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Advocacy for immunisation

This is a space for those who are working to improve immunisation systems and access to vaccines, particularly in resource-poor settings. It aims to help you to find ideas, resources and guidance to advocate for strengthened commitment to vaccines and immunisation to save lives.

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USING THE M&E FRAMEWORK

The M&E framework provides an easy-to-follow approach to monitor and evaluate your A&C strategy.

The five steps are:

  • Implementation
  • Partnership
  • Reach
  • Effectiveness
  • Maintenance

From these five components, you can construct your own M&E framework that is appropriate to your strategy and plans. Select the approaches below that fit best with what you will be doing.

The framework can be applied at two levels:

  • Individual level

    • – which focuses on individual stakeholders (decision-makers or target audience), their actions, attitudes, and concerns.

  • Setting level

    • – which focuses on the environment individuals are in, where the project is being implemented, coalitions with different stakeholders, similar institutions, and organisations.

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WORKSHEETS

Use the worksheet provided to Implementing the M&E framework.

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THE M&E FRAMEWORK IN FIVE STEPS

Implementation

Implementation refers to the complete instalment of the project according to the initial plans:

  • Is the program being delivered as intended?
  • Are we achieving the objectives?

Implementation

What to measure in the IMPLEMENTATION component?

WHAT TO MEASURE INDICATORS: THE UNIT OF MEASUREMENT EXAMPLE

Outreach:
Stating the advocacy issue in person through one-on-one or group meetings.
  • Number of briefings or presentations held with stakeholder X.
  • Number of presentations about weakness in routine immunisation shown to district leaders.
Advocating:
Attempting to influence change by communicating with target audience: decision-makers, influencers.
  • Number of meetings or briefing held with policy makers, decision makers, influencers.
  • Number of products and tools distributed.
  • Number of events held to raise awareness.
  • Number of meetings held with Parliamentarians to discuss inclusion of routine immunisation in their agenda.

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Partnership

Partnership checks up on the support and execution of activities from all partners involved in the strategy, and the influence the partnership is having.

  • Have coalitions and/or partnerships been created to develop or advance the strategy?
  • What influence is the partnership having with other organisations?

What to measure in the PARTNERSHIP component?

WHAT TO MEASURE INDICATORS: THE UNIT OF MEASUREMENT EXAMPLE

Partnerships, coalitions or alliances:
Development of mutual beneficial relationships with other organisations which support or participate in an advocacy strategy.
  • Number of members of partnerships (by whatever name) developed, and/or increase in members over time.
  • Overall improvement in the effectiveness of the network.
  • Number of new organisations willing to collaborate with your organisation to implement the A&C strategy.
  • Survey to assess whether relationships and communications with all partners runs more smoothly.
New involved stakeholders:
New organisations not formally in the partnership that have decided to support or adopt the issue.
Funding support for the issue.
  • Number of organisations outside the partnership expressing support or taking action.
  • Total funding given by new donors.
  • Number of new and different medical associations advocating for your issue.
  • Average dollar (or relevant currency) amount given by bi-lateral donors or institutions.

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Reach

Reach is a measure of refers to the number or percentage of the audience exposed to your strategy, such as messages, products and outreach efforts:

  • What percentage of the target audience has been reached by the A&C strategy?
  • To what extent are the messages reaching decision-makers?
  • What percentage of the target audience is taking the issue into consideration?

What to measure in the REACH component?

WHAT TO MEASURE INDICATORS: THE UNIT OF MEASUREMENT EXAMPLE

Reach:
Number (or percentage) of target audience members that are exposed to your messages and ‘Ask’.
  • Number or percentage of stakeholders who have been exposed to messages, content, publications, blogs, etc.
  • Number of Parliamentarians exposed (divided by the total number of Parliament members for a percentage).
Relevance:
The importance target audience gives to the issue
  • Percentage of stakeholders stating that the issue is important to them.
  • % of Parliamentarians stating that routine immunisation is important to their agenda.

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Effectiveness/Efficiency

  • This component assesses the impact of your A&C strategy, both at the individual and setting levels.
    At the individual level:

    It can measure changes in attitudes, in knowledge levels and in the target audience’s understanding of and engagement with the issues and concerns.

    At a setting level:

    it can measure the process of change, such as:

    • Are your target audiences aware of the issue you are advocating for?
    • Have the target audiences changed their attitudes, knowledge or behavior after being exposed to your intervention?
    • Are there policy changes underway or in the plans?
    • Is there an increase in political commitment?

  • Quick tips

    Remember to conduct a baseline assessment of your target audience BEFORE you start reaching out to your target audiences so you can return later and measure the Reach and Effectiveness of your efforts.

What to measure in the EFFECTIVENESS component?

