Radio Broadcasting for Health: an Issues Paper July 2004 26656 Radio Brochure Proof 25/8/04 5:09 Pm Page 2

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Radio Broadcasting for Health: An Issues Paper July 2004 26656 Radio Brochure proof 25/8/04 5:09 pm Page 2

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.

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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 26656 Radio Brochure proof 25/8/04 5:09 pm Page 4

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

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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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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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• 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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In Rwanda, for every 1 television there are 101 radio sets 1 ICD 8 AI RACSIGFRHAT:A SUSPAPER ISSUES AN HEALTH: FOR BROADCASTING RADIO Introduction 1.1 1.2 pr become anintimateandper unsurprising thatradiohas countries.” r time, haspenetratedintothe developed worldand,atthesame For theser content inver ideally suitedtoconveying unable tor does notexcludethosewhoar to zero.Asanauralmedium,it marginal costsofdistributionclose observes that: 1999). Inthisrespect,Buckley is usedbypoorpeople(UNAIDS communications technologythat of radioasthedominant in therecognitionofubiquity of radioisstrongandgrounded the socialanddevelopmentalr of poorpeople.Donorinterestin dedicated toimprovingthehealth are bothsustainableand building broadcastingsectorsthat Donors havearoletoplayin infrastr low productioncosts,with sub-sectors suchascommunity down intoanumberof Radio, asasector, canbebroken community levelshasoccur inter based interventionsforhealthat A significantexpansionofradio- der par recent years(seeDagron2001).In r means ofcommunicatingissues radio isacheapandef countries andr has occurredinmanydeveloping health ser emotest ar elating tohealth,policyand esence thr egulation oftheair t, thisisduetothe “Radio isatechnologywith national, nationaland uctur vice deliver easons itisper ead orwriteanditis (2000: 3) eas ofthepoor oughout the e costsandwith nacular languages. ecognition that y . 1 fective waves that haps est r ed in vasive , e ole • • • language groups; r favour cer inclusive, i.e.theymayactively socially exclusive,ratherthan Many stater ar public radionetworksintheSouth r broadcasting chargedwith local leveloccurs,withpublic br the BBCmodel).Withinthissector state fundedandindependent(i.e. may bestateownedandr serves thepublicinterestandwhich Community radio defined inthefollowingterms: international. Thesecanbe national orpublic,commercialand infor licensing, forenhancingthehealth commitments asarequirement of ensuring publicservice commer oppor principal focusofthispaper, popular music.Thoughnota br carry advertisingandoften stations ar public ser local leveltendstohavelittleorno Commer Public radio (AMARC 2000) community development; social inclusionandor commitment tolocalparticpation, stations tendtohaveastrong community members.Such by abroadcross-sectionof community andwhicharestaffed the community, whichservethe stations thatar eligious, politicalor eflecting issuesoflocalr e over oadcasting atbothnationaland oadcast substantialamountsof mation envir tunities doexistwithinthe cial radiosector tly propagandistandare cial radio vice commitmentand tain discr e generally r refers toradiothat un and/orcontr e situatedwithin onment; at nationaland refers toradio ete ethnic, un forpr , thr elevance. un, or ough olled ofit,

