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July 2004

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Radio Broadcasting for Health:


An Issues Paper
July 2004
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ACKNOWLEDGMENTS

This paper was written and edited by Dr. Andrew Skuse of the School of
Social Sciences, University of Adelaide, with the support of Nadia Butler.
Fiona Power and Nicola Woods of the Information and Communication for
Development team within the UK’s Department for International
Development (DFID) commissioned the work and provided critical
commentary and support. Several people commented on and contributed to
the text. They include Mary Myers, Nicola Harford, Heather Budge-Reid and
Gordon Adam.

Design by Grundy & Northedge


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Contents

page number content

5-7 Executive summary

8-11 1. Introduction

12-17 2. Research and evaluation, health messages and formats

18-21 3. Community radio: opportunities and constraints

22-25 4. Public and international radio: opportunities and constraints

26-27 5. Radio for social mobilisation

28-33 6. Building links for better health broadcasting

34-35 7. Conclusion

37-39 Appendix 1: Radio checklists

40-43 Appendix 2: Popular radio formats

44 Appendix 3: E-sources

45-48 Appendix 4: References


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ACRONYMS

AIDS Acquired Immune Deficiency KCRIP Kothmale Community Radio Internet


Syndrome Project

AMARC World Association of MBC Malawi Broadcasting Corporation


Community Radio Broadcasters
MCH Mother and Child Health
BBC British Broadcasting
Corporation MTC Media Training Centre

BBC AEP BBC Afghan Education Projects NGO Non-government Organisation

BBC WST BBC World Service Trust NPPHCN National Progressive Primary Health
Care Network
BDO Building Digital Opportunities
PLWHA People Living With HIV/AIDS
CATIA Catalysing Access to ICTs in Africa
RFD Radio for Development
CBO Community Based Organisation
SABC South African Broadcasting
CDC Centre for Disease Control Corporation

CSO Civil Society Organisation SCR Soweto Community Radio

DBU Development Broadcast Unit SW Short Wave

DFID Department for International UDHR Universal Declaration of Human


Development Rights

DRC Democratic Republic of Congo UN United Nations

DTR Development Through Radio UNAIDS Joint UN Programme on HIV/AIDS

FAO Food and Agriculture UNDP UN Development Programme


Organisation
UNESCO UN Educational Scientific and
FHI Family Health International Cultural Organisation

FM Frequency Modulation UNHCR UN High Commission for Refugees

HDN Health and Development UNICEF UN International Children’s Fund


Networks
UNIFEM UN Development Fund for Women
HIV Human Immunodeficiency Virus
UNOCHA UN Office Coordination of
ICD Information and Humanitarian Assistance
Communication for
Development UNOPS UN Office of Project Services

ICRC International Committee of the WHO World Health Organisation


Red Cross

ICT Information Communication


Technologies
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ICD RADIO BROADCASTING FOR HEALTH: AN ISSUES PAPER

Executive summary

This paper provides an overview of the role radio broadcasting


can play in promoting better health for poor people. It has been
conceptualised within the context of global efforts to reduce the
burden of disease and ill health on poor people and advocates a
people-centred and rights-based approach to health
communications that emphasises:

• working with poor communities to gain an understanding of the


full range of epidemiological, behavioural and risk taking factors
that drive disease and ill health;

• designing communication initiatives that build on such


interactions and which integrate social assessment data into
communication outputs at all levels;

• multi-method approaches, i.e. a mix of interpersonal (peer


education, counselling, etc.) and advocacy-based approaches
combined with mass and community-based media interventions;

• community driven and led interventions that help the ‘vulnerable’


and ‘at risk’ to access useful and useable health information and
build knowledge for social and behavioural change;

• poor people’s rights to information, freedom of expression and


access to health services and education;

DFID supports the creation of enabling environments in which


radio - especially at community and national level - can flourish.
It recognises the importance and popularity of technologies such
as radio and supports the production of broadcast material
relating to health and human development more broadly (Myers
1998; Slater et al 2002)

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ICD RADIO BROADCASTING FOR HEALTH: AN ISSUES PAPER

Radio broadcasting at community, national and international


level contributes to improved health outcomes for poor people
in a number of ways. Through:

• the stimulation of community dialogue and national debate;

• the provision of public information and specialised training


about health risks and disease prevention;

• stimulating positive social and behavioural change, increasing


community tolerance and decreasing levels of stigmatisation
and discrimination;

Further, this paper contextualises the relevance of radio as a


strategic tool of human development and poverty reduction and
examines its use by poor people. It addresses a range of issues
from the role of formative research and evaluation, the
development of health messages, to a range of format options
widely used in health broadcasting. It also examines the
community, public and international radio sectors and in the
process highlights a range of opportunities and constraints that
these sectors face;

Likewise, it highlights key synergies and linkages that could be


enhanced to improve access to health information for radio
producers, the poor, the ‘at risk’ and the vulnerable. In doing so,
this paper raises a number of critical questions. For example:

• how can ministries of health, non-government organisations


(NGOs) and community-based organisations (CBOs) be supported
to become better providers of health information to, amongst
others, radio broadcasters?

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ICD RADIO BROADCASTING FOR HEALTH: AN ISSUES PAPER

• what capacity needs to be built, especially at community and


national levels, to enhance health broadcasting? For example, do
broadcasters feel confident in adapting the health information
that they acquire from a range of diverse sources for broadcast?

• how can radio be used to mobilise communities towards social


action? For example, to claim their rights to relevant health
services and voice their needs?

• is the community radio sector the most appropriate mechanism


for strengthening both community voice and dialogue on
health? What opportunities and constraints face the sector?

• what role does national public broadcasting play in contributing


to better health for poor people? Can it maintain a public
service ethic in the face of competition from community and
commercial broadcasters? How can it best be supported to fulfil
a public service role?

• what are the opportunities and implications for the radio sector of
the broader availability of new information communication
technologies? How can Internet and e-mail best be used to support
better health broadcasting? Will radio, as a medium of the poor,
remain relevant in the South?

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1 Introduction
1.1 Donors have a role to play in national or public, commercial and
building broadcasting sectors that international. These can be
are both sustainable and defined in the following terms:
dedicated to improving the health
of poor people. Donor interest in
the social and developmental role
• Community radio refers to radio
stations that are situated within
of radio is strong and is grounded the community, which serve the
in the recognition of the ubiquity community and which are staffed
of radio as the dominant by a broad cross-section of
communications technology that community members. Such
In Rwanda, for every 1 television there are 101 radio sets

is used by poor people (UNAIDS stations tend to have a strong


1999). In this respect, Buckley commitment to local particpation,
observes that: social inclusion and social or
“Radio is a technology with community development;
low production costs, with low (AMARC 2000)
infrastructure costs and with
marginal costs of distribution close
to zero. As an aural medium, it
• Public radio refers to radio that
serves the public interest and which
does not exclude those who are may be state owned and run, or
unable to read or write and it is state funded and independent (i.e.
ideally suited to conveying the BBC model). Within this sector
content in vernacular languages. broadcasting at both national and
For these reasons it is perhaps local level occurs, with local public
unsurprising that radio has broadcasting charged with
become an intimate and pervasive reflecting issues of local relevance.
presence throughout the Many state run and/or controlled
developed world and, at the same public radio networks in the South
time, has penetrated into the are overtly propagandist and are
remotest areas of the poorest socially exclusive, rather than
countries.” (2000: 3) inclusive, i.e. they may actively
favour certain discrete ethnic,
A significant expansion of radio- religious, political or
based interventions for health at language groups;
international, national and
community levels has occurred in
recent years (see Dagron 2001). In
• local
Commercial radio at national and
level tends to have little or no
part, this is due to the public service commitment and
deregulation of the airwaves that stations are generally run for profit,
has occurred in many developing carry advertising and often
countries and recognition that broadcast substantial amounts of
radio is a cheap and effective popular music. Though not a
means of communicating issues principal focus of this paper,
relating to health, policy and opportunities do exist within the
health service delivery.1 commercial radio sector, through
ensuring public service
1.2 Radio, as a sector, can be broken commitments as a requirement of
down into a number of licensing, for enhancing the health
sub-sectors such as community, information environment;

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• International radio services, often


broadcast in multiple languages, fulfil
1.5 The UN ICT task force (2002) adds
weight to this assessment, noting BOX 1
The Cost of ICT Access
a role that is part public service (often that of the 816 million people
with a national or regional focus), living in Africa in 2001, 1 in 4 have
In extremely poor countries, such as
news service and entertainment a radio (205 million people), 1 in
Afghanistan or Rwanda owning and
focused. Many international services 13 own a television (62 million running ICTs represent a significant one-
are overtly propagandist and often people), 1 in 40 have a terrestrial off and recurrent expense. For example,
reflect the foreign policy concerns of telephone line (20 million people) a cheap FM/SW radio set will cost from
the countries from which they and 1 in 160 use the Internet (5 US$10 upwards, with replacement
are broadcast. million people). They identify that: batteries costing approximately US$0.50-
“Radio is still by far the most 1.00 per month. For the extremely poor
1.3 The radio sector constitutes one of dominant mass medium in Africa living on $1 per day or less, such
the many fields from which poor with ownership of radio sets expense is significant, but tends to be
justified in terms of technologies such as
people gain information relevant to being far higher than any other
radio constituting an essential
their own health and wellbeing.2 electronic device... It is estimated
information channel. Access to
However, focusing upon radio that over 60 percent of the
traditional media such as radio and
affords us an opportunity to population of the sub-continent television is critical if broader
examine how donor funds can are reached by existing radio information inclusion is to occur. In the
support better practice in health transmitter networks while delivery of health and education
broadcasting and radio-based health national television coverage is especially, the significance of terrestrial
advocacy. It also provides an largely confined to major towns.” technologies remains highly relevant to
opportunity to examine how a (UN ICT Task Force 2002: 5) the poor.
specific communication sector within
a wider range of communication 1.6 Such evidence highlights the (Myers et al. 2000)
channels and initiatives helps to relevance of radio to the poor and
contribute to improved human its potential as a tool for health
development outcomes. broadcasting. However, media
ownership is not equally
distributed amongst the rich and
Radio and the poor poor and whilst television
ownership is burgeoning within
1.4 The recent UNESCO World Culture certain countries (i.e. China and
Report (2000) reveals that levels of parts of Central Asia), television
radio ownership in the South are remains largely beyond the reach
significant and in certain contexts of the poorest.
radio represents a critical
information lifeline for poor men, 1.7 Whilst radio is a less costly
women and children. Comparative medium and is more evenly
analysis of the density of radio and distributed amongst the poor, the
television ownership shows that in very poorest often find it hard to
extremely poor countries such as afford both radio sets and the
Rwanda, for every television set regular purchase of batteries.
owned there are 101 radio sets. Nonetheless, ownership statistics
Similarly, in Nepal there are 7.1 tend to belie the significant
radios owned per television set, in amount of group or social radio
Sierra Leone and Ethiopia this listening that occurs in the South
figure stands at 20.8 and 43.9 i.e. a village shop may have a
radios per television respectively. radio set to entice listeners and

