 00:01:27.240 --> 00:01:29.100 align:middle line:84% In reality, each of these components 00:01:29.100 --> 00:01:31.110 align:middle line:90% are influenced by each other. 00:01:31.110 --> 00:01:32.880 align:middle line:84% For example, actors are influenced 00:01:32.880 --> 00:01:35.460 align:middle line:84% by the context within which they live and work 00:01:35.460 --> 00:01:37.350 align:middle line:84% at both the macro government level 00:01:37.350 --> 00:01:39.660 align:middle line:84% and the micro institutional level. 00:01:39.660 --> 00:01:43.170 align:middle line:84% Context is affected by factors such as instability created 00:01:43.170 --> 00:01:45.630 align:middle line:90% by changes in political regime. 00:01:45.630 --> 00:01:47.940 align:middle line:84% And the process of policy making in turn 00:01:47.940 --> 00:01:52.200 align:middle line:84% is affected by actors, including the actor's position, power 00:01:52.200 --> 00:01:55.266 align:middle line:84% structure, and their own values and expectations. 00:01:55.266 --> 00:01:57.990 align:middle line:90% 00:01:57.990 --> 00:02:01.290 align:middle line:84% Let's first look at actors or stakeholders. 00:02:01.290 --> 00:02:03.150 align:middle line:84% From your experience, can you think 00:02:03.150 --> 00:02:05.700 align:middle line:84% of a list of key stakeholders to involve 00:02:05.700 --> 00:02:08.130 align:middle line:90% as part of policy engagement? 00:02:08.130 --> 00:02:11.220 align:middle line:84% Consider a program you're working on now or a health 00:02:11.220 --> 00:02:15.030 align:middle line:84% issue that you think should be a priority in your country. 00:02:15.030 --> 00:02:18.600 align:middle line:84% What stakeholders would you need to engage to move forward 00:02:18.600 --> 00:02:21.150 align:middle line:90% your program or agenda? 00:02:21.150 --> 00:02:23.130 align:middle line:84% In this health policy triangle, actors 00:02:23.130 --> 00:02:25.200 align:middle line:84% are central because they have the power 00:02:25.200 --> 00:02:29.400 align:middle line:84% to influence and be influenced by content, context, 00:02:29.400 --> 00:02:32.660 align:middle line:90% and processes. 00:02:32.660 --> 00:02:35.660 align:middle line:84% Stakeholders may be defined as individuals, groups, 00:02:35.660 --> 00:02:38.630 align:middle line:84% and organizations that can collectively and individually 00:02:38.630 --> 00:02:42.080 align:middle line:84% support the development of a strong constructive policy 00:02:42.080 --> 00:02:48.650 align:middle line:84% formulation process which must have strong ownership as well. 00:02:48.650 --> 00:02:53.190 align:middle line:84% The key questions regarding who, why, what, how, 00:02:53.190 --> 00:02:56.400 align:middle line:84% and when to engage with stakeholders is crucial. 00:02:56.400 --> 00:02:59.880 align:middle line:84% Understanding the breadth and depth of stakeholder engagement 00:02:59.880 --> 00:03:03.600 align:middle line:84% at each stage of the policy cycle, what decisions need 00:03:03.600 --> 00:03:06.480 align:middle line:84% to be made throughout policy engagement, 00:03:06.480 --> 00:03:09.400 align:middle line:90% and what form is very important. 00:03:09.400 --> 00:03:10.860 align:middle line:84% These are all aspects that should 00:03:10.860 --> 00:03:14.700 align:middle line:84% be considered when planning engagement with policymakers. 00:03:14.700 --> 00:03:17.580 align:middle line:84% Who might you engage first and why? 00:03:17.580 --> 00:03:19.560 align:middle line:84% Are there gatekeepers who need to be 00:03:19.560 --> 00:03:22.260 align:middle line:84% brought on board early or else they might later 00:03:22.260 --> 00:03:24.150 align:middle line:90% serve as a barrier? 00:03:24.150 --> 00:03:27.180 align:middle line:84% Stakeholders may be directly or indirectly affected 00:03:27.180 --> 00:03:28.860 align:middle line:90% by the policy. 