Originally posted on the BBC Media Action Insight blog by Caroline Sugg, November 15 2016 - “Without strong communication, we are not going to achieve global health goals.” (Professor Peter Piot, London School of Hygiene and Tropical Medicine)

“Communication plays a critical role in engaging communities, promoting healthy behaviours and creating an enabling environment for change.” (Dr Rafael Obregon, UNICEF)

These were just some of the remarks made at BBC Media Action’s panel event looking at what makes for excellent health communication, how to fund it and – most crucially – why it should be at the centre of public health work. Here we share five of the panel’s recommendations for accelerating progress in global health communication:

1. It’s not all about information and ‘messages’

Good health communication is as much about listening to people – to understand what matters to them and why they behave the way they do – as it is about sharing information. For instance, as Professor Piot pointed out, “Vaccine hesitancy … is often greatest amongst the most informed”.

But health professionals with backgrounds in medicine and epidemiology can tend to think that information is the be-all and end-all. As the World Health Organization’s Dr Gaya Gamhewage recounted frankly, during the first few months of the Ebola crisis in West Africa, every agency was “just pushing messages, just telling people what to do”. This means that, to date, public health work on the ground still hasn’t gone completely ‘beyond messaging’.

This tendency to focus on information is by no means isolated to the Ebola response. However, Dr. Gamhewage went on to say that the field is finally beginning to learn from these mistakes, observing that Ebola has “absolutely transformed” governments’ understanding of the power of communication.

2. Community engagement is key

We’ve known for a long time that improving health requires involving communities in finding solutions to the challenges they face. Reflecting on the case of Ebola in West Africa, Dr Obregon noted that putting people at the heart of the public health response was widely seen as a new concept. But, he argued, this is a time-tested idea and a fundamental reason for those successes we’ve seen in tackling HIV for instance. We now need to consistently incorporate this knowledge into how programmes are designed and funded.

3. Remember empathy

A sense of empathy, and respect, for the communities worked with is essential. Dr Gamhewage reminded our audience that “people have the right to know, in terms that they understand, in the context that they live, according to their own religion, according to their cultural beliefs … [communication] is not a favour we are doing for people”.

Empathy needs to be reflected in the very language public health professionals use. When discussing issues of life and death with someone, Dan Metcalfe from the Wellcome Trust warned against casually using off-putting jargon like ‘isolation ward’. He mused that Nestlé puts more effort into naming a chocolate bar than the public health community does in coming up with terms like ‘antimicrobial resistance’, which simply don’t mean anything to most people.

4. Prioritise local ownership

Governments (local and national) and civil society organisations need to lead and own the health communication initiatives going on in their countries and communities. Progress is being made on this score, but ‘local ownership’ demands much greater investment in capacity strengthening, as well as critical shifts in mindsets.

To achieve this, communication firstly needs to be seen as an integral part of public health systems, not a stand-alone ‘intervention’ or ‘strategy’. Secondly, as USAID’s Dr Elizabeth Fox argued, greater accountability to communities will also help. This will maintain a focus on changing behaviour and norms, in addition to improving health facilities and services, so that funds are used in the best way possible. The health community needs to accept that there’s no use spending more money on latrines if no one’s using them – to give just one example.

5. Invest in evidence from the start

Professor Piot highlighted that the evidence base showing that health communication ‘really works’ is much stronger than in the past, even though it’s not cheap to generate evidence and there are methodological challenges.

Though progress has been made, gaps in the evidence base remain and conducting research to answer remaining questions about ‘what works’ in health communication should be a priority. Dan Metcalfe stressed that more communication programmes need to be engineered from the very start to generate evidence. Fortunately, he is hopeful the field is increasingly moving in that direction.

Creating more evidence will require investment. Dr Gamhewage pointed out that many local NGOs lack the necessary funding and expertise to do this in a systematic way, although that work has certainly started. They need more support.

Finally, Professor Piot argued that investing in evidence and developing health communication as a respected academic discipline will require looking beyond the traditional international development donors to convince mainstream health research funders that this is a proper science whose time has come.

This blog is based on remarks made by panelists at BBC Media Action’s ‘Coming of Age: Communication's role in powering global health’ event to launch its new policy briefing

Caroline Sugg is Head of Special Projects at BBC Media Action and is the author of Coming of age: communication’s role in powering global health. She tweets as @carolinesugg.

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