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Douentza, MALI.
Dogon women listening to the radio as
they work.
© Rhodri Jones / Panos Pictures
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ICD RADIO BROADCASTING FOR HEALTH: AN ISSUES PAPER

customers, or a radio listening this trend requires further Footnotes


club may be formed to improve investigation since inequality in
community access to information. access to information can result in 1 The cost of the equipment necessary to
Further, access to radio and other serious inequalities in access to set up a community radio station can
ICTs may be highly gendered health services, despite the often vary from between US$3,500-10,000.
within certain contexts, leading to explicit targeting of health The Commonwealth of Learning have
marked disparities in health services at women and children in pioneered low cost ‘suitcase’ radio
information equality. the South (UNDP 2001). stations that contain the broadcast and
transmitting equipment capable of
1.8 Equally important is the extent to 1.10 Addressing the health information broadcasting within a 50 km radius.
which radio provides a focus for needs of the poorest requires a The kit uses commonly available
community discussion and multi-stranded approach to components and is cheap to maintain
dialogue. Through everyday social building infrastructural capacity, and run (Commonwealth of Learning).
communication practices, gossip, institutional capacity and The cost of licences, for example for
debate, chat, etc. health inform- providing content. We do need to community radio stations, varies widely
ation may be passed from radio increase access to new and is context specific, i.e. from US$25
listeners to non-listeners, and in technologies for poor people, but in Canada to US$625 in Nepal per
the process the boundaries we must also be practical and cost annum (Nepal Media).
between targeted risk groups, effective and recognise that the
audiences and wider societal ‘traditional’ technologies that 2 Social communications (discussion,
impacts become blurred. For poor people use to obtain debate, gossip, etc.) and participatory
example, few existing studies of information, as well as communications (theatre, dance, song,
radio and public health make entertainment, have a strategic etc.) for development are dealt with in
the link between broadcasting role to play in realising better detail in Burke, A. 1999.
and the passage of inform- health outcomes for the poorest. Communications and Development: a
ation within communities as Practical Guide, Social Development
social communication. Department, DFID, UK. Access to and
use of other information
1.9 Little qualitative data exists on the communication technologies (ICTs)
active strategies poor people such as printed media, video, Internet,
employ to obtain health e-mail, television and film can enhance
information, be it from health the chances that both individuals and
professionals, friends, neighbours communities will act on health
or ICTs.3 Though strong evidence information and put that information
exists regarding gender, poverty into practice as disease prevention or
and information inequality risk reduction knowledge.
(Marcelle 2000), there are gaps in
our understanding of the 3 This is compounded by a general lack
strategies that women, for of health data in priority countries
instance whose public mobility which is reflected in recognition of the
may be constrained due to need to build statistical, but also
cultural norms, use to gather or behavioural, research capacity in the
access information concerning South (UNDP 2003).
health. However, we do know that
throughout the South women and
children tend to have lower access
to communications technologies
than men, and the dynamics of

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2 Research and evaluation,


health messages and formats
2.1 This section examines the role of
research and evaluation in health BOX 2
The role of research and evaluation
broadcasting. It examines how
they inform the development of
Specific research and impact evaluation
context specific and community
regimes are now routinely established
relevant health messages, the within communication initiatives and
identification of risk groups and are used to enhance their quality and
identification of media uses and relevance in a number of specific ways:
format preferences.
• through formative or baseline research
in particpation with communities that
2.2 A long standing criticism of mass
media has been that they are ‘one- examines issues such as risk taking,
way’ channels, that can, for health seeking behaviour, routine
hygiene and sanitation practices,
example, tell people about health,
information needs, media access, use
human rights or small enterprise
and preferences, and which guides the
development, but cannot allow the
production of health broadcasts in
audience to talk back or get terms of both message content and
involved. Community media are style. This process can also help
increasingly being seen as a solution decision makers to assess whether
to this very particular problem, radio is the most appropriate medium
namely, the issue of the social and for addressing the health issue at hand
cultural distance of media producers or for reaching a specific risk group;
from their audiences.
• by undertaking a desk review of
existing secondary information
2.3 Formative research and evaluation
concerning the given health issue.
have become critical components
This helps reduce the amount of
of health broadcasting in the
duplication of research;
South. This is especially so for
larger and better-funded
initiatives, such as the multi-media
• through the definition of qualitative
and quantitative indicators that are
outputs of Soul City, South Africa, relevant, targeted, measurable
which provide information in a and achievable;
range of formats on issues as
diverse as HIV/AIDS and • through the identification and
definition of key audiences and risk
hypertension (Tufte 2001). For
groups for health broadcasting;
community radio stations, which
are usually run with a minimum of
financial support, formative and • through the testing of outputs and
health messages with audiences;
systematic impact evaluation
remains largely out of reach.
However, Fordred and Lloyd
• through evaluation of the impact of
health broadcasting with audiences;
(1998), Porras (1998) and Skuse
(1998) all highlight mechanisms, • through adaptation of outputs so that
broadcasting remains responsive to the
from simple evaluation strategies,
to developing listener feedback shifting health information needs of
groups that enhance health poor men, women and children.

broadcasting through locally


derived contextual information.

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The findings of this work reduction requires holistic


suggest that: interventions, of which radio and BOX 3
Evaluating the Programme Effects of
communication more generally,
a Radio Drama about AIDS in Zambia
• community stations and national
radio interventions for health that
represent one component. Recent
papers such as The Panos
Focusing on a Zambian radio drama,
have small budgets should not be Institute’s (2002) guidance on Nshilakamona, a study was undertaken to
burdened with unrealistic HIV/AIDS and communication echo assess the effectiveness of methods used to
formative and evaluative research this stance and suggest a shift analyse the impact of radio drama on
components. Despite this, efforts away from ‘difficult to achieve’ people’s behaviour and knowledge in
should be made to establish short term goals relating to relation to HIV/AIDS. The results of surveys
audience feedback mechanisms individual behaviour change undertaken immediately before and after
(simple evaluation, listeners’ towards the more realistic the programme was aired in 1991 found
letters, phone-ins, competitions) objective of raising community that while Zambia’s population as a whole
had improved its knowledge regarding
that are in line with the scale of dialogue and public debate
AIDS, and to an extent reduced risky
the intervention, i.e. 10% of the concerning health.
behaviour, such changes could not be
overall project budget could be
attributed directly to the drama itself. This
set aside; 2.5 If raising community dialogue and conclusion was drawn because groups with
subsequently social, rather than high access to radios and groups with low
• formative research and evaluation
skills are low within the public
individual, behavioural change are
perceived as the ultimate goals of
access both increased their awareness
levels at the same rate. The fact that no
and community sectors and (this broadcast interventions for health, changes could be directly attributed to the
applies equally to international then this refocusing places a drama may be due to the method of
broadcasters) an emphasis has premium on the quality and evaluation and does not imply that radio
been placed on identifying relevance of health messages and dramas are ineffective. At the time that
the radio drama was aired, many other
general audience share, rather the need for accurate and useable
sources of information regarding AIDS
than on understanding health health information within radio
were available, making it problematic to
behaviour or the qualitative stations. It also entails a shift in
attribute changes over time to one single
impact of health broadcasting; emphasis in impact evaluation, programme. Also, due to the short time
from quantitative data concerning frame of the evaluation process, long-term
• capacity needs to be built at local
and national levels through
mortality and abstract measures of
knowledge acquisition to
changes were unable to be detected. This
highlights the need for rigour in
training in formative research and qualitative assessment about the evaluation processes and recognition that
evaluation skills that are practical community dialogue that each attributing complex behavioural changes
and useable. intervention stirs and a more to mass media, without accounting for
subtle understanding of poor other structural factors which affect health,
is extremely difficult.
2.4 Often, communication people’s health information needs.
interventions for health have (Yoder et al. 1996)
been perceived as ‘magic bullets’,
with the power of media alone
capable of delivering health
behaviour changes and risk
reduction, regardless of the
complexity of the health issue.
HIV/AIDS and long donor, NGO
and CBO involvement in
awareness and education
campaigns have taught us that
behaviour change and risk

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Burkina Faso.
Live debate on football and witchcraft on
Radio Vive le Paysan, based at Sapone,
40km south of the capital Ouagadougou.
This debate is the equivalent of a phone-in
except that no-one has a phone so
participants cycle in from the surrounding
area and gather in the studio. Some,
hearing the broadcast at home, turn up
during the programme wanting to take
part in the debate. The station gives a voice
to the surrounding villages, broadcasts are
in the local language.
© Crispin Hughes / Panos Pictures
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ICD RADIO BROADCASTING FOR HEALTH: AN ISSUES PAPER

Health messages
BOX 4 BOX 5
Social change communication The Impact of Multimedia Family
2.6 Formative research and ongoing indicators Planning on the Contraceptive
evaluation help producers to Behaviour of Women in Tanzania
identify what is important to Example indicators relevant to health
communicate and how it should broadcasting include: A multimedia family planning promotion
be communicated. The health campaign conducted in Tanzania between
information contained within • expanded public and private
dialogue and debate;
1991 and 1994 aimed to increased
contraceptive use. Evaluation found a
radio broadcasting is usually
referred to as health messages. strong link between exposure to family
Health messages if well researched • increased accuracy of the information
that people share in the dialogue
planning messages in the mass media and
contraceptive use. It found that the more
and carefully produced can and
and debate; types of media that women were exposed
do contribute to better health for
to, the more likely they were to practice
poor people (CDC 1999).
• the means available that enable
people and communities to feed their
contraception. Among the different
media used in the campaign (radio,
2.7 Didactic health message-giving or voices into debate and dialogue; television, print materials and a
fear-based messages relating to promotional logo), radio was found to be
health and risk should be avoided. • increased leadership and agenda
setting role by disadvantaged people
the most popular source of family
planning information, reaching 49% of
Such messages tend to reinforce
prejudice, self and social stigma on issues of concern resonates with survey respondents. 9 out of 10
and are generally counter- the major issues of interest to respondents who recalled hearing family
people’s everyday interests; planning messages in the media cited
productive (Singhal and Rogers
radio as one of their main sources. A
2003). Early examples of public
information campaigns in the • linked people and groups with
similar interests who might otherwise
radio drama dealing with family planning
messages, Zinduka! ("Wake Up!"), was
West typify this approach, the not be in contact. assessed independently and found to
slogan promoted in the UK ‘AIDS: have been especially successful. Women
don’t die of ignorance’ provided who recalled the drama were more likely
no positive message, no informa- than others to talk about family planning
tion that could be acted upon and with their spouses, to visit health facilities
labelled people living with and to use contraceptives. Though radio
HIV/AIDS (PLWHA) as ‘ignorant’. was the most popular source of
information, the study led to the
conclusion that multiple media sources
2.8 Effective communication can help
appear to be complementary rather than
individuals and communities to
duplicative, as the more media avenues
engage in healthy and health-
that people were exposed to, the more
seeking behaviour. This can be their attitudes and behaviour were likely
achieved by positively influencing to change. It is also recommended that
variables such as self-efficacy (the regular reinforcement of messages is
confidence in one’s own ability to needed if continued use of contraceptives
perform a behaviour), outcome is to be made. Attitudinal and
expectations (the expected result behavioural change is a long-term
of performing a behaviour), process, and scattered family planning
knowledge, perceived risk and messages and short-term campaigns are
unlikely to provide adequate support to
social norms, whilst locating this
current or prospective contraceptive users.
individual behaviour change in
the wider socio- economic and (Jato et al. 1999)
cultural environment
(Galavotti et al. 2001)

