|Posted by Jacob Jacob on August 9, 2010 at 9:40 PM|
I came across a very interesting photo-article on the BBC news website today on the changing face of health campaigns.
It is interesting how normative appeals have changed over the years. I agree with Dr. Laragh Gollogly of WHO that it is easier to evaluate impacts of commercial advertising than impacts of health campaigns or public information operations for that matter. How do you measure the impacts of HIV/AIDS awareness campaigns in Nigeria or the DRC for example? Yes, it may be easy to look at prevalence or new infection rates, but those could be attributable to several other factors. What's more, there is the issue of what media intervention approach really work particularly in health communications and other behaviour change communication campaigns. Normative appeals (be it subjective norms, injunctive norms or descriptive norms) have been proven in many researches to change behaviour on alcohol abuse, smoking, energy use etc. But my problem with most of the researches is contextualisation. In rural areas in Africa for example, where health campaigns may seek to raise awareness on the use of mosquito nets, polio, HIV/AIDS and other sexually transmitted diseases, a lot of factors come into play key among which are rumours (and other socially transmitted communications); the opinions of local elders, family heads and religious leaders. In Nigeria for example, during the early 80s and 90s communication campaigners totally ignored these variables in their polio campaigns. There were local rumours that the polio vaccines were government's strategy to cut fertility in Northern Nigeria to reduce the Hausa population. Local Imams and Uztases also had a hand in reinforcing the rumours by warning followers to avoid the vaccines.
Another factor is Memory. Memories of previous experiences is a key variable and can be easily manipulated by local opinion leaders. In Nigeria for instance, current UNICEF and Health Ministry campaigns are being met with suspicion and apathy particularly in the north. To a remarkable extent, this is based on previous experiences with vaccinations. In 1996, Pfizer tested the antibiotic Trovan on 200 sick children during a meningitis outbreak without the informed consent of their parents. A number of children are said to have died from the drug and others blinded or brain damaged. The meningitis epidemic had killed by far more children than Trovan, but people in Northern Nigeria remember Pfizer's Trovan deaths more than meningitis deaths. Unfortunately, current vaccination campaigns there ignore this Memory factor. There has been no campaign to first explain what happened in 1996 and why current vaccination drives are different.
At the end, information contents and local knowledge are essential. Health and behaviour change communications that lack or ignore these two factors have a long way to travel.