Use the media!

World Health • SOth Year, No. 3, Moy-June 1997 19 Use the media! Jane Fonda Jone Fonda with Governor Zell Miller of Georgia, USA, at a press conference on teenage pregnancy prevention. Photo WHO/The Georgia Campaign for Adolescent Pregnancy Prevention We need the media today (in rich countries as well as poor) to serve as a channel to inform a growing public about healthy practices, sensible /if estyles, as well as the importance of education and equality for girls. ublic health will be a meaning- less term unless it can truly be put across to the public. Over and above the doctor-patient rela- tionship - of crucial importance itself, of course - a whole range of issues at present impinge on the health of people everywhere on our planet. Lifestyle decisions have to be made by individuals on such health-related issues as whether or not to smoke, whether or not to start a family, whether or not to practise safe sex. Certainly, the first impact is on the individual, but these issues today are global in their consequences. The doctor in the surgery, the mid- wife in the maternity clinic, the nurse in the ward can do only so much to inform and educate the persons fleetingly in their charge. But t9 ensure that the vital health messages of our time reach people in urban slums or in remote villages calls for an effort beyond the capa- bility of the hard-working health professionals. Yet the media - press, radio and television - are still rarely used by the health profession in general to transmit key messages - about the catastrophic effects of smoking, about the need for simple hygiene before and after childbirth, about the options available to both men and women to ensure that every child born is a wanted child. In many countries, family plan- ning services are available. Yet many women do not tum to them, perhaps because local tradition urges them to have large families, or for status or cultural reasons, or because their partners forbid them to use contraception. All the medical I services in the world will not over- come these barriers to fertility de- cline and improved health for women, children and families as a whole. But more than a decade of re- search has shown that the mass media, properly used, can indeed alter behaviour and cultural norms in ways that have an impact on health, gender bias and literacy. In 1994, the International Conference on Population and Development, in Cairo, called upon countries to 20 mobilize their mass media so as to educate their audiences about health matters, reproductive behaviour and gender roles. One significant example of what can be done occurred in Mexico in the 1970s when a "soap opera" which dealt boldly with such subjects as unwanted pregnancies became very popular among viewers, and was found to have contributed signif- icantly to a 33% increase in new registrations at family planning clinics and a 23% increase in contra- ceptive sales over a 12-month period. A similar radio and television series in Kenya, broadcast from 1987 to 1989, attracted the largest audi- ence in that country's history and coincided with a 58% increase in contraceptive use and a decline in desired family size from 6.3 to 4.4 children per woman. When the broadcasts started, the programme could not talk directly about family planning because of local cultural constraints. Instead the producers focused on land issues and family health. The storyline showed an old man with four wives whose life was a mess; his land could not produce enough food for all his children and he could not afford to send them to school. But another family was shown - small, monogamous and happy - which was much better able to offer the children a brighter future . The contrast was clear without the need even to mention family plan- ning. In 1984, Doordarshan Indian television screened a "soap opera" called Hum Log ("We people") whose attractive storyline promoted a higher status for women and popu- larized family planning. Research showed that, over a 17-month period, 70% of viewers had learnt that women ought to have the right to make personal decisions and that smaller families are happier ones. Although the show did not invite viewers to write in, no fewer than 400 OOO letters flooded the studios. Radio serials have also been used very effectively to convey health messages. In the remote villages of many countries, radio is still the only channel for mass communication. Moreover, in cultures where it is difficult to talk openly about sensi- tive issues such as birth control or sex education, radio call-in shows offer a way to have questions an- swered anonymously - but publicly. There is a knock-on effect too for such radio or TV shows: they fre- quently embolden newspaper editors to embark on hitherto taboo issues and to air them in public. We need the media today (in rich countries as well as poor) to serve as a channel to inform a grow- ing public about healthy practices and sensible lifestyles, as well as the importance of education and equal- ity for girls. • World Health • SOth Year, No. 3, Moy-June 1997 Jone Fonda is chairwoman of the Georgia Campaign for Adolescent Pregnancy Prevention, a trustee of The Turner Foundation, and o Boord member of The Corter Center. Ms Fonda is married to Mr Ted Turner, Vice Chairman of Time Worner, Inc. , of which Turner Broadcasting and Coble News Network ore a port. Together they ore Goodwill Ambassadors to the United Notions Population Fund. Together they promote the use oF moss media in tackling many oF the growing health and social crises in today's world. Ms Fondo 's address is Fonda, Inc. , One CNN Center, South Tower, Atlanta, GA 30303, USA ULU,\RAllON Dt Lo~ ll11u t 110~ 1)11 NL\\ t ( . ..- . ,.._"'; r,f .\ .; '· ~,, .. .. .. . ~ Postnatal examination in Colombia. Health professionals and the media con be partners in spreading messages that will hove a positive impact on the health oF Families. Photo W HO/H Anenden