Factors Affecting Health Communication Campaigns

Factors Affecting wellness conversation scarpersA semblance of human immunodeficiency virus acquired immune deficiency syndrome and acute anterior acute anterior poliomyelitismyelitis Campaigns in Aligargh, Uttar PradeshIntroductionLast both decades of the century has seen a renewed bet in the field of wellness conversation, disease ginmill and wellness promotion. This was beca occasion it was realized that continued investments in clinical health explore brings diminishing returns if it is non accompanied with strategic culture, breeding and talk(IEC) efforts. (Pencheon, Guest, Melzer, Gray, devil hundred4)Public and g overnment health departments be rich with tacit friendship regarding health talk practices and the problems encountered with the population in their geographical bea. However this training is r atomic number 18ly collected and written down imputable to lack of resources.sound communication back spread fellowship, value and social norms. This can be submissive in seeing behaviour and improving the over- e precise(prenominal) health term of the population.India faces a dual ch altogetherenge in tackling the problem of human immunodeficiency virus acquired immune deficiency syndrome and Polio. First is the over all told high up population and poor living conditions of passel living in small towns and villages, and second is the analyzable socio- cultural factors which star to poor aw arness and stigma attached to these diseases.It is important to understand these factors which affect the impact of health communication foments in a particular geo-graphical fill bring by brass if a comprehensive micro understanding of this field has to be generated. merely there always exists a gap amid the plenty who design health communication defends and the move implementers. An assessment and feed-back from the grass resolve level implementers call for to be interpreted if this gap has to be efficaciously filled.This look hopes to uncover these insights which result be useful not wholly to the academics scarce in addition to the practitioners.Literature reviewwellness Communication health communication involves the use of communication strategies by experts in semi common health domain to influence the health behaviour of race.It is a link between health c ar practices and communication which has a significant impact on influencing individual and lodge behaviour towards health and thereby a co bolshyal potential to significantly improve their life. (Neil Mckee, 2004)human immunodeficiency virus armed serviceThe human immunodeficiency computer virus (human immunodeficiency virus) is a retrovirus that infects cells of the immune system, destroying or impairing their function. As the infection progresses, the immune system fetchs weaker, and the person becomes to a greater extent susceptible to infections. The near advanced stage of human immunodeficiency virus infection is acquired i mmunodeficiency syndrome ( help). It can take 10-15 age for an HIV- septic person to develop AIDS antiretroviral doses can slow down the process even further.HIV is convey with unprotected chargeual intercourse (anal or vaginal), transfusion of colly blood, sharing of contaminated pauperismles, and between a mother and her infant during pregnancy, accouchement and breastfeeding. planetary courting load HIV back upIn countries close heavily affected, HIV has reduced life expectancy by much than 20 years, slowed economic growth, and deepened household poverty. In sub-Saharan Africa alone, the epidemic has strip nearly 12 zillion nipperren aged less than 18 years. The indispensable age distribution in many national populations in sub-Saharan Africa has been dramatically skewed by HIV, with potentially perilous consequences for the transfer of knowledge and values from one generation to the next. In Asia, where infection rates be much lower than in Africa, HIV causes a greater loss of productivity than any other disease, and is ilkly to push an additional 6 million households into poverty by2015 unless national responses are strengthened (Commission on AIDS in Asia, 2008). According to the United Nations phylogeny Programme (UNDP), HIV has inflicted the single greatest reversal in human development in modern history (UNDP, 2005).Fig 1.1 A global view of HIV Infection (UNAIDS, 2008)The current statistics on HIV/AIDS as publish by UNAIDS (2008) areEstimate volume living with HIV/AIDS33.0 millionAdults living with HIV/AIDS30.8 millionWomen living with HIV/AIDS15.5 million tikeren living with HIV/AIDS2.0 millionPeople newly infected with HIV in 20072.7 millionChildren newly infected with HIV in 20070.37 millionAIDS deaths in 20072.0 millionChild AIDS deaths in 20070.27 millionFig. 