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African-generated Evidence must be at the Forefront of Decisions Helping to Transform African Lives - Patterson Siema

Patterson Siema is an all-round policy engagement, communications, and advocacy professional with 18 years’ experience. He holds the 2017 Daystar University, Outstanding Alumni Award in recognition of his exemplary contribution to the corporate communications field. He joined APHRC as the Director of Policy Engagement and Communications from the United Nations Gender Entity, UN Women, where he was the communications and advocacy specialist for Eastern and Southern Africa. He previously was the communications specialist for the United Nations Development Program. In this interview, he shares invaluable insights with Engage Africa Foundation's Elias Gbadamosi on how Africa can leverage effective policy engagement and communication strategies to improve positive public health outcomes across the Continent. Patterson can be reached on Instagram and Twitter @pksiema.  

What does policy engagement mean in the context of public health?

APHRC researches critical health and wellbeing issues. Our research teams orient their research agenda according to global and continental development priorities, driven by the belief that Africa and African-generated evidence must be at the forefront of decisions helping to transform lives on the African continent. To transform lives, we must translate the research findings into national and or local policies.  It is the process of working with policy actors, communities, and other stakeholders to ensure that policies are informed by research that we refer to as policy engagement.

In what ways do the APHRC’s Policy Engagement and Communications arm advance positive public health outcomes across Africa?

APHRC has two models on how to engage in the policy space to ensure that evidence is at the core of decision-making and resource allocation at both the sub-national, national, and regional levels. One is a collaboration between the Center’s policy engagement and communications experts and the various research teams and the second is exporting those knowledge translation initiatives to other institutions, both academic and community-based. The ultimate goal of these parallel and routinely integrated series of activities is to ensure the most effective, and cost-effective, policies are well-resourced and widely implemented to transform lives on the continent.

We are also ensuring that the communities we serve and draw our findings from are included in our dissemination activities, to act both as a form of demand-generation for the kinds of interventions that have been proven to work as well as a form of community-level accountability for their elected representatives. One target audience for these new approaches is the young people for whom youth-friendly services are being proposed – to make sure that decision-making about their health and wellbeing takes their needs and interests into consideration.

We are also exporting our evidence to action model through a series of advocacy driven initiatives in maternal and child health; improved domestic finance for and coverage of immunization as a cornerstone of stronger health systems; and integration of non-sewer sanitation options into national strategies for fecal waste management.

From your decades of experience as a policy engagement and communications specialist with organizations including UN Women and Africa Population and Health Research Center (APHRC), why do you think Africa’s health sector is struggling?

Over time, Africa has put in place the right policies, so the foundation for improving the health indicators for the African population exists. However, the biggest challenge is the commitment of African leaders to allocate sufficient resources. This lack of investment has resulted in very weak health systems across the continent. If you take the Abuja declaration, which countries committed to investing at least 15% of their budget on health, 20 years down the line this has not happened, only South Africa and Rwanda are on track to meet this commitment. In fact, only about 10 African counties offer free universal healthcare to its citizens. Healthcare is consequently out of reach for the majority of Africans.  This needs to urgently change and that is why APHRC is working with various stakeholders to build their capacity to advocate and ask for more investment in health by governments and funding institutions to prioritize health and allocate sufficient resources. Also, while investing in the health sector, it is important to take into consideration the spirit of SDGs and leave no one behind. Many disenfranchised groups are not able to access public healthcare especially women, young people, and those living in rural communities among others.

What role will effective Policy Engagement and Communications play towards the achievement of positive public health outcomes in Africa?

It is important that the decisions on public health mirror tangible evidence that is backed by research and empowers all stakeholders to make the right decision. Policy engagement, therefore, plays an important role in oiling the adoption of the right practices for improved health outcomes. At APHRC for example we have projects such as the innovating for Maternal and Child Health in Africa which aims to reduce infant and maternal mortality rates in some of the most dangerous countries for women to survive labor and delivery of healthy babies. Working with 13 teams in six countries, including the fragile state of South Sudan, APHRC is helping researchers and policymakers find a common language and common ground for strategies to ensure fewer women die while giving life. This has included a series of targeted training and workshops in research methods as well as the regular convening of stakeholder meetings to present interventions that could contribute to a country’s execution of its national strategy for Maternal, newborn, and child health.

What health policies would you recommend that African countries focus on if they are keen on actualizing SDG 3 (Good Health and Wellbeing) by the set date of 2030?