00:03:28.860 --> 00:03:30.450 align:middle line:84% The range of potential stakeholders 00:03:30.450 --> 00:03:33.990 align:middle line:84% is diverse and can include target beneficiary groups, 00:03:33.990 --> 00:03:36.750 align:middle line:84% locally-affected communities or individuals, 00:03:36.750 --> 00:03:39.960 align:middle line:84% national and local government authorities, civil society 00:03:39.960 --> 00:03:44.310 align:middle line:84% actors including nongovernmental organizations, Indigenous 00:03:44.310 --> 00:03:46.770 align:middle line:84% peoples, politicians, religious leaders, 00:03:46.770 --> 00:03:50.390 align:middle line:84% the academic community, private sector entities, worker 00:03:50.390 --> 00:03:53.550 align:middle line:84% organizations, UN agencies and donors, 00:03:53.550 --> 00:03:56.410 align:middle line:84% and other special interest groups. 00:03:56.410 --> 00:03:58.890 align:middle line:84% Importantly, stakeholders may include 00:03:58.890 --> 00:04:02.300 align:middle line:84% groups that are opposed to your proposed interventions. 00:04:02.300 --> 00:04:04.710 align:middle line:84% This stake that each of these different groups 00:04:04.710 --> 00:04:07.140 align:middle line:90% has in the policy will vary. 00:04:07.140 --> 00:04:10.890 align:middle line:84% That is, not only are they for or against the policy, 00:04:10.890 --> 00:04:11.805 align:middle line:90% but to what degree? 00:04:11.805 --> 00:04:14.590 align:middle line:90% 00:04:14.590 --> 00:04:16.209 align:middle line:84% The range of potential stakeholders 00:04:16.209 --> 00:04:18.610 align:middle line:84% is diverse as I mentioned earlier 00:04:18.610 --> 00:04:21.750 align:middle line:84% and as is outlined on this slide. 00:04:21.750 --> 00:04:23.920 align:middle line:84% And the identification of key actors 00:04:23.920 --> 00:04:25.990 align:middle line:84% is a critical step in understanding 00:04:25.990 --> 00:04:28.660 align:middle line:84% how you create buy-in and from whom 00:04:28.660 --> 00:04:31.690 align:middle line:84% it must be obtained to align the various actors 00:04:31.690 --> 00:04:34.630 align:middle line:84% within the organizational framework. 00:04:34.630 --> 00:04:37.420 align:middle line:84% Understanding the role of each actor in the broader 00:04:37.420 --> 00:04:39.790 align:middle line:84% environment allows the program to start 00:04:39.790 --> 00:04:42.610 align:middle line:84% thinking through the various ways key actors will 00:04:42.610 --> 00:04:45.880 align:middle line:84% be engaged, consented, and interacted 00:04:45.880 --> 00:04:49.330 align:middle line:84% with throughout the course of the program. 00:04:49.330 --> 00:04:51.190 align:middle line:84% Multiple mechanisms may be needed 00:04:51.190 --> 00:04:55.210 align:middle line:84% to obtain commitment ranging from formal legal arrangements 00:04:55.210 --> 00:04:57.670 align:middle line:84% and informed consent to memorandums 00:04:57.670 --> 00:05:02.260 align:middle line:84% of understanding and other nonlegally-binding commitments. 00:05:02.260 --> 00:05:05.310 align:middle line:84% Two aspects of an effective engagement strategy 00:05:05.310 --> 00:05:08.200 align:middle line:84% are understanding the overlap of vital interests 00:05:08.200 --> 00:05:11.600 align:middle line:84% and creating a shared sense of local impact. 00:05:11.600 --> 00:05:15.040 align:middle line:84% Effective stakeholder engagement enhances policy acceptance 00:05:15.040 --> 00:05:18.580 align:middle line:84% and ownership and strengthens the social and environmental 00:05:18.580 --> 00:05:22.360 align:middle line:84% sustainability and benefits of supported interventions. 00:05:22.360 --> 00:05:24.910 align:middle line:84% It is both a goal in and of itself 00:05:24.910 --> 00:05:28.390 align:middle line:84% as well as an effective means for achieving policy outcomes, 00:05:28.390 --> 00:05:31.480 align:middle line:84% including those related to democratic governments, 00:05:31.480 --> 00:05:33.280 align:middle line:84% protecting the environment, promoting 00:05:33.280 --> 00:05:36.095 align:middle line:84% respect for human rights, and preventing and resolving 00:05:36.095 --> 00:05:36.595 align:middle line:90% conflict. 00:05:36.595 --> 00:05:39.160 align:middle line:90% 00:05:39.160 --> 00:05:43.360 align:middle line:84% Take a moment to watch this video, a series of interviews 00:05:43.360 --> 00:05:45.670 align:middle line:84% with Global Polio Eradication staff 00:05:45.670 --> 00:05:49.630 align:middle line:84% on engaging with local leaders across different contexts. 