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2.9 Simulating dialogue on health 2.10 Given the widely accepted need
BOX 6
issues requires that the for detailed formative research
Principles of message design
information exchanged within it is and ongoing evaluation of impact,
Messages should be: accurate and useable. In turn, this the predefinition of health
places special emphasis on the messages in radio interventions
relevance of the health messages should be viewed with suspicion,
• well researched and evaluated;
• non-judgemental and inclusive;
non-technical and non-didactic; that lie at the heart of health especially when the intention
• gender sensitive; broadcasting. Many examples exist exists to work with vulnerable
• accurate and useable; of poorly targeted, confusing or communities and specific risk
• culturally appropriate; even detrimental messages. Key groups. This suggests assumptions
• sensitive to local needs; message issues include: have been made about what
• carefully worded to aid clarity constitutes appropriate and
• and understanding; • Sensitivity. For example, messages relevant health information.
regarding safe sex and family Examination of research and
• reinforced through multiple broadcasts. planning may be opposed in evaluation structures, as well as
certain cultural contexts; the goals defined within project
documentation will help desk
• Credible content. For example,
health messages must be
officers assess whether the
intervention is:
understandable and provide a a) taking an iterative approach to
message that a listener can community information needs and
reasonably implement in dialogue building or;
behaviour, i.e. if advocating b) a more didactic and less
condom use in poor communities, rigorous alternative.
condoms should be locally
available and cheap;

• Conflicting messages. For


example, radio stations with
different perspectives on health
issues such as family planning may
broadcast messages that actively
oppose each other leading to
confusion amongst listeners;

• Gender equity. For examples


health issues are gendered and
addressing an issue such as family
planning or birth spacing only
from the perspective of women is
inadequate, the roles and
responsibilities of men must also
be addressed.

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Radio formats 2.13 The impact that specific formats though this may be increased
have from country-to-country through the charging of airtime
2.11 Identifying and understanding the varies according to the nature of fees to external agencies;
media uses and preferences of the media environment, i.e. media
groups at risk from disease and
wider radio audiences is critical to
complexity and density of radio
access and use, as well as localised
• The cost, complexity and skill
required to produce a radio soap
producing health broadcasting tastes and format preferences opera generally places it out of
that has the ability to create an (Skuse 2002). This diversity places the reach of smaller community
impact that contributes to the a critical emphasis on stations and firmly locates it
realisation of the Millennium, understanding the needs, in terms within larger, often multi-method,
Development Goals and Targets. of both health information and interventions;
Knowing what is popular, be it entertainment, of radio audiences
soap operas, comedy, phone-ins,
factual programmes and so on,
and upon formative research to
guide intervention design. The
• Availability of useful and useable
health information can also be a
enable project planners and principal radio formats used in factor in the choice of radio
producers to design health health broadcasting are formats by certain stations. For
communication strategies that elaborated in Appendix 2, along example, community radio
target a number of strategic with relevant examples. presenters may not feel confident
audiences, such as: enough, given that most have no
formal training in health

• policymakers,
legislators;
politicians or Which format? broadcasting, to address a
complex health issue such as

• general public; 2.14 Though each format example HIV/AIDS beyond providing simple

• communities.
specific risk groups and provided in Appendix 2 has been
used to good effect to address a
messages regarding safe sex and
condom use.
range of health issues, their choice
2.12 A broad range of radio formats are and subsequent use by
used to address an equally broad international, public and
range of health issues. Though it is community broadcasters depends
widely agreed that the most on a number of key factors:
effective health communications
are those that raise community
dialogue, i.e. through soap operas,
• Who the broadcaster intends to
target. For example, certain
magazine formats, mini-dramas, formats may be used to provide
and radio phone-ins, less target- specific information to specific
specific formats, such as routine audiences. Here, advocacy efforts
news, short spots (a simple that target policymakers and
message conveyed quickly) and legislators may require a very
slogans, can also reinforce or different approach to that of
highlight key health messages for disease prevention within specific
the general public. risk groups;

• Available financial resources,


technical and creative capacity can
limit the scope of interventions.
For example, the cost of
producing a spot on local or
national radio may be minimal,

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3 Community radio:
opportunities and constraints
3.1 The important role that community 3.3 Community radio resonates to
radio plays in giving a voice to local concerns and needs, it
community issues is reflected in the broadcasts in local languages that
increasing focus of donors on are often ignored by public
strengthening the sector (Gerster broadcasters and is run by
and Zimmermann 2003). The community members. It can be
deregulation of radio has resulted in established to serve specific
the flourishing of empowered and groups, as does Radio Mineras
critical voices in places such as South (miners’ radio) in Bolivia, or it can
Africa, Nepal and Bolivia. address specific themes, as does
Furthermore, community radio plays Radio Sagarmatha which has a
a fundamental role in raising and focus on environmental
addressing community health issues. sustainability (Dagron 2001).
As such, it is placed at the vanguard
of efforts to address diseases such as 3.4 Community radio is recognised by
HIV/AIDS, TB and Malaria. many donors and developing
country governments as a tool for
3.2 Community radio is community- advocacy, civil society
based and is run for the benefit of strengthening, better governance
the community. It differs from local and accountability (Rodriguez
radio in as much as it is independent 2001, cited in Tacchi 2002). As
from larger state broadcasting such, community radio can be
networks, their content and thought of as a lever for the
perspective, and adheres to licensing realisation of poor peoples’ rights.
requirements concerning community Typically, poor people are exposed
participation and service. The focus to greater health risks than the
on local concerns is reflected in the non-poor by virtue of their
‘typical’ mission statement of Radio relative poverty, disempowerment
Zibonele in Cape Town, South and inability to realise their rights
Africa, which reveals both the level in a number of areas, such as
of community ownership and workers rights, rights to health
commitment to local development: services and rights to education.
“We are a group of volunteers Fundamental to each of these
with diverse skills, who have formed rights-related fields is that of the
a Community Radio Station owned, human right to freedom of
managed and programmed by the information enshrined within the
community of Khayelitsha. Our 1948 Universal Declaration of
concern is to enhance the quality of Human Rights (UDHR) that states:
life through improving the health “Everyone has the right to
standards of our people. All those freedom of opinion and
we serve are affected by poor health expression: this right includes
and poor environmental conditions. freedom to hold opinions without
Radio Zibonele is committed to interference and to seek, receive
sharing skills and information and impact information and ideas
through honest process, in the way through any media and regardless
empowering the community of of frontiers.”
Khayelitsha to have a better life.” (Quoted in Linden1999: 419)
(AMARC 2000: 26)

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3.5 Though non-binding, and perhaps


BOX 7 BOX 8
because of this, Linden (1999)
The Expansion of the Community Soweto Community Radio (SCR),
identifies that information-related
Radio Sector in South Africa Gauteng, South Africa
rights are ‘violated widely’. This is
evidenced by widespread Prior to the transition to a one-person- SCR broadcasts from the heart of
violations against the press and one-vote democratic system in 1994, the Soweto and was established in the early
the fact that only 22% of the Independent Broadcasting Authority Act 1990s to fill a community information
world’s population have access to of 1993 had already laid the foundations deficit for the huge township
independent media, in spite of for community radio broadcasting. The population who were previously serviced
over 50% of this population living aim of the act was to develop localised by the South African Broadcasting
in countries who describe media in poor rural and urban areas Corporation (SABC). In 1998 it was
themselves as ‘democratic’. that served previously disenfranchised estimated that the listenership of the
South Africans. The act made provision station was as high as 115,000 people.
Control of national media by
for four-year licences to be granted, SCR is committed to health broadcasting
Southern governments and elite
with one-year interim licences being and takes a range of externally
vested interests represents a
suggested whilst the bill was produced radio programmes, as well as
critical problem that can implemented. However, the framework producing its own. The station regularly
potentially be addressed through was not fully defined until 1997, after uses material produced by the Media
the development of ‘robust policy which further delays in implementing and Training Centre (MTC), which is
on people’s [basic] right to the act and the large number of licence affiliated to the National Progressive
communication’ applications received further slowed the Primary Health Care Network (NPPHCN),
(Linden 1999: 421). process. The relative failure of the South both of whom provide support to South
African regulatory structures to African community radio broadcasters.
3.6 The emergence of the community adequately cope with the demand for Externally produced MTC material
community radio licences left many addresses a wide range of health issues,
radio sector in parts of Africa,
having to re-apply each year for renewal from HIV/AIDS awareness to child health
Latin America and Asia has
licences, placing further strain upon an and much MTC material is integrated
enhanced poor people’s ‘right to
already congested system. The long and into the day to day broadcasting of SCR.
communication’ and can be costly process involved in renewal In terms of self-produced broadcasts,
thought of as an expression and resulted in many stations going off-air. SCR produces the popular ‘Lovers Plus
indicator of broader political The National Community Radio Forum Talkback Show’, an interview, discussion
change and democratisation (see of South Africa identifies that up to half and phone-in based format, that fills the
Dagron 2001). From this of its 100 strong membership is off-air at mid morning ‘chit-chit’ slot every
perspective, we can think of any one time. Wednesday. The show has run
community or citizen radio as a continuously on SCR since it first began
means through which broadcasting and today each show
(Tacchi 2002)
communities are able to stake receives around 2,000 calls concerning
HIV/AIDS, family planning and gender
their right to a range of services
issues. The production costs are
and engage local and national
extremely low at around US$3,000 for
government in dialogue about
six months of broadcasting and the
their own needs and constraints. station feel that impact is high, based on
informal discussions with local listeners.
3.7 From a democratising perspective, This is due, in part, to the appeal of the
community or citizen radio show’s host and its ability to raise
represents a key mechanism for community issues relating to sexual
monitoring community services behaviour that had not previously been
such as health service delivery. openly discussed in Soweto.
Communities who are empowered
with a voice are able to critically (Fordred and Lloyd 1998)
question issues such as health