WHAT TO MEASURE INDICATORS: THE UNIT OF MEASUREMENT EXAMPLE

Awareness:
The target audience’s recognition of the issue.
  • Percentage of target audience with knowledge of the A&C issue.
  • % of paediatricians aware of the need to introduce rotavirus vaccine.
Attitudes:
Target audience’s perceptions around the A&C issues.
  • Percentage of target audience’s with favorable (unfavorable) attitudes towards A&C issue.
  • % of Parliamentarians with positive views regarding routine immunisation.
Impact:
Changes (positive or negative) in participation and engagement with the issue.
  • Initial number of participants / present number of participants.
  • Changes in knowledge about the issue.
  • Changes on the perception of the issue.
  • Changes in willingness to cooperate and coordinate
    in A&C efforts.
  • Initial # of paediatricians present at the meetings compared to present # of paediatricians attending meetings.
  • Positive changes of knowledge and attitudes of religious leaders who were skeptical about routine immunisation at the beginning of the A&C strategy.
  • # of paediatricians willing to cooperate with your organisation to take part and/or coordinate in routine immunisation strategies.
Political commitment:
Willingness of decision-makers and/or target audiences to act in support of an issue.
  • Number of times issue is mentioned in decision-makers speeches or statements.
  • Number of votes for or against a specific legislation.
  • # of times routine immunisation is present in Parliamentarians public speeches and/or writings.
  • # of votes supporting the inclusion of a routine immunisation matter into a health program.

Goals/Results:
Progress towards the change you desire – such as policy and funding changes – such as:

  • Placement on the policy agenda: appearance of the issue on the list of issues that decision-makers give serious attention to.
  • Policy/funding development: creating, amending or adopting new policy or funding proposals.
  • Policy/funding implementation: adequate implementation of a policy proposal.
  • New policy proposals developed.
  • Policies formally introduced.
  • Policies formally amended.
  • Policies formally abolished.
  • Policies formally established.
  • Policies formally blocked.
  • Policies implemented according to requirements.
  • # of new policy proposals and/or policies formally introduced, amended, abolished, established and implemented for funding of immunisation.
  • % of budget increase for immunisation schemes.
  • adoption of a budget line for immunisation

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Maintenance

Maintenance is the measure that looks at both short- and long-term changes at both individual and setting level. It is crucial to keep a close look at this component and make sure that desired changes are sustained over time.

  • Is there funding and resources to sustain the immunisation changes that have been implemented?
  • Does your organisation and/or partnership have the resources and support needed to continue to implement the strategy?

What to measure in the MAINTENANCE component?

WHAT TO MEASURE INDICATORS: THE UNIT OF MEASUREMENT EXAMPLE

Policy maintenance:
Preventing cuts or other negative changes to a policy.
  • Funding levels sustained for immunisation at the national and sub-national levels.
  • Political commitment is secure over the long-term.
  • Budget line for immunisation, and sustainable funding sources secured.
  • Funding is reaching the sub-national levels.
  • # of decision-makers and stakeholders who continue to state that immunisation efforts are important.
Organisational capacity:
The ability of the advocacy partners to maintain the initial support of the issue.
  • Sustained ability to mobilise and organise tactics.
  • Interviews with partners to determine if organising techniques are working or need to change.
Funding for ongoing advocacy and support base growth:
Sustainable funding and individuals who can be relied on for sustained advocacy on an issue.
  • Revenue and resources secured to support advocacy efforts.
  • Number of stakeholders that remain in support throughout the whole process.
  • Resources secured across the partnership to support ongoing advocacy.

  • Increase or stabilisation in the number of staff.

  • # of organisations that support your strategy from beginning to end is stable or growing.

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What M&E methods can I use to collect my data?

In the table below, you will find the most common data and evidence collection methods for monitoring and evaluation. Some are quantitative, meaning they measure or count things, others are qualitative, meaning they seek out people’s thoughts, opinions and views through interviews, statements or documents.

Depending on your resources and the results you want to achieve, you may use a single method or a combination of methods.

METHOD DEFINITION WHERE TO APPLY

Survey
(quantitative)
  • Questionnaires to collect information about advocacy views or feedback from stakeholders; performed via telephone, online, or face-to-face.
  • Implementation
  • Reach
  • Effectiveness
Document review
(qualitative/quantitative)
  • Review of reports, marketing materials, funding proposals, public statements, budgets and newsletters, etc.
  • Implementation
  • Partnership
  • Maintenance
Case study
(qualitative/quantitative)
  • Revenue and resources secured to support advocacy efforts.
  • Number of stakeholders that remain in support throughout the whole process.
  • Implementation
  • Effectiveness
  • Partnership
  • Maintenance
Observation
(qualitative/quantitative)
  • Review of the participation in advocacy events or meetings.
  • Reach
  • Partnership
Interview and Focus group (qualitative)
  • One-to-one or group discussions with stakeholders to gather detailed information about their views of the issue.
  • Implementation
  • Effectiveness
  • Maintenance

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