Information for all / by Dorothy Hoffmann

Information for all by Dorothy Hoffmann 11 he existence of an informed pub-lic , who recognise their rights and responsibilities in determin- ing their own health priorities and who take part in solving some of their health problems, is vital if the goa1 of Health for all is to be achieved by the year 2000. Information and education for health have been placed first among the eight essential elements of primary health care. It follows that people who work in mass media will be key actors in the drama which will be acted out in the next 14 years. So, primary health care needs the media. But, even more important , Ministries of Health need the media. A recent series of workshops, initiated by WHO, financed by the Finnish International Development Agency 14 (FINNIDA) and orchestrated by the University of Tampere , Finland, bore witness to the fact that health adminis- trators and members of the mass media are not always in harmony. The three workshops , which took place in Kenya , Tanzania and Ethiopia, brought together journalists, radio producers and health officials, and were the first lap in a comprehensive course to train journalists from East Africa in primary health care. The mass media can be an instru- ment for delivering health messages but they must be given wholehearted backing by the health professionals. The journalists complained that minis- try officials were not forthcoming with information about health trends and policies . Their questions were passed from one person to another and they never got precise answers. When news releases were issued , they were usually too technical and incomprehensible for the lay reader. The health officials counterattacked by insisting that journalists were only interested in "sensational " news. What has been called " the silent emergency" of poverty and ill-health and the real news stories that were hidden in the health situation were never covered. A newspaper might announce the opening of a new health centre or the installation of a water pipe , but there was usually no back- ground explanation of how it might affect the disease pattern or the lives of the community concerned. " News " about some high-technology medical gimmick was often considered more important by editors than the scandal of millions dying from a preventable disease. Somehow, health officials and the media must find each other. Without the involvement of the media , the health sector cannot hope to create an informed general public. Without the health sector, the media cannot fulfil their obligation to serve the interests of the public. The media workshops concluded that , not only was better collaboration needed between the Ministries of Health and the mass media , but also intersectoral collaboration between the different ministries. Many aspects of education, food production , water supply and housing were dealt with by separate ministries but had a direct impact on the health situation . It was Workshops in Kenya, Tanzania and Ethiopia brought together journalists, radio producers and health officials to discuss primary health care. Photos WHO/D . Hoffmann W oRLD HEALTH, October 1986 "Without the media, the health sector cannot create an informed public. Without the health sector, the media cannot serve the interests of the public. " suggested that a task force comprising members from all these ministries should be formed in order to avoid overlapping or conflicting activities. The participants in the workshops identified the major obstacles facing effective health education. These in- cluded such problems as illiteracy, the need for material produced in many different vernacular languages , religi- ous and cultural taboos , the high cost of newsprint and difficulties in obtain- ing batteries for radio transistors. Health education campaigns were often felt to be badly planned and confusing. Spray your houses against malaria, said one message , while another encouraged people to keep their houses clean and to whitewash the walls twice a year. Eat more fish, said one message, but another advised that all ponds should be drained since there were breeding grounds for the W oRLD HEALTH , October 1986 vectors of disease. Participants agreed that it was no good trying to introduce new dietary practices if the foodstuffs being promoted were not available or too expensive. Nor is there much point in promoting personal hygiene if there is no soap , or , even worse , no water! The workshops emphasised that , for health information and education to be effective , there is an urgent need for proper monitoring and evaluation of the impact. Many efforts made so far have failed through lack of plan- ning and proper research into such questions as cultural and religious influences, levels of education, local resources and environment. Radio programmes addressed to women are useless unless they are transmitted at times when women are free to listen. Information intended for men should be presented where men are frequent- ly found, such as in bars or at football games. Audience participation is also important , whether it be through pub- lic debates , radio programmes or question-and-answer pages in local newspapers . Issues on sensitive sub- jects such as family planning should involve those members of the com- munity who have a strong influence, for instance grandmothers, village leaders or traditional healers . Mes- sages need to be repeated frequently to achieve comprehension, acceptance and motivation leading to a change in behaviour. Training is essential for everyone concerned in the struggle for health. Health officials need to master tech- niques of communication, and journ- alists need to recognise their social responsibility for health advocacy. The English writer H. G. Wells said that " human history becomes more and more a race between communica- tion and catastrophe. Full use of com- munication in all its varied strands is vital to ensure that humanity has more than a history- that our children are assured a future. " Health for all is a concept of hope for the future, and for that hope to be realised , every person should have an appreciation of the value of health , know how to achieve it , and how to guard it. In order to achieve Health for all , there must be information for all. • 15