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Botswana.
Community radio for school children.
© Giacomo Pirozzi / Panos Pictures
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service standards and equity of the local community’ (2002: 25). tackling sensitive health issues and
access. With support and training From this perspective, we can which is often hugely popular
the community radio sector has identify both the potential locally. This is because:
the potential to become an popularity of local media and its
increasingly powerful advocate for
poor people’s rights to health
corresponding potential to
provide public health information
• community radio stations
broadcast in local languages and
services. Nonetheless, we should that has a true local flavour and accents, lending credence to their
be mindful of the potential for impact (cf. Myers 1998 on local authenticity;
community radio to be captured community engagement with
by those with vested interests, i.e.
for political purposes, religious or
local media in Mali).
• staff are embedded within the
communities they serve and are
status reasons. Community 3.10 Despite the participatory approach usually fully aware of the critical
stations can become more overtly advocated in numerous health issues and their social
music oriented as the interests of community radio charters, with ramifications, such as HIV/AIDS.
popular young presenters come to regard to the South African However, there is also the risk that
dominate station organisation. community radio sector, Fordred they may reflect the biases, mis-
and Lloyd (1998) identify that conceptions, and inequalities that
3.8 Community radio has expanded stations are often characterised by: exist within the same community;
rapidly in the South in the past
decade as deregulation has moved
• poor internal communications;
• local staff provide a continual
forward. Significant donor
investment in the sector has
• unpaid staff;
status conflicts between paid and community dialogue that allows
stations to respond quickly to
occurred in recent years via multi-
• gender inequality; community needs.
institutional programmes such as
• little or no crisis or conflict;
understaffing and overwork;
DFID’s Building Digital
• management capacity.
Opportunities (BDO) and the new
Catalysing Access to ICTs in Africa

(CATIA) initiative, both of which Moreover, community radio may:
recognise convergence of new
technologies (such as the Internet)
with existing technologies (such as
• bepolarisation;
subject to politicisation and

radio) as a key opportunity to


bring the information revolution
• divisive if it ignores the certain
ethnic and linguistic groups it is
associated with globalisation to mandated to serve;
the poor.
• be subject to capture by specific
interest groups.
3.9 The community radio sector is
broadly perceived as a tool of 3.11 Whilst community radio stations
local empowerment that is may be severely constrained by
participatory and which is set up lack of funding, which in turn can
with the purpose of responding to impact upon their ability to
or giving voice to local needs and produce more sophisticated health
concerns, health included (AMARC programming such as soap operas
2000). As Slater, Tacchi and Lewis or drama, they are nonetheless
note, local events tend to be capable of producing exciting
‘treated as primary, and the range broadcasting (eg. live talk-shows,
of media are understood and vox-pop and interviews) that is
experienced largely in relation to cost effective, that is capable of

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4 Public and international radio:


opportunities and constraints
Public broadcasting worked together to create a
specialist-broadcasting unit called
4.1 The effects of deregulation of the the Development Broadcasting Unit
radio sector can result in pressure that sits within MBC, rather than in
being brought to bear on the the national health ministry. The
sustainability of national and local unit produces a range of
public (state) broadcasting programme material relating to
systems. This affects rural health, to service delivery, and
populations more than urban or broader development issues (DFID
peri-urban populations who are 2000a). Further, as national
increasingly served with broadcasters come under funding
community and commercial radio pressures, the national and local
alternatives. The resultant public airwaves are increasingly
increases in information inequality being opened up to NGOs and CBOs
compound the increasing urban- supporting better health.
rural human development divide
that the UNDP identify (2003: 49- 4.4 Health promotion and broadcasting
50). Though donors and NGOs are units, where they have been
often reluctant to engage with established, often sit within
national broadcasters, examples Ministries of Health or specialist
do exist where strategic support health education institutes, as is the
to national public broadcasters case in China (Skuse, Slavin and
has been offered and accepted. Adam 2002). Such units tend to have
a poor record when it comes to
4.2 Supporting national broadcasters producing entertaining, yet
to become better health informative, radio programmes. This
broadcasters represents a long- is because such units are often
term commitment that has removed from mainstream
significant funding implications broadcasters, such as public or
for donors. In poor countries community radio stations, are
where innovation and production removed from the associated
skills may be lacking, low levels of national and local broadcast talent
technical infrastructure also exist. and because health specialists rarely
Furthermore, the production of make lively broadcasters.
better quality health broadcasting
may be compounded by weak 4.5 Nonetheless, the need still exists for
transmitter capacity and poor dialogue between broadcasters and
quality recording equipment. health specialists to the mutual
benefit of the listener, because
4.3 Whilst major technical regardless of how health
infrastructural overhaul of information is packaged, it is
national broadcast systems is essential that health messages are
unlikely in the context of health accurate. Health Unlimited has
sector work, considerable progress successfully worked to integrate
has been made with skills building. Ministries of Health in media
In Malawi, the Malawi Broadcasting projects in Nicaragua, Rwanda,
Corporation (MBC) and UK-based Somalia, Cambodia and China. By
Radio for Development have including representatives from the

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Ministries in the design process, the


radio content, be it soap operas or BOX 9 BOX 10
Haka-Haki Radio (Radio Face-to-Face), Radio in China, an unfulfilled potential
phone in programmes, can be
Radio Nepal.
inclusive of government efforts and
Confusion as to what constitutes
inclusive of topical campaigns and
Radio Nepal no longer receives state effective health broadcasting is often
national issues. In China and subsidies and over the past few years has evident amongst broadcasters, many of
Cambodia, Health Unlimited trains been forced to adopt a commercial whom have no formal training in
public health extension workers to approach to its broadcasting through the development communications, but have
engage in participatory audience sale of air time to commercial interests, a public service remit to broadcast on
focus groups at village level and advertisers and the NGO sector. Though it health-related topics. High levels of
feed back findings into policy already broadcasts a considerable amount radio penetration are offset by
and programming. of health-related programmes, it is willing top-down content developed without
to sell airtime to NGOs who provide reference to audience need,
tailored programmes on various health understanding or participation. Recent
4.6 Increasingly, public broadcasters are
issues that are produced in the commercial evidence from China shows that at the
looking for partnerships with donors
sector. Increasingly, Radio Nepal is working local level radio is often used to
and the NGO/CBO sector. This is in
with the NGO and commercial sectors as a promote private clinics that offer
response to reductions in state means of increasing broadcast quality and untested clinical treatments for diseases
funding for radio and the expansion gaining specialist inputs on development as diverse as Hepatitis and TB. Similarly,
of the more innovative commercial and health-related topics. One such large pharmaceutical companies are able
and community radio sectors. collaboration is between the NGO The to buy radio and television slots to
Airtime fees are levied for such Centre for Development Communication advertise medicines and tonics that
broadcast work and though fees are and the media producer Communication make bold health claims, but which poor
often modest and significantly less Corner, who produce the broad-based people can ill-afford. Aggressive
than commercial advertising rates, development programme Radio advertising of this nature may increase
Haka-Haki (Radio Face to Face) for Radio the incidence of polypharmacy (taking
they do represent a constraint for
Nepal. Radio Haka-Haki is a magazine- multiple courses of medicine to treat the
smaller organisations.
style programme broadcast on Radio same illness) and the health risks that go
Nepal three times per week within the with it. Such broadcasting is
4.7 Donors can play a key role in 8.30 p.m. ‘prime-time’ slot. Haka-Haki supplemented by very didactic national-
supporting national and local public covers four issues in each broadcast and level programming that features
broadcast systems to become more addresses a wide range of development technical responses to specific disease
sustainable, better skilled, themes such as water rights, hygiene, related-questions. Unfortunately,
innovative and equitable, especially bonded labour, street children, and financial resources in the radio sector in
in their approach to smaller violence against women and so on. The China are very limited, yet radio remains
community development programme is popular throughout Nepal the information mainstay for many of
organisations. Support for the and though no concrete evaluation has the extremely poor and especially for
been undertaken, Haka-Haki has inspired ethnic minorities, who often find it
development of commercialisation
143 radio listening clubs to form and difficult to access health services due to
policies and strategies could help
receives over 1,300 letters each month both discrimination and
public broadcasters become more
from listeners. The radio listening clubs are geographical remoteness.
responsive to NGOs and CBOs and an interesting point of community
the health programmes that they organisation and there is evidence that (Skuse, Slavin and Adam 2002)
seek to promote. Furthermore, the these clubs are taking the information
sustainability of public service radio contained within the broadcasts to
is critical to the rural poor for many produce wall newspapers for their villages.
of whom it still constitutes an Each broadcast contains at least one field-
informational lifeline. based report, which further increases its
attractiveness to audiences.

(Centre for Development 2000)

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International 4.10 Compare this with Afghanistan 4.12 It is easy to dismiss international
broadcasting and a very different picture broadcasting as politically driven,
emerges. With the complete overtly propagandist, foreign
4.8 Like public radio, international breakdown of national media policy driven or of little practical
health broadcasting plays an often infrastructure during the 1990s, use to Southern national capacity
critical role in reaching rural and the BBC World Service emerged as building efforts within the media
remote populations, as well as the dominant broadcaster in the sector. However, international
populations experiencing some Persian and Pashtu languages, and broadcasters are starting to
form of social dislocation. had, through various health- engage in capacity building and
International broadcasters such as related broadcast formats a skills transference work with
the BBC World Service, Voice of significant impact on health, risk national public broadcasting
America or Radio Netherlands avoidance and health seeking counterparts. The BBC World
have a long history of involve- behaviour (Skuse 2002a). Service Trust (BBC WST) and BBC
ment in health broadcasting Afghan Education Projects (BBC
targeting developing countries. 4.11 International broadcasting, AEP) represent two extremely
Outputs such as the BBC’s multi- especially when working with local positive examples of the way in
language Sexwise series examine a counterparts, can often play a which skills and capacity can be
range of sexual health issues in vanguard role in addressing built in the South for health
detail, whilst an array of other sensitive issues such as HIV or birth broadcasting. The BBC WST, a
English and non-English language control, especially where local charitable trust run within the
programmes and programme taboos and conservative or BBC World Service, specialises in
material similarly address health unhelpful broadcasting developing the broadcast skills of
issues from within formats as conventions constrain the public developing world counterparts
varied as news and soap opera. information environment. For and is actively engaged in a
example, Health Unlimited’s number of ‘cutting edge’ multi-
4.9 Continuing with the example of project Urunana has built the media health promotion
the BBC World Service, each of capacity of a local production campaigns in contexts such as
their language services, such as team to make international India, Nepal and Cambodia.
Hindi, Swahili, Mandarin or standard local language radio soap
Persian broadcasts health-related operas in Rwanda. The production 4.13 Likewise, the BBC AEP has taken
content that is generally of high focuses on sexual reproductive the issue of production and skills
quality, in both technical and health, is broadcast on the BBC development directly to the area
informational terms, but which is World Service’s Great Lakes Lifeline in which it works, namely Pakistan
broadcast in substantially Service (GLLS) and studies and Afghanistan. Drawing on the
different media environments. identified it as one of the most talent of local broadcasters, the
Taking China as an example, popular edutainment programmes locally sited production unit is cost
television represents the dominant in Rwanda. This is despite it’s very effective, works in partnership
medium and the Chinese media sensitive content and the direct with local NGOs and engages
environment is also extremely approach that is uses to raise more effectively with local
dense, therefore international issues affecting youth and women. audiences through systematic
health broadcasting such as that research and evaluation work.
broadcast by the BBC may not
achieve a significant audience and 4.14 Such capacity building projects,
is therefore unlikely to have the where they link to local
desired impact on poor people’s broadcasters and partner with the
health in China. local community of civil society
organisations and international
NGO’s can result in significant

