Journal of Creative Communications, 9, 1 (2014): 83â100 ... of communication as a tool for motivating individual and social change have seen paradigmatic ...
Article
Health Communication Campaigns in Developing Countries Suruchi Sood Corrinne Shefner-Rogers Joanna Skinner
Journal of Creative Communications 9(1) 83–100 © 2014 Mudra Institute of Communications SAGE Publications Los Angeles, London, New Delhi, Singapore, Washington DC DOI: 10.1177/0973258613517440 http://crc.sagepub.com
Abstract Despite a lack of scholarly consensus on the effectiveness of health communication campaigns, there is general agreement that communication interventions are necessary to bring about and maintain large-scale behaviour and social change. Designing, implementing and evaluating health communication campaigns is a complex task with myriad challenges, multiplied manifold in developing country settings. The purpose of this article is to examine key elements of health communication campaigns in developing countries. A review of published literature revealed 43 articles and five books with chapters discussing developing country campaigns. The project locations indicated a wide geographical dispersion. The campaigns reviewed ranged from multinational initiatives to programmes confined to specific cities or villages. The health issues tackled in the manuscripts were reflective of the health goals articulated in the United Nations Millennium Development Goals. A relatively small proportion of the reviewed literature discussed the use of theory as a framework or foundation for the intervention(s); individuallevel behaviour change theories were the most commonly used. The selected campaigns utilized a range of mass media, community mobilization, and interpersonal communication strategies, and often employed multiple strategies and communication channels. A set of recommendations is presented to further our understanding of communication campaigns in developing country settings. Keywords Global health, communication campaigns, developing, international health
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Defining Health Communication Campaigns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
Defining Developing Countries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Clinic Era /The Clinic Era was marked by the mantra ‘Build it and they will come ’, and was based on the medical model that if services existed then people would find their way to them (Rogers 1973). Field Era /The Field Era emphasized the use of outreach workers, community based distribution, and information, education and communication (IEC) products (Rogers 1973). Social Marketing Era /The Social Marketing Era borrowed from commercial marketing strategies of brand promotion to generate demand and improvement in supply chain mechanics to improve access to services. This Era was characterized by the idea that consumers will buy products they want at subsidized prices (Rimon 2001). Strategic Behaviour Change Communication Era /The Strategic Behaviour Change Communication Era uses behaviour change models and theories as the foundation for interventions and emphasizes the need to influence social norms and policy environments to facilitate both individual and social change (Figueroa et al. 2002). Figure 1. Four Eras in Global Health Communication (Rimon 2001)
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Journal of Creative Communications, 9, 1 (2014): 83–100
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Suruchi Sood, Corrinne Shefner-Rogers and Joanna Skinner
Methodology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`)9\"2'a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bV')/%M)"'%&"(#'&+1&'>"-"'/,&'2)$7%*1&"2'"7#">+"-";' B>,' #"' ,4' 19#&-1*&' -"5%">#' >"-"' #)9#"M)"/&7@' *,/2)*&"2;' B+"' 4%-#&' -"5%">' ,4' 19#&-1*' #+,-&7%#&"2'' KIc'%&"(#;'Q,("'KJ'$"-'*"/&',4'19#&-1*'>"-"'"?*7)2"2'9"*1)#"'&+"'*1($1%0/'2"#*-%9"2'>1#'/,&'%/'1' 2"5"7,$%/0'*,)/&-@;'B+"'(1%/'"?*7)#%,/#8'+,>"5"-8'>"-"'9"*1)#"'&+"'%/&"-5"/&%,/#'2"#*-%9"2'>"-"'/,&'
Databases searched = 4
# of hits = 4370 # retained after title review = 257 # retained after 1st abstract review = 126 # retained after 2nd abstract revien = 103 Final # included in the review = 48 (including 5 books) 8 exclusions: fulll text not found 18 exclusions: literature reviews 29 rejected: did not meet criteria
Figure 2. Literature Review Inclusion and Exclusion Criteria
Journal of Creative Communications, 9, 1 (2014): 83–100
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Table 1. Criteria for Review of Selected Literature Criteria
Coding
Citation for Manuscript Year of Publication Project Location Project Scope Health Issue Theoretical/Conceptual Framework Communication Strategy
APA Style Manuscript 2002–2012 Region, Country Multi-national, National, Local The specific topic being addressed Specific theories or models guiding the communication campaign Broad strategic approach utilized—mass media, community approaches, interpersonal or mediated (for example, social media, interactive communication technologies, mHealth) The specific channels employed—one on one expert communication, counselling, peer education, street theatre, folk media, TV, radio, Facebook, Twitter, crowd sourcing, texting
Communication Channels
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Journal of Creative Communications, 9, 1 (2014): 83–100
96
Suruchi Sood, Corrinne Shefner-Rogers and Joanna Skinner
Table 3. Books Included in the Review by Key Elements Citation
#
Range of Topics
Hornik, R.C. (ed.) (2002). Public health communication: Evidence for behavior change. Mahwah, NJ: Lawrence Erlbaum Associates.