00:05:49.630 --> 00:05:52.100 align:middle line:90% As you watch, take notes. 00:05:52.100 --> 00:05:54.160 align:middle line:84% What are some key takeaways from this video? 00:05:54.160 --> 00:05:55.840 align:middle line:84% And how might you incorporate them 00:05:55.840 --> 00:05:57.635 align:middle line:84% into your own work moving forward? 00:05:57.635 --> 00:06:03.910 align:middle line:90% 00:06:03.910 --> 00:06:06.850 align:middle line:84% The video you just watched provided some tips 00:06:06.850 --> 00:06:09.220 align:middle line:84% on engaging with different policy makers 00:06:09.220 --> 00:06:12.340 align:middle line:84% and highlighted the importance of listening and respecting 00:06:12.340 --> 00:06:15.100 align:middle line:84% people who work within the country. 00:06:15.100 --> 00:06:17.800 align:middle line:84% In my mind, this speaks a bit to the different roles 00:06:17.800 --> 00:06:21.450 align:middle line:84% that people have within policy engagement. 00:06:21.450 --> 00:06:24.750 align:middle line:84% Let's use polio eradication as an example 00:06:24.750 --> 00:06:28.410 align:middle line:84% and consider the role of leaders at the national level. 00:06:28.410 --> 00:06:31.620 align:middle line:84% Government provides a unifying policy framework for prevention 00:06:31.620 --> 00:06:34.170 align:middle line:84% and control and establishes linkages 00:06:34.170 --> 00:06:37.420 align:middle line:84% with formal institutions for leveraging commitment, 00:06:37.420 --> 00:06:41.680 align:middle line:84% dialogue, resource mobilization, and technical support. 00:06:41.680 --> 00:06:44.580 align:middle line:84% Development partners can play a complementary role 00:06:44.580 --> 00:06:46.980 align:middle line:84% to support national efforts, including 00:06:46.980 --> 00:06:49.950 align:middle line:84% providing technical assistance and some of the others 00:06:49.950 --> 00:06:52.840 align:middle line:90% that I just mentioned. 00:06:52.840 --> 00:06:55.720 align:middle line:84% At the subnational level, policy stakeholders 00:06:55.720 --> 00:06:58.570 align:middle line:84% implement and monitor program activity. 00:06:58.570 --> 00:07:01.600 align:middle line:84% Here there is often decentralized decision making 00:07:01.600 --> 00:07:02.920 align:middle line:90% and accountability. 00:07:02.920 --> 00:07:05.260 align:middle line:84% Again, local non-government organizations 00:07:05.260 --> 00:07:08.920 align:middle line:84% can complement activities by creating demand, mobilizing 00:07:08.920 --> 00:07:11.800 align:middle line:84% communities, and identifying implementation gaps 00:07:11.800 --> 00:07:14.680 align:middle line:90% at the community level. 00:07:14.680 --> 00:07:16.540 align:middle line:84% Stakeholders at the community level 00:07:16.540 --> 00:07:19.300 align:middle line:84% may be community leaders or religious leaders 00:07:19.300 --> 00:07:21.670 align:middle line:84% or also members of the community itself 00:07:21.670 --> 00:07:25.540 align:middle line:84% who may experience impacts from the health policy or program. 00:07:25.540 --> 00:07:28.570 align:middle line:84% Community members can empower families, individuals, 00:07:28.570 --> 00:07:32.050 align:middle line:84% and decision making and form bonding relationships 00:07:32.050 --> 00:07:36.220 align:middle line:84% within the community to improve readiness for implementation. 00:07:36.220 --> 00:07:37.930 align:middle line:84% Community-based organizations may 00:07:37.930 --> 00:07:41.470 align:middle line:84% be able to facilitate reaching harder-to-reach populations, 00:07:41.470 --> 00:07:44.200 align:middle line:84% including the socioeconomically disadvantaged, 00:07:44.200 --> 00:07:46.210 align:middle line:84% and can also help bridge relationships 00:07:46.210 --> 00:07:51.110 align:middle line:84% with other communities to address inequities. 00:07:51.110 --> 00:07:54.260 align:middle line:84% We will now discuss both the content and process components 00:07:54.260 --> 00:07:56.040 align:middle line:90% of the triangle. 00:07:56.040 --> 00:07:59.480 align:middle line:84% Content again is the substance of a particular policy 00:07:59.480 --> 00:08:03.440 align:middle line:84% which details the subjects and topics covered. 