Campaigning is among the most common activities of any patient organisation. While the campaigns usually require large-scale resources (at least in terms of pro bono and volunteer contributions), such activities also have a great potential to bring about intended positive change.
There are three common mistakes that seriously diminish the potential impact of campaigning. Firstly, the societal need (related to the well-being of patients) is not defined clearly enough. Secondly, the full theory of change is not designed (including the combination of necessary and sufficient changes that are needed for really creating the conditions for improving the well-being). As a result of those two first mistakes, organising a campaign becomes a goal in itself, i.e. the method is confused with the objective. Thirdly, the full theory of change is not backed up by enough of resources, cooperation processes and other activities that are needed to support the campaign to play its role in bringing about the intended change.
The societal need has to be clearly defined. The patient organisation needs to ask some basic yet profound strategic questions. What is the main issue? Are there some changes in legislation that are needed? Or is the implementation of current regulations not good enough? Is it about resources – either on the level of patient (e.g. for medical drugs or rehabilitation), organisation (e.g. the financial capacity of patients' self-help organisations) or the whole system (e.g. the salaries of rehabilitation teams of medical personnel)? Et cetera.
Often the patient organisations define the need far too broadly, e.g. …The politicians have to become more supportive“ or …The general public needs to be more tolerant“. There are no such phenomena as “politicians” or “general public”. There are individuals or groups who have influence on the patient organisation's cause by deciding to do (or not to do) something. The patient organisation is able to identify such individuals or groups only by starting with singling out the specific need itself. If there are more needs than one, then more than one theory of change needs to be created.
The theory of change has to include all the necessary and sufficient conditions for achieving intended impact, while realising that campaigning is usually only one of several components. The theory of change needs to be built on a specific target group who has a need related to them. Then the patient organisation has to define intended outcomes and impact, i.e. how the need should disappear, decrease or change. Only then the team should brainstorm about the activities that have the potential to bridge the current situation (the need) with the intended situation (the vision). Whether campaigning can be chosen as one of the tools depends on its potential to bridge the specific need with the intended impact.
It is important to note that many patient organisations should plan their theory of change on two levels. The final outcomes are related to the patients, of course. In shorter term, however, the direct target group might actually be decision-makers, donating individuals, medical staff etc. They might not consider themselves as having a need. But the patient organisation has a need related to them – from organisation's point of view, they need to change their practices to support the patients. The theory of change can be of great help when planning the necessary and sufficient activities to inspire or force our direct target group to change their practices for the benefit of the patients. Usually, campaigning is a necessary but definitely not a sufficient activity.
The advocacy activities for campaigning (and beyond) should be undertaken collectively in advocacy coalitions. In most cases, the challenges demonstrated by designing the theory of change are simply too large for one patient organisation to tackle alone. E.g. those patient organisations who want to increase public funding need to understand very well the priorities of the government, the informal relations between decision-makers, the budgetary processes etc. Or – the campaign itself should be backed up by tireless meetings with community activists as well as civil servants. Such impacts can only be achieved collectively.
The patients organisation are strongly recommended to power each campaign with a thoughtfully formed advocacy coalition, whose first task is actually to design a theory of change, while identifying the precise needs for positive change as well as all the necessary and sufficient conditions to bring it about.
Disclosure of Interest None declared