Transcript PowerPoint Presenation

Health Communication
- from individual behaviour change to civil society
development and participatory governance
By
Thomas Tufte, Ph.D, Professor
Roskilde University, Denmark
[email protected]
Presentation given at seminar in Copenhagen 4 May 2010:
Communication for Social Change – lessons learnt from public health
ADRA/AIDSNET/ENRECA Health/Glocal NOMAD
Introduction
3
key questions framing the
discussion
3
hypotheses related to public
health, globalisation and health and
the discipline of health
communication
 Example:
Femina HIP in Tanzania
Question 1
 What
role does communication
play in the configuration of
health citizenships?
Three levels of analysis:
• The level of health policies (long trad. for broad
definitions + notion of comm??)
• The level of the sciences or disciplines (health +
comm)
• The level of health and the health communication
practice (emerging experiences..)
Question 2
 What
dimensions of globalization
are influencing the politics,
disciplines and practices of
health communication?
•
The relation between globalisation and
modernity: Arjun Appadurai
• Mass migration
• The electronic mediation of everyday life
• The articulation of an ontological insecurity
Question 3
 What
are the key challenges that
health communication face today
– in terms of policies, theories
and practices?
•
•
A discipline and a practice in crisis and in
profound transformation
There exists a strong current of rethinking the
discipline and the practice
Hypothesis I
 The
centre of public health lies
outside of the public health
system
•
Public health problems relate to broader
questions: citizenship, empowerment, socioeconomic conditions, culture, power relations and
political priorities
Hypothesis 2
 The
forces of globalisation are at
the centre of the challenges we
must understand and relate to in
order to achieve the construction
of a ’healthy’ society
•
’Glocalized’ lives that we need to
reconstruct and understand better in order
to respond accordingly and better
Hypothesis 3

Health communication is a discipline
in crisis and in transformation. There
is a strong need for a more solid
philosophical and epistemological
basis which parts from a broad notion
of health and which connects the
health related challenges more
strongly with the other key
challenges within development and
social change
Towards health citizenships
 Alma
Alta 1978
 Ottawa Charter 1986
 UNFPA Conference, Cairo 1994
 Round-table on Communication for
Development, Managua 2001 (and
subsequent ones in Rome, Addis and
Washington)
7 challenges emerging from
globalization







Epidemics travel (HIV, SARS, Bird Flu, etc)
Media development – expanding and diversifying
symbolic worlds
Transnational agency and advocacy
New Economy – mainstreaming of principles of
market liberatiion and deregulation of the media
Changing public sphere (transnational +
diasporic)
Risk society
Migration, marginalisation and social exclusion
Challenges for health comm
 Scope,
size and interconnectedness
of issues – national policy
frameworks + glocal dimensions..
 Reclaiming agency – TANs
 Questioning economic and ideological
logic informing management, org.
Dev, policies. Are there alternatives?
 Changing public sphere
Communication for social change
 Rethinking
subject, culture and social
change results in CFSC…
 Interaction
between popular culture,
communication practices and
construction of meaning
 Confront the structural challenges,
linked to questions of inequity and
social injustice
Introducing Femina HIP






Tanzanian NGO, 1999Focuses on SRHR and
HIV/AIDS
Many donors on board, but
is a ’homegrown’
organisation
EE through real life stories
Media outlets include: Two
large magazines, tv talk
show, radio drama,
interactive website
Femina clubs
Femina HIP Objectives
To build supportive
environments in Tanzania
where:

Young people in their
communities enjoy their
right to access information
& services and are
empowered to make
positive informed choices
around sexuality and lead
healthy lifestyles in order
to reduce the negative
impact of HIV/AIDS.
Today: Femina HIPs 2nd Objective
To build supportive
environments in
Tanzania where:

Communities exercise
their right to express
themselves,
participate in public
debate & engage in
civil society. (Femina
HIP Logical
Framework, 2007)
FEMA

FEMA. A glossy
magazine, 64 pages,
170.000 copies
Published 4 x year.
Targets youth aged
15-24 especially
secondary school
students in every
region of the country
SiMchezo
Si Mchezo! 32
pages, 175.000
copies.
 6 x year. Targets
out of school youth
and their
communities
particularly in rural
areas.
 Is expanding to
250.000

Results (1)
- All secondary schools in the country
have Fema magazines, read in Femaclubs and used in class
– Widespread Fema-club structure
– Increased youth talk about the subjects
– Changed authorities: collaboration with
MOE, also on Zanzibar
– Political clout
Tanzanian Context




Still low – but now
growing- levels of
participation in public
life and decisionmaking
Changing and growing
civil society
Much more diverse
media infrastructure –
new media emerging
Comparative
advantage: Femina
HIP became a visible
NGO early on
Other Media Outlets




Pilika Pilika. A radio soap opera. Carries messages from
Femina as well as two other organisations. Airs on national
radio 4 times a week.
FEMA Tv Talk Show. Half ½ hour talk show. Broadcasts
on national TV 4 times a week. Mobile phones are used for
feedback and voting, particularly around the TV.
ChezaSalama (‘play safe’). Interactive website with a
series of activities and information in English and Swahili.
First of its kind in Tanzania.
Individual Publications: Range of specialist publications
produced on for example HIV-testing, Treatment (500.000
copies distributed to all CTC clinics), youth empowerment
(Watata Bomba, for children/youth was produced in
90.000).
10 years down the line…
FEMINA HIP today: reaching 25% of the
population!
 Conceptual sharpening

– Participatory Communication/CFSC
– Exploring citizenship and governance
perspectives on an HIV/AIDS communication
initiative
– Exploring CFSC-oriented process indicators
(ownership, leadership, particpation, social
norms, etc)

Improving M&E
Re-examining results

KAP: Increased knowledge, changing attitudes
and practice

Voice: Established and growing ’discursive
spaces’

Media: Strong media vehicle for any
subject/developed media infrastructure

Organisation: Grown NGO with huge network of
stakeholders

Embryonic civil society at community level
CFSC Indicators
Leadership
Degree and Equity of
Participation
Information Equity
Collective Self-Efficacy
FEMINA HIP
Emerging amongst youth
Broader participation
Sense of Ownership
Growing engagement
(letters)
Long term change
Social Cohesion
Social Norms
Voice of all groups
Open talk
Democratic values..and
others (gender,
entrepreneurship, etc)
The driving forces of
communication for social change

CFSC is horizontal and strengthens community bonds by amplifying the
voices of the people who are poorest

people within poor communities must be the protagonists for their own
change and manage their own communication tools
rather than focusing on persuasion and information dissemination,
CFSCpromotes dialogue among equal voices, and debate and negotiations
within communities


the results of the CFSC process go beyond individual behaviour and
consider the influence of social norms, values, current policies, culture and
the overall development context

CFSC strives to strengthen cultural identity, trust, commitment, voice,
ownership, community engagement and empowerment

CFSC rejects the linear model of information transmission from a central
sender to an individual receiver, and relies instead on a cyclical process of
interactions focused on shared knowledge and collective action
Thanks!