00:08:03.440 --> 00:08:06.920 align:middle line:84% And process is the way in which policies are initiated, 00:08:06.920 --> 00:08:09.560 align:middle line:84% developed, negotiated, communicated, 00:08:09.560 --> 00:08:12.030 align:middle line:90% implemented, and evaluated. 00:08:12.030 --> 00:08:14.780 align:middle line:84% Kingdon's model, which I'll describe in a moment, 00:08:14.780 --> 00:08:19.750 align:middle line:84% highlights the three streams of this policy process. 00:08:19.750 --> 00:08:22.220 align:middle line:84% The problem stream captures the attention 00:08:22.220 --> 00:08:25.160 align:middle line:84% of the public, government, and health officials 00:08:25.160 --> 00:08:27.560 align:middle line:84% and is considered a very first step 00:08:27.560 --> 00:08:30.620 align:middle line:84% in formulating a policy or a change in strategy 00:08:30.620 --> 00:08:32.970 align:middle line:90% to address a problem. 00:08:32.970 --> 00:08:37.039 align:middle line:84% So this is really the perception of a problem as a public matter 00:08:37.039 --> 00:08:41.070 align:middle line:90% requiring government action. 00:08:41.070 --> 00:08:43.429 align:middle line:84% The second stream is the policy stream, 00:08:43.429 --> 00:08:47.330 align:middle line:84% which encourages debate and discussion and further analysis 00:08:47.330 --> 00:08:50.390 align:middle line:84% of the problem and the proposed solutions. 00:08:50.390 --> 00:08:52.880 align:middle line:84% This stream also helps in narrowing down 00:08:52.880 --> 00:08:55.460 align:middle line:84% the problem and the possible solutions which 00:08:55.460 --> 00:08:57.890 align:middle line:84% are doable within a given timeframe 00:08:57.890 --> 00:09:01.670 align:middle line:84% and are acceptable to the public. 00:09:01.670 --> 00:09:03.800 align:middle line:84% The final and the third stream is 00:09:03.800 --> 00:09:06.680 align:middle line:84% to feel the pulse of the political leadership's 00:09:06.680 --> 00:09:10.520 align:middle line:84% interest, the nation's mood, changes in government, 00:09:10.520 --> 00:09:12.800 align:middle line:84% and the priorities of interest groups. 00:09:12.800 --> 00:09:17.380 align:middle line:84% And this is described as the political stream. 00:09:17.380 --> 00:09:21.340 align:middle line:84% It's by aligning these three streams that the policy 00:09:21.340 --> 00:09:23.800 align:middle line:90% process can move forward. 00:09:23.800 --> 00:09:27.400 align:middle line:84% The three streams often remain as separate streams. 00:09:27.400 --> 00:09:29.380 align:middle line:84% And advocacy efforts or strategies 00:09:29.380 --> 00:09:34.000 align:middle line:84% are needed to merge them and to identify this policy window. 00:09:34.000 --> 00:09:36.820 align:middle line:84% That is an ideal opportunity for advocates 00:09:36.820 --> 00:09:38.950 align:middle line:84% to bring attention to their issues 00:09:38.950 --> 00:09:41.290 align:middle line:84% and to craft and implement solutions. 00:09:41.290 --> 00:09:44.750 align:middle line:90% 00:09:44.750 --> 00:09:48.160 align:middle line:90% Finally, let's discuss context. 00:09:48.160 --> 00:09:49.750 align:middle line:84% It is important to take into account 00:09:49.750 --> 00:09:53.800 align:middle line:84% contextual opportunities and constraints to policy change 00:09:53.800 --> 00:09:56.920 align:middle line:84% or those factors including situational, structural, 00:09:56.920 --> 00:10:00.490 align:middle line:84% cultural, et cetera that are unique to a specific setting 00:10:00.490 --> 00:10:01.810 align:middle line:90% and time. 00:10:01.810 --> 00:10:05.650 align:middle line:84% And these condition the limits of policy change or influence, 00:10:05.650 --> 00:10:09.660 align:middle line:84% which is that policy window that I described previously. 00:10:09.660 --> 00:10:13.140 align:middle line:84% Policies are implemented in complex, multifaceted, 00:10:13.140 --> 00:10:15.840 align:middle line:84% and dynamic environments, which arguably 00:10:15.840 --> 00:10:18.570 align:middle line:84% means that the same policy intervention would rarely 00:10:18.570 --> 00:10:22.260 align:middle line:84% work in the same way in different contexts or even 00:10:22.260 --> 00:10:25.550 align:middle line:84% in the same location but at different times. 