Development communication engages strategic social change in a variety of areas, yet a great proportion of resources in this field are allocated toward the field of health communication (Hemer & Tufte 2005). There is no universal strategic communication response to complex health-related challenges, but rather a framework of general principles, ranging from behavior change through mediated communication to advocacy communication directed toward policy and structural change, through the processes of participatory communication (Nutbeam & Harris 2001. The practices engaged follow the standards invoked in development communication campaigns (McKee et al 2000).
In issues of health, a central challenge has been the replication of health campaigns across different communities and issues (Piotrow et al. 1997). The particular contexts of the health concern and the community at risk differ greatly. For example, the social marketing of individual behaviors (condom use) in family planning strategies in the 1970s and 1980s was very rapidly transferred into a dominant strategy in HIV/AIDS in subsequent decades. This happened in part due to HIV/AIDS being conceived as primarily a problem arising from certain kinds of sexual behavior. In more recent years there has been a growing recognition of the need to complement and replace social marketing as the (exclusive) strategy in HIV/AIDS prevention, incorporating advocacy and entertainment education approaches (Airhihenbuwa & Obregon 2000). Currently this issue has arisen in response to development campaigns addressing the health issue of avian flu. Many campaigns have attempted to reproduce behavioral strategies known from the earlier HIV/AIDS days by emphasizing consumer behavior at the expense of other potential approaches.
In the field of health, development communication campaigns might consider a variety of factors in articulating an appropriate strategy (Tufte 2007). First, a distinction between types of health programs should be made. For example, a communicable disease such as malaria would require a different approach from cardiovascular disease. The problem of malaria requires dealing with individual behavior vis-à-vis the risk of mosquito bites, but also attention to policies on access to both prevention (bed nets) and treatment, and ultimately and ideally attention to the waters where mosquitoes breed. Addressing cardiovascular disease, on the other hand, requires attention to lifestyle over time, physical activity, smoking patterns, food patterns, etc. It also requires attention to individual behavior, policies, and environmental factors. In other words, carefully tailored communication interventions should be based on a profound understanding of the health problem encountered while at the same time drawing on the generic options of individual behavior, policy, and environmental factors.
Second, emergency diseases, such as SARS or avian flu, need to be distinguished from more fairly typical development-oriented health problems, such as those directly related to conditions of poverty. This distinction relates to the difference between broad-based and narrow-based problems. With sexual or reproductive health, for example, one could focus on a concrete practice, such as condom use, or more broadly based issues related to gender and power, poverty, and public health.
Development communication campaigns in the field of health should consider several criteria, beginning with the timing and duration of the intervention, from immediate and short-term to carefully (slower) planned long-term interventions. For example, emergencies require immediate and in the first instance short-term intervention, such as tackling food shortages in drought situations or required infrastructure to avoid cholera epidemics. In contrast, longer-term intervention is needed to insure sanitation in addressing long-term health issues.
Second, health campaigns in development need to consider the level of intervention, whether it is to be engaged at a local community, national, transnational, or global level. Third, the nature of the intervention – whether it should be addressed from a behavioral or from a socio-economic and political structural angle – should be considered. Fourth, the content of the intervention should be related to these issues, directing attention to specific messages or social processes, such as women’s empowerment and gender roles in considering family planning practices. Fifth, the expected outcome of the development campaign might include a recognition of the processes or focus on specific results.
Development communication campaigns in the field of health face several challenges. First, more collaborative and comprehensive strategies are needed to engage the complexity of health concerns. Many campaigns illustrate the fact that the core challenges of many health problems lie outside of the public health system and require cross-sectorial collaboration. The work of the FEMINA Health Information Project in Tanzania is one example. In countering the growing HIV/AIDS pandemic and other issues related to sexual and reproductive health, such as gender equality, they engage in formal and informal education, income-generating activities, and public debate (Fuglesang 2005). The South African health communication campaign “Soul City” is another example illustrating complex multilevel and multi-sectorial responses to HIV/AIDS. Responding to the complexity of health concerns has been acknowledged in WHO since the Ottawa Charter for Health Promotion was adopted in 1986 and even at a previous conference which resulted in the Alma Alta Declaration. the social determinants of health were already acknowledged at that time. However, the practice of health campaigns are still only gradually responding to these broader-based challenges. Second, a range of characteristics of globalization are today impacting upon health and will subsequently pose fundamental challenges in health campaigns for development. One case in point is the growing migration, for example in Africa, that is leading to the explosion of “modern” diseases, such as diabetes and obesity, in many developing countries. Another is the increased transnational mobility that leads to epidemics traveling, as in the case of SARS, avian flu, and HIV/AIDS. This requires stronger transnational collaboration in health campaigns.
- Airhihenbuwa, C. O., & Obregon, R. (2000). A critical assessment of theories/models used in health communication for HIV/AIDS. Journal of Health Communication, 5, 5 –15.
- Fuglesang, M. (2005). Si Mchezo! Magazine: Communication media making a difference. In O. Hemer & T. Tufte (eds.), Media and glocal change: Rethinking communication for development. Buenos Aires and Gothenburg: CLACSO and NORDICOM, 2005.
- Hemer, O., & Tufte, T. (eds.) (2005). Media and glocal change: Rethinking communication for development. Buenos Aires and Gothenburg: CLACSO and NORDICOM.
- McKee, N. et al. (eds.) (2000). Involving people, evolving behaviour. Penang: Southbound; New York: UNICEF.
- Nutbeam, D., & Harris, E. (2001). Theory in a nutshell: A guide to health promotion theory. Sydney: McGraw-Hill.
- Piotrow, P. T., Kincaid, D. L., Rimon, J. G., II, & Rinehart, W. (1997). Health communication: Lessons from family planning and reproductive health. Westport, CT: Praeger.
- Singhal, A., & Rogers, E. (2003). Combatting AIDS: Communication strategies in action. New Delhi: Sage.
- Tufte, T. (2007). La comunicación y la salud en un contexto globalizado: Situación, logros y retos. In M. Moreno et al. (eds.), La Salud y la Comunicación. Bogotá: Universidad Nacional de Bogotá.
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