As more Africa survive childhood mortality from infectious diseases as a result of improved public health interventions, chronic diseases are becoming the leading cause of death and disease. However, as the continent becomes more affluent, we are witnessing changing means of production, increased pollution, and a shift in the people’s lifestyle.  This has ultimately resulted in an increased burden of non-communicable diseases.  This is happening when we are witnessing a persistent high burden of infectious diseases such as HIV/AIDS, Tuberculosis, and malaria. All these are straining the health systems on the continent and policy actors must put in appropriate measures to counter this emerging trend if we are to meet the SDG goal on good health and wellbeing.

Bringing people together to create change could be an effective way to improve people’s health. How can local, suburban, and urban communities across Africa organize strategically to achieve common health goals?

In the recent past, citizen engagement or advocacy has gained increased prominence in Africa. We are witnessing new spaces for public involvement and engagement at the local, national, and global levels. However, as citizen engagement becomes central in social transformation including championing for health access, it needs to be executed effectively and within a realm of power politics to ensure meaningful engagement in the policies and decisions that affect people’s lives. More important is that communities must take up this responsibility and carry it out well. This, therefore, calls for sector players to actively build the capacity of the communities to take ownership and drive the health access agenda.

Do you have examples of communities that have successfully leveraged community organizing to improve public health outcomes in Africa?

APHRC is implementing the Immunization Advocacy Initiative, which brings together civil society organizations in East and West Africa to advocate and drive policy change to encourage more allocation of resources to immunization by middle-income countries in Africa. We are currently working with over twelve CSOs in three countries Ghana, Ivory Coast, and Kenya, to enable and support them to advocate for increased domestic financing for immunization and broader health initiatives. Our achievements in this project include building stronger, better coordinated in-country civil society networks that are armed with appropriate knowledge and skills. These networks have been able to drive policy change and increase domestic investment in national immunization programs.

What actionable steps can we take at individual and community levels to protect ourselves from the deluge of fake health information that threatens our health in this age of digital and fast news?

Infodemic is a critical public health issue that must be managed, unfortunately, the increased use of digital media especially the advent of smartphone communications in Africa has made the generation of false news quick and also very easy to propagate.  This situation has been witnessed more during the Covid-19 period, where we have seen an increase of information flowing to the general public on the pandemic and related topics. Unfortunately, most of the information shared is false and misleading to the public and sometimes policymakers. Infodemic propagates misinformation, disinformation, and rumors during a health emergency and can hamper an effective public health response and create confusion and distrust among people.  Unfortunately, the low level of science literacy in Africa has created a fertile environment for infodemic. Public health practitioners must therefore be at the forefront of addressing this misinformation and disinformation and create structured, organized, and consistent ways of sharing the right information. This also calls for strong collaborations and partnerships with the mainstream and emerging media organizations to share the correct information.

One of the most popular sustainable development maxims is “Leave No One Behind”. However, people who live in Africa’s rural, hard to reach communities seldom can contribute their views to the formulation of health policies that impact them directly. How can policymakers reach these communities to ensure that they are not left behind as far as important health policies are concerned?

The voices of rural communities are seldom heard, and there is a risk that they could be left behind. However, Africa is witnessing massive transformation in its governance structures. Many countries are putting in place devolved systems of governance with elected leaders. Engaging these leaders is one way through which we can listen to the views of the rural communities. Besides, policy actors must identify existing communications mechanisms. This could include the use of community radio stations which are very useful, working with traditional leaders and rulers, engaging faith-based institutions, and their leaders. We must further invest in research that is designed to reach rural communities and or any group that could be left out.

Multi-sectoral collaborations across and within countries have been touted as one of the best ways to galvanize positive public health outcomes in Africa. However, the divergent political context of each African community/country remains a major impediment. Are there ways that these governments can exploit to sustain multisectoral collaborations to our advantage despite this nagging impediment?

One way of addressing this challenge is to work with regional economic blocks like the African Union, the East African Community, Southern Africa Development Community, and ECOWAS. These institutions have elaborate mechanisms that ensure policies trickle down and are implemented at the country level. As a policy actor, working with these institutions requires commitment and resources through people and money.

Thank you Patterson for shedding more light on how policy can drive health change and sharing these insightful examples with us.

About the author: Driven by an avid interest in sustainable development, Elias Gbadamosi’s research and teaching interests lie at the intersection of civic engagement, policy development, and communications. He is a graduate student currently researching how governments and their agents can effectively communicate social policies to citizens in a bid to cultivate civic trust, foster inclusive governance, and accelerate sustainable development outcomes.

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