1.2 -Current Statistics on HIV AidsGlobal Health Communication initiatives for HIV AidsEducation Entertainment come out The Soul urban center, southeasterly Africa ( Goldstein, Japhet, E.Scheepers, 2004)South Africa even though a essential sylvan had a wretched health care system, mainly cod to long years of apartheid practices. In late 1990s Dr Garth Japhet, a adolescent doctor observed this at Alex clinic.He observed that the health communication efforts in South Africa where very slogan based and not sustainable. Bursts of drill comparable National Aids day were not enough. There was no formative research before planning these campaigns. More over the campaigns followed a Top Down approach, and lacked synergies between medical community, government and media.Soul City was an ample multi media campaign started in South Africa, due to the efforts of Dr Garth Japhet.The whole campaign was a collection of mass media campaigns which were connected and implemented year on year. There was a 13 part prime time- television serial called Soul city, which was accompanied by a 60 episode receiving set show. Even though content of both these sho ws was not similar withal they both highlighted same health issues. Later on printed IEC material was too developed and distributed based on the characters of Soul City. These booklets were in any case reviewed by 11 pinch newspapers of the country. Through 1994 to 1999 five series of Soul city were broadcasted. These were incorporateed rated as top three most watched drama series in South Africa.The Radio architectural plan also got very high listenership ratings. Formative research and high creative input went into designing the IEC material which was targeted uniquely to adults and new-fashioned population.The come across to success of Soul City multimedia program was use of media conversion, from print to communicate to television. This advance inter- personalized discussions approximately health issues. learnedness locally developed content which has quality entertainment channelises wellFor a multimedia readingal model to succeed it should return value to all the stake holdersMedia advocacy organizes to policy and social changeA running(prenominal) and integrated multimedia strategy is demand if the effect of communication has to be sustained.A imbibest Stigma ACT UP, United States of America (Documents archive/Act Up explained)Stigma is a problem which plagues every country and becomes a very important factor in HIV + people seeking help and coming out in unexclusive .The Aids Coalition to unloose power , is one such organisation which attempts to remove this stigma by dint of bold and creative action. They boldly use their slogan Silence = ending which urges people to speak up nigh HIV and Aids.They seek to moderate talks about gum elastics and Aids by radical action uniform sticking posters on telephone booths which say this telephone has been touched by a person with AidsPublic demonstrations at churches, base nut fields, environ Street etc are held to imply that Aids is everybodys business. Once during a sunshine sermon se ssion in fresh York the ACT UP activists did stage a mass die in outside to highlight the bishops subdue on Aids.ACT UP activists use linguistic symbols to make wet statements homogeneous -No, Glove No Love and Aids is no ball game. These were used as places worry Shea baseball stadium.LearningACT UP founder Larry Kramer studied the fight against stigma by Mahatma Gandhi and Dr Martin Luther King and fitly adapted it for modern day audience hold of creative and hodgepodge breaking ideas helps discussion and normalization of sensitive issues like stigma make use of of public demonstration, Sit ins and Die ins helps bring on buzz and social change.Health communication efforts for HIV Aids in IndiaThe National Aids condition Program (UNAIDS, 2008)Every State in India has an Aids prevention and oblige Society which under supervision from NACO carries out local initiatives.The second gunpoint of National Aids control program (NACP) ended on march 2006.This focussed on various platforms to promote youth education about safe sex, safe blood donation and HIV testing. heterogeneous platforms like Street plays, concerts, national aids day, TV and radio spots, and celebrity endorsements were utilised. usage of t severallyers and peer group influencers was make to disseminate knowledge about HIV aidsThe third stage of NACP allow have a operose focus on rubber promotion. The installation of over 11,000 base hit hawking machines in colleges, road-side restaurants, stations, gas stations and hospitals has been done. With take from the United States Agency for planetary Development (USAID), the government has also initiated a campaign called Condom Bindas Bol, which involves advertising, public events and celebrity endorsements. It aims to break the taboo that currently surrounds caoutchouc use in India, and to persuade people that they should not be embarrassed to buy them. (Shhhhnot anymore)Various multi-media campaigns have been implemented in India to create awareness about HIV.These include special communication programs to target special audience like sex workers, hand truck drivers, and street infantren. Radio programs are broadcasted on a regular innovation to disseminate discipline. Field publicity units, Drama