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production capacity being built exacerbation of conflict with


within a number of different famine or as a result of BOX 11
Radio in Afghanistan:
radio sectors (community, public, geographical remoteness.
a humanitarian lifeline
commercial). A potential
exception to such an approach 4.17 During conflict and crisis radio
In Afghanistan, the aforementioned BBC
resides with international radio- can: AEP New Home, New Life radio soap
based health interventions that opera has provided an information
target countries experiencing
conflict or humanitarian crisis.
• provide a humanitarian and
information lifeline;
lifeline for millions of Afghans cut off
from aid during the 1990s. Issues such as
Here, health broadcasting neo-natal tetanus and safer birthing are
produced by the likes of the BBC
World Service or VOA can play an
• address issues of basic disease
prevention, hygiene and sanitation;
mixed with more prosaic concerns such
as basic hygiene and sanitation. Within
important role in maintaining a this context, diarrhoea is a major driver
of under-5 mortality and oral
focus on health, livelihoods and
rights when national and
• address more complex medical issues
in areas where high mortality rates
rehydration salts (ORS) are routinely
promoted within the drama as a simple
community broadcasting has exist, such as mother and child health
and effective way of maintaining fluids
collapsed or is used for negative (MCH), TB, Cholera, etc. in young children. Similarly, a focus on
purposes to fuel conflict and major trauma injuries resulting from
ethnic animosity.4
• provide a means of raising awareness
of harmful or hazardous materials,
land mine explosions is evident in
storylines that seek to raise awareness of
4.15 For example, large concentrations land mines and unexploded heavily mined areas and reduce risk-
of people combined with chronic ordinance; taking, especially by young people.
malnutrition tend to lead to
significant increases in disease
vectors and a corresponding
• provide information concerning the
harmful effects of certain lay-
(Skuse 1999)

increase in morality rates. Given treatments, the risks of


this, radio is being used widely to misprescription and polypharmacy
address public health issues in (the harmful combination of drugs to
areas undergoing conflict or crisis treat the same illness);
for populations who remain in
their villages and towns or who
are displaced and are forced into
• provide a means of working through
issues relating to mental health or
refugee or feeding camps. trauma;

4.16 Conflict and non-conflict


emergencies can overwhelm
• provide a means for addressing
livelihood concerns, income
existing health services, they can generation and the maximisation of
lead to the rapid breakdown of nutritional status.
such services and in areas
experiencing chronic emergencies
health services and government
structures may be entirely absent. Footnotes
This places a critical emphasis
upon radio as a means of reaching 4 See DFID (2000b), Working with Media
populations who are beyond the in Conflicts and Other Emergencies for
remit of routine aid delivery a more detailed examination of the
mechanisms, due either to the role of radio broadcasting in
intensity of the conflict, the humanitarian interventions.

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ICD RADIO BROADCASTING FOR HEALTH: AN ISSUES PAPER

e ourselve
chang s by
them rel
ke yin
a g
m on
an
c o
e

ur
tw

ow
ha

n
dt

ab
an

ilit
ge

ies’
‘Thanks to the radio, we’ve found out that there are many things that can chan

5 Radio for social mobilisation


5.1 The ability of radio at all levels to equipment that allows clubs to
mobilise communities towards social document their attempts to engage
action is of concern to both funders local government and service
and radio producers. The simple providers to assist in areas as diverse
broadcast of specific health-related as crop irrigation, bridge building
material without corresponding and the establishment of village-
efforts to ensure that it articulates based orphanages for children
with risk groups or the most whose parents have been lost to
vulnerable has been recognised as AIDS (DFID 2000). The material
potentially inadequate. In this developed by the listening clubs is
regard participatory mechanisms broadcast in a thirty-minute
such as radio listening clubs aimed programme that highlights the
at empowering the most marginal clubs’ experiences with service
members of society become a providers and which provides broad
priority. As the UNDP note: information and features on a range
“… pro-poor priorities – such as of development issues.
basic health and education – receive
little political attention. The more 5.3 The use of radio listening clubs in
unequal a society, the less likely it is Central and Southern Africa is at the
to generate sustained political forefront of the concept of
support for the Goals, because Development Through Radio (DTR),
political power is usually which is promoted by, amongst
concentrated and overlaps with others, Panos Southern Africa, the
economic wealth and social MBC and the Federation of African
dominance.” (2003: 133) Media Women. DTR uses radio as a
Increasingly, radio projects are tool of empowerment, as a means
piloting the concept of the ‘listening for the identification of needs and
club’ to ensure that community the claiming of rights and services.
audiences access information, discuss Once empowered with information,
it and if appropriate, try to take club participants engage in a process
action based on such discussion. that is more akin to peer education,
From the perspective of the using their knowledge to
Millennium Development Goals and problematise relevant local concerns
Targets we can think of how such over issues such as HIV/AIDS and
mechanisms could usefully build child spacing.
constituencies that advocate for
their achievement. 5.4 Working in Zambia with the Zambia
National Broadcasting Corporation,
5.2 The Malawi-based Ndizathuzomwe a Panos Southern Africa evaluation
(It’s all ours, so let’s protect it) of the clubs highlighted how radio
project has used radio listening clubs becomes a more intimate and
as a mechanism through which potentially powerful medium when
communities can secure rights and listening groups are organised. A
access to local services. Working club member from Mununga,
with the MBC, Radio for Zambia, reveals that:
Development (RfD) and a host of “When the health workers were
village-based radio listening clubs, going round the villages trying to
the project provides basic recording educate people, a lot of people

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were not interested, they didn’t requires further examination. If


think it was important, but when it radio listening clubs are to be BOX 12
started coming from their fellow scaled up significantly on a Lessons from a Little Known
women, from the clubs, a lot of national basis and support Experience: Radio Candip, Zaire (DRC)
people have got interested.” structures strengthened, then such
(http://www.comminit.com) evaluation represents a priority Operating with the belief that listeners
identify with localised examples given by
concern for donors.
their peers in their own language Zaire’s
Panos Southern Africa work to four
Radio Candip broadcasts in seven
specific objectives when 5.7 Despite such concerns, encouraging
languages and gets local people
approaching DTR, chiefly: the development of radio listening involved through innovative radio
clubs through support to CSOs and listening clubs. A radio club is a group of
• enable clubs to develop their own
communities;
CBOs deemed representative of poor
men, women and children may be a
people who come together to listen to
the radio, to discuss the issues raised on

• empower women; useful and cost effective mechanism the programme and to respond actively

• national debates concerning


raise the voice of rural women in for community-based social
mobilisation around key
by providing feedback to the station
and using the information they have
development; health issues. received to implement community
projects. Radio listening clubs found to
• stimulate debate.
5.8 Equally, mobilising listening clubs and
be operating successfully are given a
cassette recorder with which to record
5.5 Working principally with national providing radios that can be located in
voice pieces in a range of formats, for
public service broadcasters, DTR- public places such as schools, clinics, broadcast on the radio. Although the
oriented projects have been shops, local government offices, etc., success of some radio listening clubs has
successful in achieving such may lead to greater ICT access for poor been limited due to the indirect nature
objectives. Their ability to get the people (providing the technology is of their access to the studio, and due to
often dissenting and critical voices used appropriately and not captured the undertaking of unrealistic
of the rural poor on national radio by elites). By association, this may lead community projects, on the whole the
where service providers such as local to increased levels of public station has been successful in
clinics and hospitals can be held up information and increased levels of transforming passive listening into
dialogue and communication. As one
to local scrutiny represents an community dialogue concerning
elderly man has said: ‘we used to think
important accountability mechanism relevant health issues.
that we lived in an unchangeable
contributing to better governance.
situation. Thanks to the radio, we’ve
5.9 The cost of providing equipment to found out that there are many things
5.6 A number of issues of concern can listening clubs is low. Radio sets that can change and that we can make
be identified with regard to radio typically cost between $5-10 and them change ourselves by relying on our
listening clubs. Though meant to maintenance is cheap and widely own abilities’.
be participatory, clubs that are available. The only significant recurrent
established with very broad aims, expense associated with radio is that (Aw,W 1992a)
as opposed to those that are more of batteries, though to an extent, this
discreet in composition, i.e. poor cost can be offset by the use of solar
rural women or children, can be powered radio and clockwork radio
captured by village-based self- sets, though clockwork radios remain
interest groups and used to their initially expensive ($50+). A cheap
own advantage, thus alternative is solar conversion kits,
perpetuating inequality and which, at around $3.00 per conversion
marginalisation. Further, evidence also represent a potential avenue for
of the example clubs set for other small business development.
communities wishing to emulate
their role remains unclear and