00:10:25.550 --> 00:10:29.470 align:middle line:84% So we need structured and comprehensive conceptualization 00:10:29.470 --> 00:10:32.800 align:middle line:84% and assessment of context within the implementation 00:10:32.800 --> 00:10:35.110 align:middle line:90% of policy interventions. 00:10:35.110 --> 00:10:38.770 align:middle line:84% Context is not so much a backdrop for implementation 00:10:38.770 --> 00:10:42.430 align:middle line:84% but rather interacts, influences, modifies, 00:10:42.430 --> 00:10:45.250 align:middle line:84% and facilitates or constrains the intervention 00:10:45.250 --> 00:10:49.040 align:middle line:90% and the implementation effort. 00:10:49.040 --> 00:10:52.260 align:middle line:84% The PESTLE framework captures contextual factors 00:10:52.260 --> 00:10:55.080 align:middle line:84% that influence implementation of programs 00:10:55.080 --> 00:11:00.690 align:middle line:84% and are in turn influenced by the implementation of programs. 00:11:00.690 --> 00:11:03.200 align:middle line:84% There are six core dimensions of this framework. 00:11:03.200 --> 00:11:05.610 align:middle line:84% And I'll provide some examples of contextual factors 00:11:05.610 --> 00:11:09.150 align:middle line:84% within the polio eradication initiative that influenced 00:11:09.150 --> 00:11:11.730 align:middle line:90% the program at each level. 00:11:11.730 --> 00:11:14.760 align:middle line:84% At the political level, we could think about instability, 00:11:14.760 --> 00:11:18.510 align:middle line:84% geopolitical shifts, and variable commitment and program 00:11:18.510 --> 00:11:20.880 align:middle line:90% ownership by different groups. 00:11:20.880 --> 00:11:23.010 align:middle line:84% Economically, there were a lack of finances 00:11:23.010 --> 00:11:24.870 align:middle line:84% sometimes to support the initiative 00:11:24.870 --> 00:11:27.810 align:middle line:90% or to support emerging needs. 00:11:27.810 --> 00:11:29.460 align:middle line:84% At the social level, we sometimes 00:11:29.460 --> 00:11:34.480 align:middle line:84% saw misinformation or competing priorities for the community. 00:11:34.480 --> 00:11:36.270 align:middle line:84% We've also seen the role of gender norms 00:11:36.270 --> 00:11:38.940 align:middle line:84% both within communities and polio eradication 00:11:38.940 --> 00:11:41.010 align:middle line:84% organizations that needed to be accounted 00:11:41.010 --> 00:11:43.900 align:middle line:90% for for implementation. 00:11:43.900 --> 00:11:47.860 align:middle line:84% Legally, we could consider a legal or policy recourse. 00:11:47.860 --> 00:11:49.660 align:middle line:84% And at the technological level, there 00:11:49.660 --> 00:11:53.320 align:middle line:84% were so many innovations such as mobile and tablet-based data 00:11:53.320 --> 00:11:57.160 align:middle line:84% collection and GIS mapping that emerged in response to needs 00:11:57.160 --> 00:11:59.327 align:middle line:90% to the polio program. 00:11:59.327 --> 00:12:00.910 align:middle line:84% And finally, environmentally, we could 00:12:00.910 --> 00:12:04.060 align:middle line:84% think about population density and geographical 00:12:04.060 --> 00:12:07.270 align:middle line:84% access to areas, which can make some populations harder 00:12:07.270 --> 00:12:09.320 align:middle line:90% to reach. 00:12:09.320 --> 00:12:11.330 align:middle line:84% Also, of course, political priorities 00:12:11.330 --> 00:12:14.690 align:middle line:84% are based on many factors like I've just described. 00:12:14.690 --> 00:12:16.520 align:middle line:84% And sometimes, unfortunately they're 00:12:16.520 --> 00:12:19.430 align:middle line:84% not driven by public health research evidence 00:12:19.430 --> 00:12:24.340 align:middle line:84% but rather by other factors as well or instead of. 00:12:24.340 --> 00:12:26.020 align:middle line:84% I'd like to end by describing two 00:12:26.020 --> 00:12:28.330 align:middle line:84% examples of a similar strategy that 00:12:28.330 --> 00:12:32.080 align:middle line:84% was used in polio eradication but in two different contexts 00:12:32.080 --> 00:12:35.620 align:middle line:90% both dealing with conflict. 