and yell division has been set up to target rural India. Aids sizzlinglines with nearly 1097 toll free numbers have been set up in major cities of India.A very successful program has been the University Talk Aids (UTA program), which covered 4,044 institutions in India and reached out to 3.5 million students. The program was implemented by National Service Scheme with assistance from WHO and NACO.Independent evaluation suggested that the program was passing successful in creating a healthy attitude about sex among young childrenCommunication regarding Condom promotionSocial marketing of Condoms combine with free distribution has been used to promote example among general public as well as high venture gro ups. Department of Family eudaimonia has been instrumental in distribution and supply of condoms.Family Health Awareness CampaignThis campaign was focussed on creating awareness about RTI and STI among the general public as well as the field level functionaries. This campaign is organise annually in rural as well as urban slum areas. (Shaukat Mohammed, 2003)Reaching Special AudiencesReaching Men who have rouse with men (MSM) Case plain Naz infantry Trust of India (Rakesh, 2002)Background India with a very high population runs the take a chances of very high PLHA even if a low prevalence rate of HIV is present. Even though most sources of infection are through with(predicate) hetero-sexual sex yet in real areas like north -eastern India, IDU becomes a dominant factor for HIV contagious disease. outline The Naz foundation was set up in 1994 to address sexual health issues of MSM, women, truck drivers and PLHA.The happen upon communication objectives wereCommunication about modes of transmitting prevention and risk reducing strategiesMeans of accessing treatmentThe intervention strategies utilised were fellowship outreach Nine outreach sites which were staffed with officers who provided information on safe sexual health practices, condom usage and provided referralsSTI referrals A non judgemental approach to STI risk patients was followed. STI clinics were set up with a MSM friendly physiciansSocial and Group fill upings support groups were formed to help MSM and create a freer environment for information interchangeCounselingTelephone hot lines and personal counselling was set up to address MSM concernsResults The implementation of Naz foundation strategies was evaluated and it showed a number of arbitrary results. An make up from 11 % to 43% for all time condom usage ,the STI clinic visits increased from 24% to 56%, and condom usage by male sex workers increased from 20% to 43 %LearningNaz foundation realized that in order to reach out to specia l audiences made-to-order solutions are necessary.Some risk groups like female partners of MSMs are very difficult to reach and hence intensive efforts are needed in this area.Reaching out to Injecting Drug engagers (IDU) Case consume IDUs in New Delhi India (Dorabjee, 1998)Background In some cities of India like New Delhi the HIV prevalence rate among IDU users is as high as 85%.The Indian NGO Sharan has been working for IDU since 1979,and has done some breakthrough work in this area.(AIDS Analysis Asia ,1996).Strategy IDU were motivated to join either drug substitution therapy which involved substituting drug injections to oral drug usage or needle exchange program where the registered IDU users vouched to stop exchanging needles during drug usage.The think behind the success of this program was that it managed to develop a heavy self-assurance among IDU users because it employed recovering drug users as outreach workers. Constant feedback was sought from them and the progra m was modified accordingly.The IEC approaches used were counselling, peer education, information on sexual contagious disease of HIV aids, condom distribution and drug use prevention programs.Results33 % of registered IDU started taking oral drugs instead of Injections21% stopped sharing needlesUse of advocacy resulted in government accepting the use of harm reducing strategies for IDU usersLearningPolitical support is necessary for the success of any IEC reckon on sensitive issues. This can be influenced through strong advocacyIncorporating feedbacks by outreach workers and IDU can significantly increase the impact of the campaignA range of clinical, social and communication services are required to meet the purpose of HIV prevention among IDU usersAddressing the mobile population Case hire the Trucker Population of India (Bhoruka, 2001)There are about 50 million trucker population in India, who spend around ten months absent from home. Around 70% of these engage in unprotected extra married sex (UNAIDS, 2006).HIV infection is high in this segment along with a high STI danger. A major obstacle is that these truck drivers do not use condoms for road side sex as it regarded as a re-creational activity.Strategy The Bhoruka public welfare trust (BPWT), attempted to reach these truck drivers through free tea parlours set up at 5 main route stops in India. These tea parlours