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6 Building links for better


health broadcasting
6.1 For health broadcasting to have
BOX 13
an appropriate impact - and ICD
Combating anti-vaccination rumours:
initiatives more broadly - it is
lessons learnt from East Africa
essential that the information
contained within the wide variety A study recently undertaken in East Africa
of formats and approaches examined the extent to which anti-
available to producers is both vaccination rumours concerning potential
accurate and useable. Assessment side effects affected levels of vaccination
of the information needs, existing coverage, and the impact of strategies to
knowledge, risk taking and health combat the rumours. For example, in
seeking behaviour of target Uganda, Greater Afrikan Radio was one of
audiences also represents a critical several radio broadcasters that have been
attributed to causing a decline in polio
priority and essential element of
immunisation of children. The study found
health communications
that it was a lack of good health
intervention planning and design.
information within the radio stations
themselves that resulted in rumours being
6.2 The quality and accuracy of health broadcast and that rumours needed to be
information accessed by radio staff countered through all available channels,
during production impacts directly including radio, film vans, television and
upon health broadcast outputs. newspapers. However, it is important to
This is illustrated above with first assess whether or not the rumours
regard to detrimental rumours have in fact impacted on behaviour, before
surrounding health issues, which overreacting and risking raising the profile
of the rumours and rumourmongers
radio can both knowingly and
further. It may also be useful to make
inadvertently exacerbate. Rumours
available a place to register rumours, such
concerning the perceived
as a toll-free rumour hotline, or a rumour
detrimental health effects of call-in radio programme.
certain medical procedures,
treatments, vaccinations and so on, (UNICEF 2002)
are as commonplace as the
rumours, stigma and discrimination
that are socially constructed about
diseases and the people that are
both known or suspected of having
them. For example, Lupton
(1994: 16-18) reveals that in the
late 1980s in the West, media
coverage of HIV/AIDS focused
almost exclusively on
homosexual men and female
sex workers as ‘vectors of HIV’.
This focus on so-called
‘dangerous social categories’
(despite epidemiological evidence
to the contrary) was at the expense
of ‘at risk’ people engaging in
unprotected heterosexual sex.
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6.3 Much of the developing world, 6.5 The example cited above indicates
BOX 14
Africa in particular, is stereotyped the need to work closely with risk
Countering negative stereotypes -
as overly promiscuous within groups and the need to enhance
Sathi Sanga Maka Kura (Chatting
western national and health information flows to key
with My Best Friend) Radio Nepal
international media (Lupton 1994: information providers such as
18). However, such media radio stations. It also highlights ‘Chatting with My Best Friend’ is a
coverage tends to ignore: (i) the the need for simple, but sound, magazine format radio programme,
socio-economic dimensions of the formative research amongst the broadcast nationally, that is focused on
disease; (ii) the inability of many target audience prior to youth and seeks to inspire interaction
poor people to have STIs treated, broadcasting. Adam and Harford and communication regarding HIV/AIDS.
due to lack of health services or (1999), with reference to HIV/AIDS UNICEF and FHI Nepal identified young
their cost; (iii) the relatively low broadcasting, suggest that people under the age of 15 as being at
especially high risk from HIV and
levels of public information broadcasting should primarily
therefore sought to support a lively and
available to the poor; and (iv) the respond to the critical health
entertaining programme that would
broad range of contextual drivers information needs of the poor.
capture the attention of young radio
of the disease, such as the They identify a number of areas listeners. Young people were involved
disempowering and endemic relevant to the strengthening of throughout the design and
levels of violence against women health broadcasting. implementation of the project, from
that occurs in Southern Africa or research phase to production. The aim
the significant volume of 6.6 Obtaining a flow of accurate, of the programme is to enhance life
economic migration that occurs in useful and useable health-related skills, reduce stigma and strengthen
the region (UNIFEM 2000). information and support material, prevention. In Nepal self and social-
combined with a community-led stigma regarding HIV/AIDS is widespread
and the programme, which designs
6.4 Importantly, radio can help to approach, remains the
discussion points and stories drawn from
counter negative and harmful cornerstones of better health
real life scenarios, aims to bring
stereotypes and promote positive broadcasting and here,
HIV/AIDS in to the public arena for
community dialogue concerning governments have a clear role to discussion, and to openly address issues
health. However, with respect to play. Rather than seeing the non- relating to sex, peer pressure, stigma,
HIV/AIDS many countries still have state radio sector as a critic and relationships and discrimination. The
a long way to go in coming to competitor there is clear scope to hour-long programme features drama,
terms with its social, economic work in partnership with the music and chat and a listeners’ letters
and political implications. In expanding community and slot. Up to 500 listeners’ letters are
China, for example, denial of the commercial sectors for the benefit received each week. The programme’s
scale of the HIV/AIDS problem has of public health. Increasingly, stance is non-judgemental, supportive
and positive.
resulted in a weak national project partnerships are drawing
response and paucity of targeted broadcasters into close cooperation (http://www.unicef.org)
health promotion activities. In with NGOs in particular.
such contexts the public radio
response tends to be moralistic,
didactic and over-technical,
leading to concerns regarding the
usefulness of such broadcasting
for the poor
(Skuse, Slavin and Adam 2002).

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6.7 For increased donor support to flow


BOX 15 BOX 16
to the radio sector it is important
Building information support for BBC World Service’s New Home, New
that strong linkages and clear
radio professionals Life radio soap opera: ensuring
developmental outcomes are
quality health messages for
identified for poor communities Radio professionals need: Afghanistan through agency co-
that flow from their engagement ordination and partnership
with radio, i.e. increases in the
levels of public information
• information about health issues to
ensure that the information being The BBC’s soap opera for Afghanistan,
available or increases in the broadcast is accurate, relevant and up- New Home, New Life, relies upon a
accuracy of information shared in to-date; broad network of funders and specialist
social communication. Whilst the NGOs to provide technical input in to its
argument that community radio in • information about the target
audience; their knowledge,
script development process. The project’s
funders are numerous (including FAO,
its own right is critical to comm-
perceptions and risk taking and health DFID, ICRC UNICEF, UNESCO, UNHCR,
unity empower-ment and voice is
seeking behaviour; UNOCHA, UNOPS, WHO) and all bring
valid (Aw 1992b; David 1992),
with them certain requirements, in
strategic attention needs to be paid
to linkages with health information • information concerning radio
listenership patterns, data on radio
terms of the broad social development
themes, that they wish to raise through
providers, with government ownership and access, preferred the soap opera. For example, UNICEF
ministries and with local informa- programme formats, listening times themes include ‘clean births’ and ‘safe
tion providers, such as health clinics and quality of reception; motherhood’, whilst WHO themes
and NGOs. This will serve to include the ‘rational use of drugs’ and
increase the flow of accurate health • information about other organisations
providing health education and
mother and child health (MCH). The
production must choose from a list of
information to radio producers,
services in the area. around 25 themes, much health related,
which ultimately is of benefit to
for incorporation in to the script. The
listeners. Ministries of information
necessary technical input occurs through
also have a vital role to play in
a process that exposes funders and
helping build media environ-ments
specialist contributors to script
conducive to better health, through development ideas, through the
the inclusion of public service circulation of a synopsis of forthcoming
commitments for commercial themes and dramatic content, and a
station in licence agreements. follow up meeting called to discuss the
technical content.
6.8 Community radio stations represent
a key local channel for health (Skuse 1999)
information and their local
popularity and potential has not
escaped the notice of donors and
NGOs seeking to strengthen the
sector. Increasingly, health content is
being syndicated to national
networks of community stations
through a number of means, prin-
cipally on CD, tape or via the
Internet. Also, Internet has been
trailed, albeit with partial success, to
respond to listeners’ information
requests through a format called
radio browsing.

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6.9 Despite the problems associated potentially important information


with the use of new ICTs in the channel for the community radio BOX 17
Radio and new technology: Kothmale
South, i.e. slow download times, sector, although the use of such
Community Radio, Sri Lanka
the cost of computer technology services remains relatively under-
and the need for skills training, examined. There is also the
A recent study by Slater, Tacchi and
health information content potential problem of these Lewis (2002) of the Kothmale
syndication through e-mail and generic ‘features’ lacking cultural Community Radio Internet Project in Sri
Internet, as well as through specificity, which may lessen their Lanka (see also KCRIP) found that poor
routine Internet web-surfing, impact in terms of behaviour people valued information highly,
represent key areas for capacity change within discrete especially that relating to livelihoods
development within the sector. communities and risk groups. and health. Despite near universal radio
ownership, local information resources
6.10 Increasingly, content is being 6.12 Enhancing useful and useable were found to be poor and national
media was generally not perceived as
syndicated to community radio information flows and supporting
trustworthy due to its politicised nature.
stations through international links to radio stations represents a
Because of this, local people tended to
Internet-based content (audio and priority for donor support, as does
prioritise local media and local concerns.
text) sites such as the OneWorld broader skills and capacity The Kothmale project began as an
Radio HIV/AIDS resource and building support for the experiment that sought to combine the
InterWorld Radio run by Panos community and public sectors in Internet with community radio in
UK, and through regional and particular. However, it is important innovative ways. Initially, the mechanism
national sites such as AMARC’s to stress the general principle that of ‘radio browsing’ – where the
Pulsar News Service in Latin stand alone interventions for broadcaster would search for answers to
America. Pulsar has been health, be they radio-based or listeners’ questions delivered by phone,
specifically set up to serve the otherwise, tend to be less post or in person in ‘real broadcast time’
was employed. However, the study
community radio sector with effective than multi-method or
found that radio-browsing programmes
audio and text-based news related channel approaches. In part, this
were not especially popular and that
items. Within such sites, a key reflects the recognition that
using the Internet in this way was
focus is on health and the behaviour change is a process that cumbersome and inefficient.
provision of detailed case studies is reliant upon multiple factors Subsequently, it has been integrated
and national and regional and influences (i.e. gender, into day to day broadcasting in more
information regarding diseases availability of commodities such as mundane ways, with Internet being used
such as HIV/AIDS, TB or Malaria. condoms, access to credible public as a mainstream resource, with the
information and so on) rather information derived from it being
6.11 Important national health than health communications or incorporated into broadcast content
information sites are also education components alone. without listeners being explicitly aware
of it. The Internet component of such
beginning to emerge. In South
broadcasts has since been replaced by
Africa the online health news
station staff referring to an electronic
service called Health-e provides a
encyclopaedia on CD-ROM in order to
range of health information and answer listeners’ questions.
audio features to a wide range of
organisations. The website allows (Slater, Tacchi and Lewis 2002: 24)
users to download audio news
features, for example, on living
with HIV/AIDS and provides
statistical data and information
resources for journalists. The
website allows users to freely
access the service and represents a

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Zimbabwe.
Villagers gathered around listening to the
radio outside a hut adorned with an
AIDS emblem.
© Chris Sattlberger / Panos Pictures
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6.13 Though single media


BOX 18 BOX 19
interventions and single formats
Radio broadcasting and Healthworks: Internet and radio-
occasionally have a significant
new technologies based training for health workers
impact on health their success is
often driven by context specific Convergence and new ICTs: The Australian based institutions Health
factors, such as conflict, poverty Communication Resources and Curtin
or the simplicity of the media
environment, rather than the
• expand the inter-connectivity
between different media, for example
University of Technology have worked
together to produce a 13 part radio
format itself (cf. Skuse 2002a). allowing for the convergence series that helps health and social
Despite the fact that radio is a between radio and Internet, which in development practitioners to develop
relatively cheap medium to both turn opens up new broadcast and their health promotion, needs
establish and broadcast, it is now linkage opportunities; assessment and evaluation skills through
widely recognised that exposure this distance education method. Those

to multiple messages with the • can help radio reach people to whom it
has previously been difficult to
taking the course of work, complete a
companion workbook. The programmes
involvement of the ministries,
broadcast, for example, the Worldspace are syndicated to local radio stations that
serves to reinforce the overall initiative is using satellite technology to also supply workbooks to those listening.
impact of health campaigning. broadcast radio programmes and Healthworks has joined forces with
Single radio-based interventions material to listeners and receiving OneWorld Radio to aid dissemination of
that are not linked to other stations across Africa. The potential to the resource and the training course is
communication (i.e. TV, video, tap this resource for improved health available to download online.
theatre) and education efforts information flows is significant, though
(i.e. peer, life skills), services (i.e. whether the initiative will be either
counselling, vaccination) or sustainable or affordable in the long-
term remains in question;
commodity provision (i.e.
condoms) are unlikely to have a
significant impact. • can improve information flows to
stations in the form of completed and
packaged health programmes on
given issues, or materials that can be
easily adapted and ‘localised’ for
community broadcast;

• represent a channel and means of


learning from each other and a
mechanism for the networking of
stations with similar concerns over
community health issues.