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International radio services, often 1.5 The UN ICT task force (2002) adds • broadcast in multiple languages, fulfil 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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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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Research and evaluation, 2 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 2.2 A long standing criticism of mass in particpation with communities that 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 • through the definition of qualitative initiatives, such as the multi-media 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 hypertension (Tufte 2001). For definition of key audiences and risk groups for health broadcasting; community radio stations, which are usually run with a minimum of through the testing of outputs and financial support, formative and • health messages with audiences; systematic impact evaluation remains largely out of reach. • through evaluation of the impact of However, Fordred and Lloyd health broadcasting with audiences; (1998), Porras (1998) and Skuse (1998) all highlight mechanisms, • through adaptation of outputs so that from simple evaluation strategies, broadcasting remains responsive to the 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 represent one component. Recent radio interventions for health that 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 individual, behavioural change are access both increased their awareness skills are low within the public perceived as the ultimate goals of 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 mortality and abstract measures of changes were unable to be detected. This and national levels through knowledge acquisition to 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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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 1991 and 1994 aimed to increased radio broadcasting is usually dialogue and debate; contraceptive use. Evaluation found a referred to as health messages. strong link between exposure to family Health messages if well researched • increased accuracy of the information planning messages in the mass media and that people share in the dialogue 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 contraception. Among the different people and communities to feed their 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 the most popular source of family Such messages tend to reinforce setting role by disadvantaged people planning information, reaching 49% of 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 productive (Singhal and Rogers people’s everyday interests; planning messages in the media cited radio as one of their main sources. A 2003). Early examples of public linked people and groups with radio drama dealing with family planning information campaigns in the • similar interests who might otherwise 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 2.8 Effective communication can help conclusion that multiple media sources 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 social norms, whilst locating this unlikely to provide adequate support to 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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2.9Simulating 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 • well researched and evaluated; relevance of the health messages should be viewed with suspicion, • non-technical and non-didactic; that lie at the heart of health especially when the intention • non-judgemental and inclusive; broadcasting. Many examples exist exists to work with vulnerable • gender sensitive; of poorly targeted, confusing or communities and specific risk • accurate and useable; even detrimental messages. Key groups. This suggests assumptions • culturally appropriate; message issues include: have been made about what sensitive to local needs; • constitutes appropriate and carefully worded to aid clarity • Sensitivity. For example, messages relevant health information. and understanding; • 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, officers assess whether the health messages must be 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 complexity and density of radio • The cost, complexity and skill wider radio audiences is critical to access and use, as well as localised 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, and upon formative research to • Availability of useful and useable factual programmes and so on, guide intervention design. The 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, politicians or Which format? broadcasting, to address a legislators; complex health issue such as • general public; 2.14 Though each format example HIV/AIDS beyond providing simple • specific risk groups and provided in Appendix 2 has been messages regarding safe sex and communities. used to good effect to address a 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 • Who the broadcaster intends to dialogue, i.e. through soap operas, 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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Community radio: 3 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 because of this, Linden (1999) BOX 7 BOX 8 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 Control of national media by South Africans. The act made provision station was as high as 115,000 people. 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 radio sector in parts of Africa, community radio licences left many addresses a wide range of health issues, 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 broadcasting and today each show means through which (Tacchi 2002) communities are able to stake receives around 2,000 calls concerning their right to a range of services HIV/AIDS, family planning and gender 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 corresponding potential to • community radio stations poor people’s rights to health provide public health information 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. local media in Mali). • staff are embedded within the for political purposes, religious or 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 • status conflicts between paid and community dialogue that allows investment in the sector has unpaid staff; stations to respond quickly to occurred in recent years via multi- • gender inequality; community needs. institutional programmes such as • understaffing and overwork; DFID’s Building Digital • little or no crisis or conflict; Opportunities (BDO) and the new • management capacity. Catalysing Access to ICTs in Africa (CATIA) initiative, both of which Moreover, community radio may: recognise convergence of new technologies (such as the Internet) • be subject to politicisation and with existing technologies (such as polarisation; radio) as a key opportunity to • divisive if it ignores the certain bring the information revolution 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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Public and international radio: 4 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 Radio in China, an unfulfilled potential phone in programmes, can be Haka-Haki Radio (Radio Face-to-Face), 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, understanding or participation. Recent 4.6 Increasingly, public broadcasters are tailored programmes on various health 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 the incidence of polypharmacy (taking they do represent a constraint for Haka-Haki (Radio Face to Face) for Radio 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 ethnic minorities, who often find it development of commercialisation been undertaken, Haka-Haki has inspired 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 • provide a humanitarian and lifeline for millions of Afghans cut off conflict or humanitarian crisis. information lifeline; 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 • address issues of basic disease mixed with more prosaic concerns such World Service or VOA can play an prevention, hygiene and sanitation; 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 address more complex medical issues • rehydration salts (ORS) are routinely rights when national and in areas where high mortality rates 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 4 ethnic animosity. • provide a means of raising awareness land mine explosions is evident in of harmful or hazardous materials, 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 • provide information concerning the (Skuse 1999) vectors and a corresponding harmful effects of certain lay- 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 • provide a means of working through are displaced and are forced into issues relating to mental health or refugee or feeding camps. trauma; 4.16 Conflict and non-conflict • provide a means for addressing emergencies can overwhelm 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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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 CBOs deemed representative of poor people who come together to listen to communities; men, women and children may be a the radio, to discuss the issues raised on • empower women; useful and cost effective mechanism the programme and to respond actively • raise the voice of rural women in for community-based social by providing feedback to the station national debates concerning mobilisation around key and using the information they have development; health issues. received to implement community projects. Radio listening clubs found to stimulate debate. • be operating successfully are given a 5.8 Equally, mobilising listening clubs and 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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Building links for better 6 health broadcasting