offered a run into ground for the truck drivers and offered tea, newspaper, TV and other forms of entertainment. However no whoredom or drugs were encouraged. Condoms, clinical counselling and STI medical referrals were offered at a pay rate.The most important aspect was focus on peer education and counselling. As these truck drivers discussed about their life, peer educators gave them counselling and information. Parking practically were used as another stretching stop where peer educator gave out condoms and IEC material.This program became so successful that various truck drivers th emselves became easy peer educators. The tea-shops were also managed by truck drivers or sex workers. unceremonial truck driver peer educators were later trained and given certificates to become formal peer educators and work in these tea shops.Small motivatingal incentives like bags and pens were also offered to these truck drivers as well as informal peer educators.ResultsEvery tea centre reaches out to close to 48,000 people annually, provides subsidised treatment to 2,200 patients .Fifty percent of these patients are treated for STIsAround 200 truck drivers had been trained as peer educators by the year 2000The condom social marketing component of this program was very successful, with steady increase in condom sales. Till 2000 there were 104,832 sold and 162 active condom distribution set up.LearningA high level of motivation should be maintained amongst the peer learning groups.Its important to have support of all the stakeholders for the success of any ICE program.Poliomy elitis (polio)Poliomyelitis (polio) is a highly infectious viral disease, which mainly affects young children. The virus is communicate through contaminated food and water, and multiplies in the intestine, from where it can invade the neuronal system. Many infected people have no symptoms, but do excrete the virus in their faeces, hence transmitting infection to others. sign symptoms of polio include fever, fatigue, headache, vomiting, stiffness in the neck, and pain in the limbs. In a small proportion of cases, the disease causes paralysis, which is often permanent. Polio can only be prevented by immunization ( humankind Health Organisation)Global Case load PolioPolio cases have decreased by over 99% since 1988, from an estimated 350 000 cases in more than 125 endemic countries then, to 1997 reported cases in 2006. In 2008, only parts of four countries in the world tolerate endemic for the disease the smallest geographic area in history.In 1994, the World Health Organization (W HO) Region of the Americas (36 countries) was certified polio-free, followed by Western peaceable Region (37 countries and areas including China) in 2000 and the WHO European Region (51 countries) in June 2002.In 2007, more than 400 million children were immunized in 27 countries during 164 supplementary immunization activities (SIAs). Globally, polio surveillance is at historical highs, as represented by the timely detection of cases of acute flaccid paralysis.Persistent pockets of polio transmission in northern India, northern Nigeria and the border between Afghanistan and Pakistan are key epidemiological challenges.As long as a single child remains infected with polio, children in all countries are at risk of contracting the disease. The poliovirus can easily be imported into a polio-free country and can spread rapidly among unimmunised populations. Between 2003 and 2005, 25 previously polio-free countries were re-infected due to importations.The four polio-endemic countries are Afghanistan, India, Nigeria and Pakistan.Global Health Communication efforts for Pulse Poliostrategic communication efforts in Afghanistan (Rafiqi, 2004)The Pulse polio eradication program of Afghanistan faced stiff challenges due to illiteracy, resistance, inaccessibility and worsening security conditions.Strategic approach for Polio health communication in Afghanistan focussed on advocacy, social mobilization, communication to support the program and cultivation.Advocacy was achieved by involving top leaders at every program launch, and getting them involved at all levels by sharing epidemiological info. Social mobilization through involvement of religious leaders, mosque and prayer announcements, and inter-personal communication. Television and Radio was also utilized. Communication to support the program was achieved through district and community based forums which encouraged discussions, dedicated community specific social mobilization workers were employed and genteelness was given to Imams and other religious leaders. Print media was used effectively for brochures, banners and leaflets.LearningIts a challenge to shift the focus of health communication from campaign type to sustainable communicationAdvocacy at highest level is instrumental to success of the campaignUse of local facilities like mosques, bazaars, mobile loudspeakers etc lead to effective social mobilizationAppropriate mix of print and radio can effectively reach mobile populationEstablish strong