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7 Conclusion
7.1 This paper has provided a broad
overview of health broadcasting at
• efforts should be made to
enhance health information flows
multiple levels. It has highlighted, to radio stations at national and
through case study material and community levels to ensure that
analysis, the different qualities and health broadcasts are built upon
approaches of community, public accurate and useable information;
and international radio stations to
health broadcasting and
investigated a range of linkage and
• coordination efforts need to be
enhanced so that the radio sector
mobilisation issues that could help is drawn in to partnership with
to strengthen health broadcasting specialist health NGOs, CBOs, UN
and access to health information for bodies and government ministries
the poor more broadly. The key who can provide the specialist
conclusions to emerge from the information they need in an
discussion include: accessible form. In this respect,
work undertaken at ministry level
• radio interventions work best
when integrated into long-term
to enhance the usability of their
health information outputs is
and multi-media health critically important;
promotion campaigns that address
a broad spectrum of constraints,
issues and spheres (socio-cultural,
• new technology has provided a
means of providing such
political, economic, policy); information flows and the
integration of new technologies
• radio formats that support and
create community dialogue, such
into the radio sector should
be expanded;
as soap operas and mini-dramas,
are especially relevant to
addressing complex health issues
• support for the establishment and
maintenance of national and local
and should be broadly supported; health information
‘clearinghouses’ or ‘content banks’
• support for community radio
should not disadvantage national
for health broadcasting/mass
media that can be accessed
public service radio, which remains through Internet or CD-ROM and
a key health information lifeline which contain information, scripts,
for rural populations in particular; audio clips and radio production
guidance for health broadcasting,
• efforts should be made to
enhance access to radio and social
the development of new formats
and techniques (e.g. ‘Health-e’
mobilisation, through support of in S. Africa);
radio listening clubs and the
provision of radio sets for
communal listening;
• radio staff require training in
broadcasting for health and in
formative research and impact
evaluation that is in line with the
scale of their programme
initiatives. There is the
corresponding need to build
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capacity within organisations, communication practices, other


academic, non-governmental and electronic media, as well as social
commercial sectors, to carry out and economic policy and so on;
social communications research and
evaluation to complement training
for broadcast organisations;
• the extent to which radio listening
clubs lead to effective social
mobilisation for better health
• donors should support the
provision of such training and the
outcomes requires further
investigation. How and to whom
publication of evaluation benefits accrue within the
guidelines to assist stations in community remains a critical
undertaking such work; question that is largely
unanswered in existing literature;
• further long-term research is
required in health broadcasting
generally, and the synergies
• community, public and
international radio broadcasting
between health broadcasting and are very different entities that have
routine social communication different objectives and different
practices more specifically. audiences. In health terms, all can
play a significant role in raising
awareness of health issues within
Knowledge gaps and any given country or community,
research priorities though how they reinforce each
other’s health-oriented material or
7.2 A number of research gaps and how they can work together and
priorities emerge from this paper support each other to enhance the
relevant to enhancing a broader well-being of the poor more
understanding of the role that broadly requires investigation;
radio plays in supporting better
health outcomes for the poor:
• further research needs to be
undertaken on the mapping of
• synergies
a clearer picture is required of the
evident between the
health information flows within
communities, so that radio’s role
various media and participatory and its importance, relevant to
communications efforts used in other information flows, may be
multi-method or integrated health better contextualised and assessed;
promotion campaigns (Steckler et
al. 1995). Multi-method campaigns
may operate at different levels;
• similarly, further thought and
investigation needs to be given to
community to national, and the the accuracy and usability of
way in which they interact to health information within radio
reinforce health messages is an stations and other media channels,
understudied field. Concentration with linkages and support
on single media within integrated structures being fully explored in
campaigns tends to occur to the geographical context.
detriment of a broader focus that
could explore links evident
between radio, social

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Appendix Radio checklists

1 Community radio checklist

Opportunities Community radio stations:

• are Local;

• address community issues;

• broadcast in local and minority languages;

• serve community, specific interest and occupational groups;

• encourage community participation;

• understand community information needs;

• broadcast accessible and often innovative material such as simple spots,


phone-ins, chat shows and testimony;

• reflect local news;

• increasingly link to content providers and are engaging in broader health


promotion campaigns by broadcasting spots and material produced elsewhere;

• represent an independent voice;

• can be a powerful community health and political advocate.

Constraints Community radio stations may have:

• little capacity to produce more complex programme formats such as soap opera;

• budget constraints which similarly impact on the type of programming they can
realistically produce and upon station sustainability overall;

• little capacity and experience of taking complex health information and


transforming it into innovative and accessible programming;

• problems accessing or affording technology that would enhance their access to


health information and to networking opportunities with other stations;

• difficultly in obtaining broadcasting licences and maintaining their community


service ethic;

• difficultly in monitoring or evaluating impact due to weak capacity;

• difficulty sustaining their output in times of political and financial pressure.

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Public radio checklist

Opportunities Public radio stations are:

• itself
able to broadcast to mass audiences and are usually popular, therefore lending
to the broad dissemination of general health messages, such as spots and
slogans;
• able to produce programmes that reach multiple audiences, such as policy makers,
government officials and employees and poor people;
• better equipped and often well funded and are able to produce programming of a
more technical and complex nature, such as national news, ongoing soap operas or
magazine-format programmes;
• able to work in partnership with relevant ministries and NGOs to gain access
to expert opinion and advice;
• often the only source of health information, news and entertainment at the local
and national broadcast levels for the rural poor, due to the relative absence of
community stations in such areas;
• usually able to undertake basic audience evaluation as limited research and
evaluation capacity often exists within public broadcasters;
• increasingly able to link to national and international health content providers.

Constraints Public radio stations may have:

• reduces
an overt political stance and broadcast propagandist or inflammatory material that
the willingness of donors to get involved in supporting radio sector
• funding crises that impact upon the quality of its health broadcasting, the quantity of
strengthening at this level;

• such broadcasting and its ability to maintain essential production and transmission
equipment;
• difficulties engaging with NGOs and CBOs and may have a tradition of producing
• research and evaluation units that are often chronically under funded;
didactic and unengaging health programming;

• difficulty retaining their most innovative and creative staff as the commercial and
community sectors start to develop;
staff that want to be more creative and innovative, but who require training in
health broadcasting, message development and creative formats.

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International radio checklist

Opportunities International radio stations are:

• able to broadcast to contexts undergoing conflict, as such they can become a


humanitarian lifeline for the poor;
• able to use their capacity to help build the capacity of national and community
broadcast structures;
• technically advanced and are able to produce programmes of high technical quality
and complex formats, such as investigative journalism, magazine-style programmes
and soap operas;
• able to challenge negative broadcasting where liberal broadcast regimes currently
do not exist;
• able to raise sensitive health issues such as HIV/AIDS because they are not produced
nationally, but internationally.

Constraints International radio stations may have:

• difficulty reflecting local concerns or even national concerns as many of the


languages in which they broadcast cut across discrete nation states, for example, as
does Arabic;
• to resort to addressing health issues from a very general perspective in order to
overcome their social distance from their audiences;
• difficulty in holding and maintaining a significant audience share in countries with
diverse media environments.

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Appendix Popular radio formats

2 Spots and slogans


BOX 1
Using Spots in Diarrhoea Education
Spots and slogans are short simple
messages of between 30 seconds and
The following radio spot script used an
two minutes that can feature a short
interview clip and announcer to get
dialogue, announcement or interview. across the message that it is important to
Spots commonly air on national and help children to eat whilst they are
community radio and television (often as suffering from diarrhoea.
a result of material being syndicated),
and are designed to address broad Announcer: Children need to be
health issues that are relatively simple to encouraged to eat when they have
convey. They may be disease specific or diarrhoea. Feed your child small portions
may be used to promote specific health of food at least six times a day, so he
wont lose weight when he has diarrhoea.
service availability, free or subsidised
Listen to the voice of experience.
health treatments.
Real mother [interview except]: I thought
I was going to have to bury that child
Mini-dialogues and dramas because of her diarrhoea. She didn’t
want to eat a thing. She was listless and
Mini-dialogues and short dramas are really skinny. I was getting really worried.
used to convey one or two key health So I began feeding her little portions of
messages and are usually short in food every couple of hours. At first she’d
duration (i.e. between 2-5 minutes). only eat a few bites. Then each day she
They may comprise a single would eat a little more and finally her
appetite came back (laughing). Now look
dialogue/drama with the health issue
at her, that child eats and eats.
and resolution contained within the
same broadcast or a short mini-series, in
Sound effect: child laughing
which an initial drama positions the
listener into a dilemma and another Announcer: Listen to the voice of
resolves the issue. experience. When your child has
For example, many young women diarrhoea and doesn’t want to eat, feed
face acute pressure from their partners him small portions of food at least six
to have unprotected sex for a number of times a day. Little by little [their] appetite
reasons, many of them cultural. From will return.
this perspective a dialogue can be
structured between two young women (Adam & Harford 1998: 46)
focusing on the decision that one of
BOX 1
them has to take, i.e. whether to use a
The Cost of ICT Access
condom and risk being accused of not
trusting her partner or to engage in
unsafe sex.
The following box highlights how the
BBC World Service Trust (BBC WST) has
used the ‘dilemma’ and mini-drama format
to good effect in both India and Nepal to
address leprosy and blinding trachoma. In
this instance, the use of free airtime,
donated by the national broadcaster, has

