Futures Group’s policy and advocacy services area encompasses

• Policy Development and Implementation
• Policy Analysis and Barriers
• Legal and Regulatory
• Advocacy and Coalition Building
• Community Mobilization
• Workplace Policy Development
• Stigma and Discrimination
• Gender Equity Promotion

Our services are described in more detail below.

Policy Development and Implementation

Policies are essential to the success of any long-term health program. Futures Group is a leader in developing and implementing policies that ensure human rights, broaden societal participation, and improve public health. We utilize evidence to assist decisionmakers in developing new policies, reforming existing ones, and eliminating barriers to effective programs and services.

Our policy development and implementation work includes
•Multisectoral policy work
•Advocacy and policy dialogue promotion
•Workplace policy development
•Planning and finance assistance
•Policy-relevant research
•Capacity development
•Institutional strengthening
•Modeling and forecasting (SPECTRUM suite of policy models)

A hallmark of Futures Group’s participatory approach is to bring together
partners across the spectrum to contribute to policy development affecting the lives of families and fellow citizens. Through ownership and empowerment, our process improves access to high-quality services, increases resource allocations for public health and social development programs, safeguards human rights, strengthens collaboration, and ensures long-term sustainability of programs and services.

Policy Analysis and Barriers

Operational policy efficiency is an integral element of health reform; however, policies are not always implemented as envisioned and do not necessarily achieve intended results. Futures Group brings together partners from various sectors, identifies barriers to implementation, and encourages dialogue and consensus on country-owned solutions, which together result in concrete action items to improve implementation. We embrace the view that operational policy analysis and change are best carried out in partnership with local experts and stakeholders.

Under the USAID | Health Policy Initiative, Futures Group has developed tools for assessing policy barriers, including Policy/Program Implementation Barriers Analysis (PIBA, for HIV programs) and the Policy Implementation Assessment Tool (PIAT, for family planning, reproductive health, maternal health, and HIV policies).

For example, use of PIAT has inspired dialogue and action in Uttarakhand, India. As of early 2009, stakeholders in Uttarakhand were revising the state’s policy based on the PIAT assessment, latest health data, and results of innovative reproductive health interventions.

Our tools can be adapted for use in other countries at different levels (e.g., state and district) and for varying health policy issues. Futures Group also undertakes analyses that look at a range of barriers, such as stigma, poverty, gender inequality, resources, and capacity.

Legal and Regulatory

Futures Group assists in the formulation of laws, policies, and regulations to foster equitable access to services and to prohibit discrimination. The depth of our expertise in legal and regulatory review provides a solid foundation for our policy reform work.

We prepare guidelines and standards on quality of care, such as national antiretroviral therapy, palliative care, and voluntary counseling and treatment, as well as guidelines on medication-assisted treatment and provision of culturally appropriate family planning and reproductive health services to poor and indigenous groups.

We are recognized for innovative work, such as setting up HIV legal clinics in Vietnam and dispute resolution centers in Peru. We led the development of an HIV model law in West Africa, now being used as a regional template for development of national HIV laws.

We identify barriers to the implementation of laws and policies. For example, we assessed implementation of the reproductive health section of Guatemala’s Social Development and Population Policy, which resulted in creation of a permanent National Monitoring Board to monitor a range of reproductive health and HIV laws and policies.

We build the capacity of government and civil society to monitor implementation of laws and policies. For example, in Tanzania we will build the capacity of the Commission on Human Rights and Good Governance. We also conduct legislative audits to assess whether laws and policies adhere to international standards, treaties, and best practices.

Advocacy and Coalition Building

Advocacy and coalition building are essential aspects of improving the policy environment for successful and sustainable long-term health programs. Advocacy can raise awareness of important, yet neglected, issues and encourage greater political commitment for necessary programs. Advocates are drawn from across the spectrum—from a government official calling for more funding for HIV programs to a midwife fighting for greater access to emergency obstetric care in rural areas.

Futures Group’s approach to advocacy promotes the participation of NGOs, public and private sector groups, and other civil society representatives in policymaking and program development, as multisectoral participation is essential for ensuring that programs meet the needs of those most in need and that resources are mobilized from all sectors.

Under the USAID-funded POLICY Project and its current follow-on, the USAID | Health Policy Initiative, Futures Group has assisted government and civil society partners in policy advocacy and formulation in more than 30 countries across Africa, Asia and the Near East, Europe and Eurasia, and Latin America and the Caribbean.

We provide technical assistance and training in forming networks and coalitions and in helping partners collect, analyze, and use evidence for better decisionmaking. Strengthening advocacy skills in this way builds in-country capacity among various groups to participate in the policymaking process, fosters the sustainability of policies and programs, and ensures accountability of implementing agencies.

