In a fascinating recent
in The New Yorker, surgeon,
health researcher and writer Atul Gawande examines why some health
innovations  – surgical anaesthesia for
example – have spread fast, while others – such as the use of antiseptics or
critical childbirth practices – take years, even generations, to become
accepted and save lives.

He argues that technology isn’t the answer: in an era
of the iPhone and Facebook, he says, "We yearn for frictionless, technological
solutions… But people talking to people is still the way that norms and
standards change."

This focus on "people
talking to people" as the way to affect change, however, implies it is
the only kind of communication that really matters, or that decisions resulting
from such human interactions operate in isolation.

And while "people talking to people" in the developing
world is critical to spreading life-saving innovations, using other means of
engaging people with new ideas and products is also an important way to
stimulate change.

It's not a matter of either/or but both. 

Media's role

Take for example the impact of mass media on influencing
our behaviour and the norms that shape what we feel comfortable doing – or not
doing. This is well documented in behaviour change theories as well as proven
by the sheer existence of the advertising industry.

media can introduce and stimulate contemplation of something entirely new. It
can legitimise or highlight a neglected subject and model behaviour that we
want to emulate. And it can stimulate debate of something that has long been
taboo, such as sexual health.

For example, a 17-year-old listener to BBC Media Action's
Abugida radio
show in Ethiopia
, wrote to us to say, "Abugida
has helped and encouraged me to make some very important decisions. The radio
programme has inspired me to discuss sexual and reproductive health with my
friends at school and even with my parents. I was overjoyed when my mother
declared that she had decided not to have my sisters circumcised after all
[after listening to the programme]."

A recent UNICEF report on female genital mutilation/cutting argues that if
harmful practices are to change it is vital that people have a common
understanding of what other communities are really doing as opposed to what
they think other communities are doing. If the attitudes of individual
families remain private, others may infer that they support female genital mutilation/cutting,
when in fact they may not. This misunderstanding may mean families cut their
daughters to avoid social disapproval.  The
UNICEF report highlights the important role media can play here to provide information
and stimulate discussion.

forms of communication

is too complex and media – in all its forms – too ubiquitous to conclude that
just one source of information or social interaction is the most effective in
every context.

A more
sophisticated analysis of communication in behaviour change includes
understanding how various forms of communication, from mass media exposure to
interpersonal discussion, interact and perhaps strengthen one another.

Improving our understanding of how this can work is at
the heart of what BBC Media Action does.

Reinforcing messages 

In the Indian state of Bihar, for example, we are using
all forms of communication – technology, mass media and “people talking to
people” to improve family health. 

With over 82% of women in Bihar having access to a mobile
phone, we’re using mobiles
to train and equip 200,000 community health workers with the information they
need to counsel families about maternal and child health during their face-to-face
home visits.

The health messages the families hear through their mobiles and from the health workers are strengthened by radio programmes, listening groups, TV ads and street theatre. (Read more about the project’s "360-degree" approach.)

A community health worker on a visit to a family with the mobile phone service Mobile Kunji.

Well-designed health innovation initiatives tend to combine
interpersonal and group discussion approaches with mass media and mobile phones
to achieve impact at scale.  

discussion may be a critical last step in influencing the uptake of some health
innovations. But it should not be underestimated how media and communication
solutions can spark, shape and support these discussions.  



BBC Media Action’s work on health

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