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allowed programmes to be aired tend to focus on a broad range of


and repeated frequently which in development issues, though health BOX 2
BBC World Service Trust (WST) India
turn has resulted in an increased naturally constitutes a major focus.
Leprosy project
social impact. Evidence suggests that sensitive
health topics, cultural constraints
In 1999 the BBC World Service Trust,
and norms affecting health are working with Indian national radio and
Soap Operas and serials best approached through formats television, launched a 12-month
that ground such issues in familiar campaign in 5 states of India, to raise
Radio has been well documented contexts and which use believable awareness of Leprosy and the
in terms of its ability to engage the characters (de Fossard 1997; availability of treatment. The volumes of
imagination and here, the Galavotti et al. 2001). The episodic production were unprecedented in the
connection between innovative nature of soap operas allows time campaign, with 27 TV spots and 146
radio formats and the creation of for listeners to mull-over the radio spots being produced in a total of
20 languages, as well as 13 TV dramas
positive community dialogue diverse range of positive and
and 53 radio dramas. In total, during 2
emerges strongly (Crisell 1986; negative outcomes that are
campaign phases, these outputs were
Skuse 2002b). For example, radio embedded in the dramatic
broadcast 808 times on TV and 5,545
soap opera is broadly accepted as storylines (Rigbey 1993). Typically, a times on radio. For ‘media-dark’ areas,
one of the best mechanisms for radio soap opera will employ a 2,175 song and drama performances and
broaching complex and socially format that features characters 5,455 ‘video van’ screenings were
sensitive health-related issues, such that are for and against a health conducted. No airtime payments were
as HIV/AIDS (Adam and Harford issue or practice and another that made to the media institutions involved.
1999). Galavotti et al. (2001) wavers between both options, but During and immediately after the
suggest some of the most effective who ultimately chooses the more campaign, some 186,000 patients were
behavioural interventions have positive course of action. Because diagnosed and treated by the Ministry
of Health. Also, evaluation found a
been linked to existing social and radio soap operas and serials are
dramatic impact on attitudes towards
cultural contexts through fictional, they are able to open a
leprosy occurred:
'edutainment' formats such as soap neutral and recrimination free
opera. These formats articulate social space in which public debate
with community dialogue on can occur about sensitive health
• the % of the total population
believing leprosy is hereditary fell
health and use existing cultural related issues and choices such as from 56% to 19% during the project.
narratives and resources to both discrimination, rights and stigma. This means 172m people changed
humanise and destigmatise disease. Though popular with funders their attitudes on this issue;
Soap operas and serials are and listeners, soap operas can be
used extensively to promote expensive to produce, require • the percentage of people believing
leprosy is transmitted by touch fell
aspects of human development. extensive organisational and
from 52% to 37% to 27% (i.e. 117
Productions are typically broadcast creative capacity and require
million people potentially changed
between 1 and 5 times each week significant research and evaluation
their minds);
and are generally between 10 and structures. A thrice-weekly national
30 minutes in duration. Soap radio soap opera can cost as much
operas tend to be open-ended or as US$500,000 to run annually and
• the percentage of people that claimed
they would not sit next to a leprosy
continuous, whereas serials have a increasingly producers of initiatives patient fell from 44% to 33% to 27%
defined run of episodes (i.e. 10-20 such as Soul City in South Africa, (i.e. 93 million people changed their
episodes). Radio soap operas are engaging with the commercial minds).
usually have 4 or 5 scenes within sector to secure funding and long
each episode; and each will address term sustainability (Tufte 2001). (Adapted from Eastwood et al. 2001: 46)
a certain storyline that unfolds Soap operas are often funding-
over the course of time. dependent and represent an
Edutainment-type soap operas ongoing commitment for donors.

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ICD RADIO BROADCASTING FOR HEALTH: AN ISSUES PAPER

The cost of soap operas makes Magazines, talk shows,


them largely unfeasible as a phone-ins BOX 3
Twende Na Wakati (Let’s Go with the
community-based intervention.
Times), Tanzania
Magazines, talk shows, and
phone-ins are mainstays of radio
broadcasting, health broadcasting In July 1993 a radio drama began
Stories and testimony broadcasting on Radio Tanzania aimed at
included. Magazine formats
provide an often-eclectic mix of promoting family planning, which at the
Stories and testimony are used features, interviews, competitions, time, was considered a sensitive issue.
widely to promote better health music and drama and are The twice-weekly broadcasts were
as a means of contextualising and designed to be pacy and topical. educational and entertaining and
‘humanising’ disease. Testimony, Health related talk shows come in addressed a wide range of health issues
a number of guises, but most use including HIV/AIDS and were found to
often a monologue from a person
studio based interviews as a substantially raise local dialogue
affected by a specific disease, i.e. means of addressing relevant
concerning health. The drama targeted
people living with HIV/AIDS, tends health issues in detail.
rural audiences, who had low access to
to be short in duration, but high Often such formats can be
television, but high access to radio, which
in impact. Stories and comedy overly didactic, especially if
was perceived by project planners as the
monologues can be entertaining if doctors are used to provide over- cheapest and most effective means of
well written and presented. complex epidemiological reaching large numbers of rural people.
Control over the quality and information on a given disease. Of The long running drama, which has to
accuracy of the health information perhaps more relevance is date broadcast over 1,000 episodes, has
presented, like other formats is engagement with CSO, NGO and been continuously evaluated:
critical. Careful selection of oral CBO staff working with people
testimony segments must occur to who are at risk or who are ill. • 88% of people who listened to the
drama suggested that they had
ensure that incorrect or unhelpful Interviewing people with diseases
learned about family planning and
health messages are not around which high levels of self-
86% suggested that they had also
broadcast. For example, testimony stigma, social stigma and
learned about HIV/AIDS;
that details a negative experience, discrimination are created can be
such as discrimination, may not a first step towards their social
send a very helpful message. acceptance (HDN 2001). • they
23% of the audience reported that
adopted family planning in direct
Similarly, storywriters must make A related format is that of the response to listening to the drama;
every effort to engage experts in phone-in, which uses a studio
the specific diseases they choose
to write about, as the broadcast
based presenter, as well as
professionals working in the field
• 55% of listeners revealed that they
talked to a friend about the
of incorrect information is (doctors, nurses, NGO, CSO, CBO issues raised.
counterproductive. fieldworkers), to answer questions
from people that have phoned-in (http://www.comminit.com)
direct to the studio. This approach,
BOX 1
one favoured by community radio
The Cost of ICT Access
stations, often uses a local ‘agony
aunt’ or ‘agony uncle’ character to
give instant responses to callers.
Despite their popularity, their
impact, in terms of the quality of
the information that they provide
has yet to be sufficiently examined
and risks are evident.

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ICD RADIO BROADCASTING FOR HEALTH: AN ISSUES PAPER

With regard to health related News, documentary


interviews, Fordred and Lloyd and health journalism BOX 4
Capital Doctor, Uganda
(1998), in discussion of the
community sector in South Africa, News, from short items regarding
Capital Doctor is one of the best known
reveal that radio presenters often health to documentary and
and most successful of the phone-in type
feel they should be able to answer investigative radio journalism formats to address health issues. The
every question asked of them and regarding topics from hour-long evening show began in 1994
that a very real risk lies with the discrimination, to national policy on Capital Radio FM in Uganda and is
provision of ‘misinformation’ to service delivery, represents a broadcast once a week. DJs and doctors
resulting from a presenter being mainstay of radio broadcasting at field the calls (up to 25 each broadcast)
out of his or her depth. From all levels. Regular exposure to from young people (the target audience
this perspective: news – frequently the most is 15-28 year olds) on a number of
popular of radio formats in the health topics, most of which relate to
sexual health, HIV/AIDS and risk
• training of community and
national radio staff in health
South - about diseases such as
HIV/AIDS or TB is important
avoidance, family planning, as well as
diseases such as cholera. The direct
information gathering and because it can help hold the issue
approach to these sensitive issues has
adaptation for broadcast in the public eye. Also, news and created a significant impact amongst its
represents an urgent need; short documentaries items can be target audience. In part, this is due to
used to provide positive health the insistence of producers’ over the

• similarly, supporting networks


that provide informational and
features relating to the
overcoming of disease-associated
accuracy of information and consistence
of messages provided by ‘on-air’ health
training support for health stigma or the provision of free workers. A survey undertaken in 1996
broadcasting more broadly could health services. found that of 200 clients using an STI
help to raise the quality and Investigative radio journalism clinic in Mulago, 70% listened to Capital
Doctor and 57% were able to cite the
accuracy of health information can also bring issues of corruption
day and time of the broadcast. 71% of
contained in radio broadcasting. to light, highlight poor service
people who reported that they always
standards, the withholding of
used a condom were found to be
services for the sick, issues of listeners and that non-listeners were less
discrimination and also highlight likely to use a condom, thus increasing
inadequacies in national policy. As their exposure to risk.
such, radio news represents an
important advocacy tool with (http://www.comminit.com)
which to target policymakers and
BOX 1
legislators and an important
The Cost of ICT Access
accountability mechanism. The
key challenge is to work with
reporters not to oversimplify and
sensationalise health issues that
require sensitive handling. The
importance of obtaining a good
story for the journalist will often
outweigh any educational
objectives. Therefore, health
journalism capacity needs to be
built throughout the radio sector.

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Appendix E-sources

3AMARC A site dedicated to community radio that features useful references, addresses a range of
www.amarc.org project interventions, connects to Internet-based audio features and news items, as well
as listing member radio stations from around the world.

BBC World Service Trust A site highlighting the work of the Trust across a range of sectors, civil society, training
www.bbc.co.uk/worldservice/us/trust and health, that also provides details of its current project activities.

Biodesign A site examining cheap solar panels used to convert radios into more affordable
www.biodesign.org.uk commodities for poor people.

Commonwealth of Learning A site that examines the use of radio in education with a focus on community radio and
www.col.org empowerment. Also details of the COL ‘suitcase radios’ are provided.

Communication Initiative A communication for development-dedicated site that covers mass and participatory
www.comminit.com media, social change and planning models and has a separate themed section on radio.

Digital Opportunity Channel A site examining the role of new communication technologies and convergence issues in
www.digitalopportunity.org development, with useful research reports and features.

Freeplay Foundation A site dedicated to promoting ‘clockwork’ radios, which have been used extensively in
www.freeplayfoundation.org humanitarian relief efforts to increase information flows to displaced people.

OneWorld Radio A site focusing explicitly on radio, deregulation, research and containing downloadable
http://radio.oneworld.net audio features.

Panos Institute A site featuring policy and research papers contained within a themed section on
http://panos.org HIV/AIDS. Other relevant sections include ICT and oral testimony.

Rockefeller Foundation A site featuring useful publications relating to the Foundation’s work in communications
www.rockfound.org for social change.

Soul City A site tracing the history and activities of the Soul City multi-media health education
www.soulcity.org.za vehicle used extensively in Southern Africa to address a range of health and community
issues from HIV/AIDS to domestic violence.

UNAIDS The site of the joint UN programme on HIV/AIDS which features numerous publications
www.unaids.org on every aspect of HIV/AIDS, from social dimensions to specific publications on formal
education, peer education and mass media.

UNDP The site for the UN Development Programme with specific subsections on the Millennium
www.undp.org Development Goals and Targets and the 2003 Human Development Report.

UNESCO A site that features a wealth of publications relating to all aspects of communication for
www.unesco.org development, both formal and informal.

World Radio Network A site that focuses exclusively on radio and which contains downloadable audio material
www.wrn.org from over 200 radio public radio stations spread throughout the globe.

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