Communication for social change - HIV/AIDS, social mobilisation, evaluation

Journalism is an essential element of effective health communication. Media ranging from radio phone-ins to television documentaries to articles in women’s magazines can reach people who cannot access other types of information about health. But is it the role of journalists to support dialogue and ongoing community engagement?

Development programmes supporting health journalism will only be successful if they engage with the professional culture of journalism rather than seeing journalists as a conduit for health information. This means moving beyond short-term training for individual journalists and taking the media context into consideration. This was a clear message that emerged from a lunchtime discussion where staff from Panos Institute invited feedback on the Health Journalism Partnership – an initiative finding ways to support health journalists in developing countries.

Journalists, health communicators and development programme managers identified different forms of health journalism during the discussion. “Health journalism is not just straight health news”, said one discussion participant. But the divisions are blurred between, for example, “edutainment” (such as soap operas with embedded health messages), community radio and news journalism. However, when researching capacity development for journalists, training in news journalism is an established field, so analysing what is already being done – rather than focusing on alternatives to news journalism – may be a constructive approach.

As well as analysing the role of the media, the role of people who want to use the media is worth considering. Improving the ability of development workers to contact the media can complement training for journalists, editors and media managers. One example was a workshop that trained journalists then did media training with NGOs, then brought the two groups together.

Communities want to talk, rather than be talked about, pointed out one discussion participant from an international NGO. This is where tension between the aims of health and development programmes to generate a stronger voice for the people they work with and journalists’ needs to get an engaging story may be most obvious. People from poor and marginalised communities obviously make up a sizeable share of media audiences in developing countries, but if these people are not paying customers, it relies on social and ethical incentives for broadcasters, publishers and editors to encourage journalists to represent their perspectives.

“The story hits the target audience, but does it make a difference?” asked one discussion participant.

Timing is all in news media. If a story breaks too early, it will miss the “tipping point” and fail to be taken up by action groups, said one discussion participant. But even if a story is well timed, it is difficult to attribute changes in health to one story or approach. Acknowledging that media coverage is one component in a complex social situation is an essential element of working with editors or journalists to bring about change.

“Health issues aren’t seen as being news”, said a discussion participant from a media training and broadcasting organisation. So, in order to increase media coverage of health, can health stories be more exciting? That depends who’s deciding on what makes health interesting. For example, media coverage of HIV and AIDS makes up a sizeable proportion of health coverage, which may be linked to international rather then local or national agendas. “Who says that AIDS is more important than malaria or TB? There is a huge AIDS lobby in the developed world”, pointed out a discussion participant. This illustrates a difference between the public domain and what information or dialogue particular audiences may need.

“Straight news is not an appropriate channel for some health issues” said one discussion participant, even though emphasising the social and economic aspects of health – “the juicy bits” – can produce newsworthy stories that also represent the concerns of marginalised people. An insert in a women’s magazine in Brazil on safer sex is one creative example of using non-news media to talk about sexual health. However, another participant pointed out that the history of social activism in Brazil was as important as vibrant media in making this sort of communication work.

Good communicators know their audience and develop engaging content – this is the case for journalists as much as for other communicators. But dialogue is always between people and can only be encouraged – or discouraged – by media stories. Who gets to participate in the dialogue is the key question.

Building community participation into content development is most obvious in radio – whether this is through a long-term participatory communication approach or more directly through a skillfully facilitated radio phone in.

One discussion participant said that although both commercial and non-commercial community radio is expanding, the potential to communicate negative messages or inaccurate health information meant that this was not automatically a good thing for health communication. It’s also worth looking at both public service broadcasting and commercial broadcasting: “Public service broadcasters report on health more but commercial broadcasters might be better at generating audiences – if it’s in their interests” said a discussion participant.

Development journalists and media trainers are – and should continue to be – embedded in the culture of journalism. Their engagement with health and development issues is informed by their professional culture. But NGOs, media trainers and journalists’ organisations can strengthen their links and take a pragmatic approach to changing the culture of health journalism through their ongoing work. This type of joined up approach stands the best chance of ultimately engaging people who live in marginalised communities and contributing to health improvement.

How can journalism strengthen health responses?