Similarly, under the West Africa regional USAID-funded AWARE-HIV/AIDS program, Futures Group had primary responsibility for increasing stakeholder advocacy for policy change, thus building a broad base from which to advocate for improved policies, procedures, and norms at both national and regional levels.

Community Mobilization

An essential element of efforts to develop and implement policies to improve quality of and access to health care is mobilizing communities in support. As a result, Futures Group makes this a cornerstone of our work in the policy arena. By working with hundreds of local experts and institutions in project countries, we not only help to strengthen the current policy environment, but perhaps more important, to stimulate the creation of an established “policy community” that will continue to address local policy concerns well into this century.

Religious and other community leaders in particular can play a major role in influencing community attitudes and practices and persuading local leaders and decisionmakers to invest in effective family planning and reproductive health strategies and programs, as well as assisting efforts to mobilize communities against stigma and discrimination and other important efforts. These leaders are often a vital element of Futures Group’s community mobilization strategy.

Futures Group has successfully implemented this strategy around the world. For instance, the POLICY Project, in collaboration with World Vision, assisted in setting up the Kenya Network of Religious Leaders Infected and Affected by HIV/AIDS (KENERELA)—the first of its kind in East/Central and Southern Africa—which features 20 denominations. By accepting the presence of HIV-positive clergy in their own churches, religious communities have extended a hand of healing to their members and provided leadership in tackling HIV-related stigma.

Stigma and Discrimination

The effects of stigma and discrimination (S&D) can be felt on many levels: individual, family, community, programmatic, and societal. Recognizing the importance of addressing and measuring S&D, Futures Group has pioneered efforts worldwide to understand and reduce HIV-related S&D and has produced tools, publications, and software to facilitate S&D advocacy, policy, planning, and evaluation efforts. We work with people living with HIV, religious and community leaders, and public and private sector representatives to build multisectoral capacity and support surrounding S&D in order to reduce barriers to effective implementation of and access to HIV programs.

Building on efforts to integrate family planning, reproductive health, and HIV initiatives, Futures Group also focuses on training service providers and community members to reduce S&D in the provision of family planning and reproductive health care to HIV-positive women. Our team remains committed to developing and applying new tools and approaches to S&D and recently piloted a citizen’s monitoring model in Ethiopia and Vietnam through the USAID│Health Policy Initiative, which will serve as a tool for key stakeholders to engage in policy dialogue and advocacy to reduce S&D barriers impeding HIV service delivery.

Workplace Policy Development

Mobilizing a multisectoral response to HIV that involves workplaces and private companies is good for people and good for business. Futures Group seeks to guide the development of strong HIV workplace programs that help eliminate discrimination in employment practices, protect employee benefits, serve as an additional venue for raising HIV-related awareness, and reduce stigma in the broader community.

Our approach to mobilizing businesses to combat stigma and discrimination in the workplace emphasizes four key components
•Sound evidence base
•Collaboration, commitment, and champions
•Capacity development
•Program implementation and resource mobilization

For more than 15 years, our team has worked throughout the world to promote workplace policy development and establish business councils that bring stakeholders from across all sectors to address HIV in the workplace. In addition, Futures Group developed the Workplace Policy Builder, a computer program used to assist organizations in developing their corporate HIV workplace policies.

Focusing on these four elements, Futures Group’s POLICY II Project guided the development of the Mexican Business Council on HIV/AIDS (CONAES), which includes in-country and international corporations operating in Mexico. With continued support under the USAID│Health Policy Initiative, we have guided more than 20 members of CONAES through development and adoption of HIV workplace policies.

Gender Equity Promotion

Futures Group is committed to development approaches that transform gender inequities, as a means to achieve both better health outcomes and gender equity outcomes. We employ a dual strategy: leading initiatives on critical gender issues, while promoting true equitable treatment and access in all health activities. We work to improve gender equity worldwide through the following activities:

• Evaluating programs and policies that seek to decrease gender barriers, highlight replicable processes, and assess health and gender outcomes
• Mainstreaming gender-equitable approaches into policies, implementation, and action plans within public and private sectors
• Facilitating development of guidelines for USAID global and regional programs for responding to gender-based violence
• Promoting the involvement of both men and women in creating policies and policy environments that support gender equity
• Implementing participatory research, action, and advocacy projects to address gender-related barriers to HIV prevention, treatment, and care among most-at-risk populations
• Devising innovative advocacy approaches to realizing women’s rights in the context of deeply entrenched cultural issues, such as women’s property rights, early marriage, and female genital cutting
• Documenting outcomes and best practices of gender-equitable programs
• Creating state-of-the-art capacity-building and training processes to promote gender analysis and mainstreaming in programs and policies