The last week has been filled with much research, compilation, writing and tool development in Dhaka. I visited ICDDR,B, an internationally-renown research institution in Bangladesh, to check out their newer and grand Monitoring and Evaluation department. Sareeta Apa and I plan to schedule meetings with experts in the department in the weeks ahead to seek their input on strengthening monitoring culture in Friendship. On my own, I also paid a surprise visit to BCCP, a non-profit communication NGO started in 1996 as the successor to the Johns Hopkins Bloomberg School of Public Health Center for Communication Programs. By surprise, I mean I literally walked into the center and asked to speak to someone because I was a public health student. The term “public health” was very welcome indeed and the director himself came down to speak with me.
I had passed the center many times during my first week in Bangladesh because of its proximity to my house, but when I visited it, it had been closed on holiday. Later on in the field, I noticed the Center’s logo in the right-hand corner of almost all of the posters and visual aids that Friendship’s community health workers used during uthan boitak or community health meetings. I had promised myself to follow up.
The visit was very insightful and I got a personal tour of its facilities. BCCP is committed to providing high quality services to audiences in rural and urban settings, helping them adopt positive behavior towards various social issues, such as education, anti-trafficking, agriculture, democracy and local government, terrorism, and social development. Thus, BCCP helps develop communication strategies, but also implements, monitors and evaluates them, along with designing materials and developing community-based, mass media, BCC (Behavioral Change Communication) and Inter-Personal Communication (IPC) interventions. The Center seems to be very involved in capacity-building as well, training key personnel of relevant institutions in strategic communication, message development and development of Entertainment-Education programs.
The Center’s work verifies what I have been learning in this internship thus far, as well as at Gillings and my own dabbling: the process of communication is intrinsically linked to the success (or failure) of public health interventions. It seems to be a repeating pattern in my public health education.
Social marketing oriented towards public health began decades ago, but it wasn’t until the mid to early 1990s that HIV prevention and family planning media campaigns started getting major press for playing a pivotal role in encouraging use of contraception and safer sexual behavior around the world. (Check out this 2003 paper by our own Carolina Population Center based in Chapel Hill, showing that higher exposure to BCC messages in mass media was associated with higher contraceptive intentions and use in Uganda). Collaborations between schools of public health in the United Sates and abroad increasingly involve media campaigns (check out this one in Vietnam!).
Everything from the impact of celebrity involvement in the AIDS pandemic to managing uncertainty and fear in the face of swine flu, the impact of communication spans the entire spectrum of our activities in public health. And that’s not even the end of it. The Center for Communication Programs at Johns Hopkins, the Population Media Center, programs like PRACHAR in India show the extent and vast coverage of this phenomenon.
Which begs me to ask: we communicate, but do we do our best listening? I know Social Change isn’t linear, but true change seems difficult to attain if these interventions aren’t at least bilateral or participatory, even at the macro scale.
As a dynamic process that unfolds over time, communication geared towards public health should involve networks to harness the insight and knowledge of the message “recipients” to aid in its own evolution. Ideally, the “recipients” should somehow be directly involved in the actual creation of the communication material. I’m reminded of Dr. Bonnie Duran’s speech at the Minority Health Conference this year, not-so-softly warning that evidence-based interventions may be a form of forced acculturation. For global public health experts to strike a fine balance between taking full advantage of communication and mass media, while at the same time remaining true and close to the recipient communities seems a tremendous task, but one well worth the attention.
I’m almost imagining real-time feedback that includes more than just message recipient or beneficiary numbers, but provides a platform for interpersonal communication amongst the beneficiaries and to the message disseminator. Then, the question becomes how to develop, implement and sustain such a network in low-resource settings?