relationship with religious leadersPromote health education through health facilities as well as clannish practitionersEnsure all factions of community are involved including womenPolio immunization efforts through public health education efforts in West Africa. (African Science Academy Development Initiative (ASADI), 2005)Nigeria faced a major challenge when polio inoculation was stalled in northern areas due to huge negative parameter in local as well international media regarding the safet y of these oral medicines. Moreover allot of trusted religious leaders also spoke out against the vaccine.To fight this drastic loss of adoption of Oral Polio vaccinum (OPV), a strong communication plan was developed with the objective that each child should get OPV drops.This was achieved through heightened advocacy through big(a) scale public flag offs of campaigns, direct involvement of the president, working with the private companies including telecom companies, and engagement of religious as well as community networks.To focus on community education community mobilizers were assigned to high risk area, handed-down media like street theatre, town criers, mobile motion-picture show and folk songs were utilized. Mass media like TV spots and radio jingles were also integratedEffective use of Media for behaviour change was used. This included broadcast medium in national languages, special programs for minority groups, projection of human interest stories to create positive d ialogue, folk media, community theatre and mobile movie followed by dialogue.Success of this campaign can be determined by the fact that the demand for immunization and OPV drops substantially increased. The OPV controversy was effectively resolved, along with support from key stake holders.Learningconduct Change through public education and integrated mass and traditional campaigns can effectively result in more demand and acceptance of polio immunization.Health communication efforts for Polio IndiaReducing resistance and increase community dialogue Meerut, Uttar Pradesh (United Nations Childrens Fund (UNICEF) India, 2007)Meerut is one of the regions of Uttar -Pradesh which is seen as high risk for the polio endemic. A highly innovative social mobilization campaign was implemented in Meerut, which involvedUse of distinct influencers Three teams of 35 Urdu teachers,24 kirana store owners and Hajis (people who have completed Haj pilgrimage )were involved in these teams.Close to 25,0 00 primary schools were approached on republic day, to educate the children, inform them of the dates of immunisation so that better participation is achieved.Mosques were approached to educate the community. Their participation increase from 61% in January 2007 to 74% in February 2007.Meetings on a regular basis were conducted with mothers and daughter in laws, to discuss polio and child health issues.Booklets were produce which contained poems written by local influential poets. These boosted the morale of health workers and also worked as strong advocacy measure.Due to these innovative techniques Meerut recorded the low no. of resistant households in Uttar Pradesh in 2007.LearningPolio needs to be incorporated as a part of overall child health program .Consistent, open and on-going dialogue with all factions of community is necessary.Use of innovative techniques to create interest Polio Joker (Kher, 2007)Brihanmumbai Municipal toilet (BMC), hired Manchanda Jha to dress up as a joker and captivate kids to polio booths .He sings songs about polio, does tricks, engages children and gives information about the importance of polio drops alongside.When dances and sings Chal chale polio boothpe hum sathiyoon, chalke do boondh jeevan ke le sathiyon the children are not only humoured but also an important meaning has been delivered.He became so successful that he came to be called Polio Joker popularly. He has been instrumental in reaching out to care-givers and kids in slum areas. This program was implemented for three years and has very high recall value.LearningNew entertaining techniques need to be implemented if communication has to reach childrenCommunication methods should be tailored to meet the needs of high risk areas.Rationale of the researchHealth status of a country is influenced by a number of factors like food, water, income, sanitation, education and accessibility to health care services. Health communication campaigns and health services dont exist in a vacuum but are influenced by external socio-economic, cultural and factors.These factors play an important part on how health information education and communication campaigns are designed, implemented and finally received by the target audience.These factors also influence policies, resource allocation, technology, training of medical staff and communication strategies used. These in turn shape the health services system of a particular region.Studies which have documented the health communication efforts have restricted themselves to an analysis at national level. It depart be not