3
Mass media, HIV, Ghana, mass media, vasectomy, Brazil, child survival, multi-country
Obregon, R., & Waisbord, S. (ed.) (2012). The handbook of global health communication. Chichester, UK: Wiley-Blackwell.
12
MCH, condoms, FP, Avian flu, sexuality, HIV, violence, social marketing, mass media, journalism, peer education
Haider, M. (2005). Global public health communication: Challenges, perspectives, and strategies. Sudbury, MA: Jones & Bartlett Learning.
11
HIV, cancer, vaccination, communicable, chronic, MCH, FP
Rice, R.E., & Atkin, C.K. (eds) (2012). Public communication campaigns, 4th edition. Thousand Oaks, CA: Sage Publications.
3
Thompson, T., Parrott, R., & Nussbaum, J. (eds) (2011). The Routledge handbook of health communication, 2nd Edition. New York, NY: Routledge.
1+
HIV
One review chapter on campaigns in developing countries.
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Health Communication Campaigns in Developing Countries
97
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Discussion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`-"5%,)#'7%&"-1&)-"' +1#' #+,>/' &+1&' (1##' ("2%1' *1($1%0/#' 1-"' "44"*&%5"' $-,5%2"2' &+"@' 1-"' /"#&"2' >%&+%/' 1' 71-0"-' #,*%,' "*,7,0%*17' 4-1(">,-C' *,/#%#&%/0' ,4' D&E' 1' #)$$,-&%5"' $,7%*@' "/5%-,/("/&g' D9E' 1/' 12"M)1&"' #)$$7@' ,4' #"-5%*"#' 1/2' $-,2)*g' 1/2' D1E' *,(()/%&@' 91#"2' %/%&%1&%5"#' &,' $-,(,&"' 9"+15%,)-' 1/2' #,*%17' *+1/0"' DF1C"4%"72'"&'17;'IJKJE;'B+"'4%"72',4'+"17&+'*,(()/%*1&%,/'9@'1/2'71-0"'1$$"1-#'&,'9"'#7,>'%/'(,5%/0' &,>1-2'&+"'2"5"7,$("/&',4'1'07,917'&+",-@',4'+"17&+'9"+15%,)-'1/2'#,*%17'*+1/0"'1#'*,/*"$&)17%."2'9@' Q&,-"@'1/2'S%0)"-,1'DIJKIE; =(,/0'&+"'KJ'9%0'%2"1#'4,-'&+"'4)&)-"',4'+"17&+'*,(()/%*1&%,/8'&+"'H"17&+'a,(()/%*1&%,/'`-,X"*&' DHa`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
Limitations B+"-"' 1-"' #"5"-17' 7%(%&1&%,/#' &,' &+%#' -"5%">;' A/' 1/' 1&&"($&' &,' 9"' 1*12"(%*177@' -%0,-,)#8' >"' ,/7@'' *+,#"' &,' "?1(%/"' $)97%#+"2' 7%&"-1&)-"' D$""-' -"5%">"2' X,)-/17' 1-&%*7"#8' 9,,C' *+1$&"-#' 1/2' *,/4"-"/*"' $-,*""2%/0#E;'B+"-"'%#'1/'19)/21/*"',4'/,/:$""-'-"5%">"2'0-"@'7%&"-1&)-"'151%7197"',/'&+"'F"9',/'&+"' Journal of Creative Communications, 9, 1 (2014): 83–100
98
Suruchi Sood, Corrinne Shefner-Rogers and Joanna Skinner
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Journal of Creative Communications, 9, 1 (2014): 83–100