00:12:35.620 --> 00:12:38.200 align:middle line:84% Nigeria and Afghanistan are two countries 00:12:38.200 --> 00:12:39.910 align:middle line:84% that have struggled with conflict, 00:12:39.910 --> 00:12:42.130 align:middle line:84% which has made many populations harder 00:12:42.130 --> 00:12:44.710 align:middle line:90% to reach by the polio program. 00:12:44.710 --> 00:12:46.750 align:middle line:84% In both settings, different approaches 00:12:46.750 --> 00:12:49.060 align:middle line:84% to community and political engagement 00:12:49.060 --> 00:12:53.020 align:middle line:84% helped the program access some turbulent regions. 00:12:53.020 --> 00:12:56.530 align:middle line:84% One GPEI staff member at the global level 00:12:56.530 --> 00:13:00.250 align:middle line:84% described this in Nigeria and said, 00:13:00.250 --> 00:13:02.380 align:middle line:84% "If you take Nigeria, for example, where 00:13:02.380 --> 00:13:04.960 align:middle line:84% we had a case I think in August 2016 00:13:04.960 --> 00:13:07.180 align:middle line:84% in the Northeast, which is Borno, 00:13:07.180 --> 00:13:09.940 align:middle line:84% they were dealing with this Boko Haram factor. 00:13:09.940 --> 00:13:13.480 align:middle line:84% We were unable to access I think around 600,000 00:13:13.480 --> 00:13:15.620 align:middle line:90% children in those areas. 00:13:15.620 --> 00:13:17.320 align:middle line:84% And then the program came up again 00:13:17.320 --> 00:13:19.810 align:middle line:84% with a number of innovative strategies. 00:13:19.810 --> 00:13:21.490 align:middle line:84% There was engagement of military. 00:13:21.490 --> 00:13:24.580 align:middle line:84% And participation of imams was requested. 00:13:24.580 --> 00:13:26.470 align:middle line:84% There was a high political commitment 00:13:26.470 --> 00:13:27.975 align:middle line:90% that it was supporting." 00:13:27.975 --> 00:13:30.890 align:middle line:90% 00:13:30.890 --> 00:13:34.040 align:middle line:84% In conflict areas, militant or religious groups 00:13:34.040 --> 00:13:37.300 align:middle line:84% are important stakeholders to consider. 00:13:37.300 --> 00:13:41.770 align:middle line:84% In this next example, Taliban, who are Muslim fundamentalists, 00:13:41.770 --> 00:13:46.300 align:middle line:84% released fatwas denouncing vaccination as an American ploy 00:13:46.300 --> 00:13:49.400 align:middle line:90% to sterilize Muslim populations. 00:13:49.400 --> 00:13:53.950 align:middle line:84% So here high-profile endorsement by political, international, 00:13:53.950 --> 00:13:56.440 align:middle line:84% and military figures in Afghanistan 00:13:56.440 --> 00:13:58.030 align:middle line:84% might actually be counterproductive 00:13:58.030 --> 00:14:01.060 align:middle line:84% in nonsecure areas as anti-government elements 00:14:01.060 --> 00:14:03.460 align:middle line:84% would likely oppose high-priority government 00:14:03.460 --> 00:14:05.080 align:middle line:90% programs. 00:14:05.080 --> 00:14:06.760 align:middle line:84% Therefore, different stakeholders 00:14:06.760 --> 00:14:09.520 align:middle line:84% had to be considered to access populations 00:14:09.520 --> 00:14:12.930 align:middle line:90% living in these conflict areas. 00:14:12.930 --> 00:14:15.990 align:middle line:84% These two examples showcase why careful planning 00:14:15.990 --> 00:14:18.930 align:middle line:84% and consideration of context is so important. 00:14:18.930 --> 00:14:21.900 align:middle line:84% One strategy, even in terms of engagement, 00:14:21.900 --> 00:14:25.170 align:middle line:84% is not likely to be successful in all places. 00:14:25.170 --> 00:14:28.350 align:middle line:84% As you move forward and think about the importance of policy 00:14:28.350 --> 00:14:31.440 align:middle line:84% engagement, remember, when done successfully, 00:14:31.440 --> 00:14:35.280 align:middle line:84% it can yield buy-in, provide access to resources, 00:14:35.280 --> 00:14:41.790 align:middle line:84% and facilitate implementation in diverse and complex contexts. 00:14:41.790 --> 00:14:44.540 align:middle line:90% [MUSIC PLAYING] 00:14:44.540 --> 00:14:49.000 align:middle line:90%