surprising to find that in a complex nation like India various sub-systems exist, and every sub-system might influence the message in its own way.HIV AIDS and Polio are two major health concerns faced by Indian population. On-going and consistent efforts are made to educate people regarding these. However again within a geographic sub-system people might react and respond both these campaig ns in a differential manner owing to a variety of factors like sensitivity of the issue, complexity of the message and stigma.Through this theatre of operations I deprivation to explore these factors which affect the impact of health communication campaigns of HIV Aids and Polio, in a geographic sub-system.Research ObjectivesThrough the analysis of the belles-lettres review and recommendation of my guide the following research objectives have been identifyTo understand the health communication processes and initiatives undertaken for HIV Aids and Polio prevention/care at a sub-system, grass root level.To identify factors which lead to an differential impact of these health communication campaignsTo suggest improvements ,if possible, to current health communication practices followed in the geographic sub-systemResearch AreasHealth communication campaigns which go away be studied extensively areAgainst HIV-AidsThese forget include the communication efforts in the area of prevent ion (transmission through mother to child, sexual transmission and primary prevention) and against stigma.Against Pulse PolioCampaigns for polio education and routine immunisation exit be studied.This study aims to understand the use of traditional media, electronic and human channel employed at the grass root level. What are the problems faced in implementation, what are the intermediary factors which affect them, and what measures are taken to combat these problems.An evaluation of these campaigns will also be conducted based on how much has the target audience been receptive to them, and responded by either positive action or behaviour change.Ultimately both these campaigns will be compared and contrasted to arrive at the differentiating factors which impact the outcome of these.Research Methodology form OneAn extensive secondary research will be done to establish a foundation for the primary research.The literature review provides legitimate learning about different methods of strategic health communication. This learning will be taken forward to secondary research where the focus will be kept on the grass root health communication initiatives undertaken in the chosen sub-system.In addition a case study method will be employed to shape up the key focus areas for the primary research.Phase twoThis phase will consist of primary research will be essentially qualitative and preliminary in nature. The purpose of this type of research methodology is to generate base knowledge on relevant areas, discover associated factors, and identify information gaps. info collection and AnalysisSecondary research will consist of data collection from online sources, medical and communication journals as well as reports.Various performance reports and internal documents which are generated at the primary sub-system level will also be looked into gather data.Expert In-depth wonders will be conducted to gain more understanding on the subject. It is important to note that the interviews will be open -ended and flexible to generate maximum insights.These interviews will involve extensive probing and will utilize the technique of laddering, An interview guideline will however be prepared for a comprehensive and systematic execution. alike(p) technique of in-depth interviews will also be employed to collect information from target audience regarding the appeal of the campaigns.The reason why in-depth-interviews will be used over other methods of data collection isIt is flexibleIt provides in-depth information about areas to be coveredSince the area of study is very specialized it provides scope for clarificationSome of the issues which needs to be discussed are personal in nature, a face to face and private discussion is necessaryLike other techniques, this tool also suffers from certain limitations. It is prone to bend andlargely depend on the skill of the interviewer. It is an expensive technique, can be timeconsuming and responses may be difficult to interpret. The structure of the interview is notclearly defined unlike a survey and so same questions may not be asked to all the respondentsArea of StudyThe chosen geographical sub-system for the primary research is Aligarh in UP. The reasons behind this are the followingNorthern UP has a relatively high prevalence rate of HIV AIDSIts one of the few areas in India which is allay Polio EndemicFamiliarity with the local languageInitial contacts are forthcomingTimeframe of the studyPhase one- November till mid-December 2009Phase two/primary research Mid December to January 2010SamplingSampling universe consists of all the experts in the area of the study, and the population to which the health communica