6.1 For health broadcasting to have an appropriate impact - and ICD BOX 13 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 priority and essential element of attributed to causing a decline in polio 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 radio can both knowingly and of the rumours and rumourmongers 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 Africa in particular, is stereotyped the need to work closely with risk BOX 14 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 levels of public information broadcasting should primarily especially high risk from HIV and 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 6.4 Importantly, radio can help to approach, remains the and the programme, which designs 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 resulted in a weak national project partnerships are drawing and positive. 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 to the radio sector it is important BOX 15 BOX 16 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 • information about health issues to levels of public information 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 script development process. The project’s its own right is critical to comm- audience; their knowledge, funders are numerous (including FAO, 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 • information concerning radio terms of the broad social development to linkages with health information listenership patterns, data on radio 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 mother and child health (MCH). The information to radio producers, providing health education and production must choose from a list of which ultimately is of benefit to services in the area. around 25 themes, much health related, 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, principally 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 interventions and single formats BOX 18 BOX 19 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 • expand the inter-connectivity University of Technology have worked environment, rather than the between different media, for example 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 can help radio reach people to whom it taking the course of work, complete a to multiple messages with the • has previously been difficult to 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- commodity provision (i.e. term remains in question; condoms) are unlikely to have a can improve information flows to significant impact. • 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 • efforts should be made to overview of health broadcasting at 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 • coordination efforts need to be investigated a range of linkage and 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 to enhance the usability of their when integrated into long-term health information outputs is and multi-media health critically important; promotion campaigns that address a broad spectrum of constraints, • new technology has provided a issues and spheres (socio-cultural, means of providing such political, economic, policy); information flows and the integration of new technologies • radio formats that support and into the radio sector should create community dialogue, such be expanded; as soap operas and mini-dramas, are especially relevant to • support for the establishment and addressing complex health issues maintenance of national and local and should be broadly supported; health information ‘clearinghouses’ or ‘content banks’ • support for community radio for health broadcasting/mass should not disadvantage national 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 the development of new formats enhance access to radio and social and techniques (e.g. ‘Health-e’ mobilisation, through support of in S. Africa); radio listening clubs and the provision of radio sets for • radio staff require training in communal listening; 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 • the extent to which radio listening for broadcast organisations; clubs lead to effective social mobilisation for better health • donors should support the outcomes requires further provision of such training and the 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 • community, public and generally, and the synergies 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 • a clearer picture is required of the health information flows within synergies evident between the 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 • similarly, further thought and may operate at different levels; 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: • able to broadcast to mass audiences and are usually popular, therefore lending itself 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: • an overt political stance and broadcast propagandist or inflammatory material that reduces the willingness of donors to get involved in supporting radio sector • strengthening at this level; funding crises that impact upon the quality of its health broadcasting, the quantity of • 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 • didactic and unengaging health programming; research and evaluation units that are often chronically under funded; • 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 Spots and slogans are short simple Using Spots in Diarrhoea Education 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 service availability, free or subsidised wont lose weight when he has diarrhoea. 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 dialogue/drama with the health issue appetite came back (laughing). Now look 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 • the % of the total population with community dialogue on can occur about sensitive health 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 aspects of human development. extensive organisational and leprosy is transmitted by touch fell 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 • the percentage of people that claimed operas tend to be open-ended or as US$500,000 to run annually and 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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The cost of soap operas makes Magazines, talk shows, them largely unfeasible as a phone-ins BOX 3 community-based intervention. Twende Na Wakati (Let’s Go with the Magazines, talk shows, and Times), Tanzania phone-ins are mainstays of radio In July 1993 a radio drama began Stories and testimony broadcasting, health broadcasting included. Magazine formats broadcasting on Radio Tanzania aimed at 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 often a monologue from a person including HIV/AIDS and were found to 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 ensure that incorrect or unhelpful Interviewing people with diseases drama suggested that they had health messages are not around which high levels of self- learned about family planning and 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 • 23% of the audience reported that send a very helpful message. acceptance (HDN 2001). they 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 based presenter, as well as • 55% of listeners revealed that they to write about, as the broadcast professionals working in the field 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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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 South - about diseases such as • avoidance, family planning, as well as national radio staff in health HIV/AIDS or TB is important 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 features relating to the accuracy of information and consistence that provide informational and overcoming of disease-associated 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 3

AMARC 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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Appendix References 4 Adam, G. & Harford N. 1998. Health on Air. Health Unlimited, London, UK

Adam G & Harford N. 1999. Radio and HIV/AIDS: Making a Difference. A Guide for Radio Practitioners, Health Workers and Donors. UNAIDS Publications, Geneva, Switzerland.

AMARC. 2000. The African Community Radio Manager’s Handbook: A Guide to Sustainable Radio. AMARC Africa, Johannesburg, South Africa.

Aw, W. 1992a. Lessons from a Little-known Experience. In B. Girard (ed.). A Passion for Radio. Black Rose Books, Montréal, Canada.

Aw, W. 1992b. Pluralist Responses for Africa. In B. Girard (ed.). A Passion for Radio. Black Rose Books, Montréal, Canada.

Buckley, S. 2000. Community Radio: the New Tree of Speech. Unpublished paper.

Burke, A. 1999. Communications and Development: a Practical Guide. Social Development Department, DFID, UK.

Centre for Development Half Yearly Report of CDC. Report. Kathmandu, Nepal. Communication (Nepal). 2000.

Centre for Disease Control. 1999. Scientific and Technical Information: Simply Put. CDC, Atlanta, Georgia, USA.

Crisell, A. 1986. Understanding Radio. Methuen, London.

Dagron, A. 2001. Making Waves: Participatory Communication for Social Change. Rockefeller Foundation, New York, USA.

David, MJR. 1992. Mahaweli Community Radio. In B. Girard (ed.). A Passion for Radio. Black Rose Books, Montréal, Canada.

De Fossard, E. 1997. How to Write a Radio Serial Drama for Social Development: A script Writer’s Manual. Population Communication Services, Centre for Communications Programs, Johns Hopkins University School of Public Health, Baltimore, USA.

DFID. 2000a. Ndizathuzomwe Radio Project Review. DFID Central Africa & Social Development Department report. Unpublished report.

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