Lesson One: Health Communication works

Lesson Two: It doesn't work by itself - people need opportunity to perform the new behaviour, environment must be supportive, services and products must be accessible

Lesson three: It does more than create demand - important positive side-effects eg: measles immunisation programme boosts immunisation coverage for other diseases

Lesson four: It works differently for different interventions - some health issue are inherently more difficult than others and therefore demand different approaches

Lesson five: It may not work as dramatically as public health experts expect - often unrealistically high expectations for communication strategies

Lesson six: Interpersonal channels are important - eg: in Swaziland, clinic staff and outreach workers were more effective channels in increasing knowledge and use of ORT than radio

Lesson seven: But so are the mass media - also for Swaziland, health staff reached 22% of the population, outreach workers 16% and radio 60%, therefore radio more effective overall

Lesson eight: It needs to be sustained - [after-all] Coca-cola keeps on spending [on advertising]

Lesson nine: It must be multi-disciplinary - health communication requires collaboration across disciplines

Lesson ten: It is difficult to institutionalise in developing countries

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"HEALTHCOM - Lessons from 14 years in Health Communication" by Mark Rasmusson, Holly Fluty and Robert Clay in Development Communication Report, 1992/2, lead article; which was available from The Clearinghouse on Development Communication 1815 North Fort Myer Drive, Suite 600, Arlington, Virginia, 22209, USA. Best contact now is AED, 1255 23rd Street, NW, Washington D.C. 20037 (phone: 202 862 1900).