Watch 5 minute video clip on evidence-based information and policy change: WMV (2.3mb)

My name is Sin Somuny and I am an Executive Director of Medicam. Medicam is a membership organisation for NGOs active in the health sector in Cambodia. We currently represent 117 NGOs. Medicam's mandate focuses on information sharing. We share a lot of information by providing monthly bulletins and publications in the health sector to inform the policy-makers as well as the health professionals in the field, including government policy-makers, donors and NGO implementers. We have also a database for NGOs and geographical mappings for sharing information. We also have a website and library resources in order to share information among the health sector players.

Medicam's second mandate is to facilitate advocacy work. The health sector covers a large spectrum - there are more than a hundred NGOs working in many different areas of health - so in order to get best practices into policy and advocacy processes, we have established different working groups for NGOs in different areas. For example, we have a working group on reproductive health, a promotion working group and a child survivor working group. Those NGOs that are working specifically on reproductive health have joined together as a working group in order to help facilitate advocacy. Those working in child survival are working together in order to bring consistent messages to the policy-makers.

Thirdly, we are building capacity for partners. We have two capacity building programmes. One is called BMCC, which builds management capacity for local NGOs and focuses on organisational development issues such as strategic planning, human resource management, financial management, proposal writing and evaluation, and so on. The other component is called PNCB, Provincial Network Capacity Building, which focuses on expanding the mini-cab services to the regional areas and the grassroots levels, as well as feeding the grassroots-level voice back into policy-making processes. In the PNCB programme, there is one programme for training, which focuses primarily on health-related topics. It is mainly about communicating existing policies to the grassroots-level NGOs, which may not otherwise understand what the existing policies are, in order to maximise their impact in terms of implementation at the grassroots levels.

We are representing civil society in many significant fora, such as the conservative group meeting, where donors and high-ranking government officials meet together to discuss government agendas as well as financing issues. So that is a brief overview of Medicam is all about.

Let me give you one specific example of a successful experience that we have had in terms of bringing best practice or evidence-based information into policy development or policy change. Over several years, we have worked together with the reproductive health working group in order to advocate for men to be integrated into reproductive health policy. There are about 15 NGOs in the reproductive health working group, and they work together to identify the priority policy bottlenecks in terms of improving reproductive health in Cambodia. The priority issue in all the areas of policy bottleneck is male involvement in reproductive health, which is still not fully integrated into policy. So after identifying the topic, the group were able to work together on policy analysis to make sure that all the existing policy is now in place and that they have integrated male involvement into the policies or the strategies.

The group of NGOs under the facilitation, coordination and leadership of Medicam are also trying to collect experiences of projects implemented by NGOs, such as the Reproductive Health Association of Cambodia and the Reproductive and Childs Alliance (funded by USAID and CARE International in Cambodia). They have been working to involve men in their programme, for example. Usually it is only women who are invited to go to listen to the counselling about how to take care of their health during pregnancy, but NGOs have been inviting the husband to come so that he understands how to take care of his wife, because often his behaviour in many areas affects the woman's health. This means that it is very important that the man also gets the messages and understands, so that his behaviour can help to improve the woman's health. After having these in-country experiences that have shown that involving men in the reproductive health process has produced some good results, we also collected other evidence from different countries such as China, and we put all of the information together into a very short two-page fact sheet including 'killer data' or 'killer facts' and key messages on the results and the outcomes.

We have another group, which we call a support group network, that delivers the fact sheet after we have developed it. They go to the primary networks of the policy-makers, have meetings with them and try to explain where this experience has resulted in good outcomes in terms of male involvement in the process - not only in terms of how male behaviour effects women, but also in terms of promoting male services as well. In Cambodia, we mostly have child health centres, which should be called family health centres where parents and couples are included in the process as well, and this is something else that we are trying to advocate in terms of what we mean by male involvement. So the support networking group goes to meet with the prime minister and the networks of the policy-makers to try to explain and get their support.

The next step is to hold stakeholder meetings, to which we invite policy-makers, donors and key players in the health sector, as well as guest speakers from the USAID headquarters in Washington. We also invite very famous and prestigious people from UNEPA to convince stakeholders and policy-makers how important it is to involve men in the process if we want to improve reproductive health. Then the workshop, with the government policy-makers in attendance, comes to the conclusion that we do need to develop male involvement guidelines. But these are not stand alone guidelines, rather they will be principles that can be integrated into policy and strategies. That is what we really want. From there, we develop draft principles for male involvement. Then we invite key policy-makers from other sectors as well, such as the education sector and the ministry for women's affairs. Key decision-makers such as the minister of health are also included in this roundtable discussion in order to help finalise the concept of male involvement. At the roundtable, we facilitate, discuss and debate.

One very important lesson that we have learnt through this is that, because we can already provide killer facts, good information and concrete results that have been shown in-country as well as outside the country, and we get the people around us who are already supporting our ideas, the roundtable will look like it is just to formalise a process that everyone has already accepted. From this, we have the principle and concept for male involvement and later on, the Minister of Health established different working groups to develop reproductive health strategies. They have invited us as members of the reproductive health NGO working group to meet together in order to integrate male involvement into each step of the reproductive health strategy. Now they use this male involvement principle and concept as an attachment to the national reproductive health strategy paper. I think that the lesson learnt from this is that if you have good evidence-based information, this information needs to be brought not only to policy-makers, but also to all those who are networking around the policy-makers. We also need to understand the timing for discussion and to involve all the stakeholders, including those donors who support us as well as the famous and prestigious people who are supporting this movement in other countries. This was very successful experience in getting evidence into policy development.

How did you go about identifying the primary network of the policy-makers?
Medicam represents a link or bridge between NGOs and the government of Cambodia. As a result, at Medicam we work a lot with the Ministry of Health, the Ministry of Education and the Ministry of Women's Affairs, so we know exactly who the relevant people are. It is very important that we are able to identify the people that we need to talk to in our advocacy and representation. We need to know who the relevant Ministers are, and those in whom we can have trust and confidence. Because we already know and work with all the people in the working group, it is very important that they tell us all the people with whom we need to make contact. Because Medicam is a network, it can bring those working group members to meet with the primary networks and the policy-makers.

Can you tell us more about the type of sources you were using for your 'killer facts'?
Because the male involvement policy is not in place yet, we really cannot get any statistics to use as proof of its benefits. The statistics that we use are from the work of NGOs over one or two years, where they have some good data on baselines from before the start of the project to compare with data from the end of the project. We use that information from the various NGOs in our fact sheet or as part of our 'killer facts'. We also get data from international sources where there have been good results from male involvement. We use public studies from international contexts, which provide very good data to include in our fact sheets. We also engage parliamentarians and invite them to be at the roundtable. We have published a concept paper on male involvement in the form of a short booklet.

Are some countries more useful than others in terms of providing comparable data? Are there any biases?
One country from which we have very good data is India, because they have organisations that are doing the same thing in terms of male involvement and it has been very successful. Other countries from which we have used data include Guatemala, Madagascar and China. We have not used any data from the US or the UK.

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