By Dr. Megha Kaushik
Community radio is a powerful public health tool for widespread health promotion. The following report outlines a proposal for the development of a not-for-profit community radio programme to discuss key health issues and encourage healthy behavioural change in a Nigerian community.
Why radio is appropriate
The radio is an effective means of health promotion and communication as it is associated with low production, infrastructure, and distribution costs. Importantly, it is a medium that is accessible to people who cannot read or write. “Radio has become an intimate and pervasive presence throughout the developed world and, at the same time, has penetrated into the remotest areas of the poorest countries” (Skuse 2004). Health messages within radio broadcasting if well researched and carefully produced can contribute to better health for poorer communities (CDC 1999).
Radio is the most prevalent electronic device in Africa. In 2002 it was estimated that over 60% of the population of the sub-continent are reached by existing radio transmitter networks (UN ICT Task Force 2002). This contrasts to mediums such as television which are far less accessible in rural and poorer communities.
The radio sector is an important means of distributing information about health and wellbeing to poorer communities. It not only provides health information to its listeners, but encourages wider community discussion between radio listeners and non-listeners. Some studies even identify and report this link between broadcasting and the passage of information within communities.
Community-focussed radio is run for the benefit of the community. It differs from local radio as it is independent from larger state broadcasting networks, their content and perspective, and adheres to licensing requirements concerning community participation and service. Community radio resonates to local concerns and needs, it broadcasts in local languages that are often ignored by public broadcasters and is run by community members. Thus it can be established to serve specific groups and lends to local authenticity.
Emergence of community radio in poorer communities is seen as a tool for advocacy, civil society strengthening, and better governance (Rodriguez 2001, AMARC 2000). It allows communities to voice and protect their right to health care and engage local and national government in dialogue about their needs. It can help protect the rights of poor peoples to important areas like health, education and work. The human right to freedom of information is enshrined within the 1948 Universal Declaration of Human Rights.
Topics promoting health that will dominate the proposed radio broadcast include:
60% of people with HIV live in the sub-Sahara African region, with an estimated 2.6 million infected individuals in Nigeria alone. It is a disease that has been grossly stigmatised due to misunderstanding, ignorance, and fear. Such discrimination has limited knowledge about the disease and simple methods of prevention which in turn has perpetuated its transmission. Radio offers flexibility in the creativity and delivery of evidence based facts to reduce discrimination associated with HIV and increase prevention.
2. Accidents and Injury
Worldwide, 5 million people annually are killed by injuries by violence, road traffic, violence against children, drownings and more (WHO). Injuries account for considerable mortality and morbidity which could otherwise be reduced by improving occupational health and safety, environmental factors, and community knowledge of dangers of the built and rural environments. Community radio has the ability to promote the latter as well as gather information on the types of common injuries and encourage changes to policy within the local government to improve environmental structures to prevent accidents and injury.
3. Maternal and child health
Half of the children under 5 years of age die in Nigeria. Causes are predominantly infectious diseases (pneumonia 18% and diarrhoeal diseases 15%) followed by preterm birth complications (12%) and birth asphyxia (9%). Undernutrition is a major contributor to these deaths. Radio has the ability to raise funds to help reduce early morbidity and mortality, make the community aware of the maternal and child health situation in Nigeria, as well as make the community aware of socio-cultural factors that could improve maternal, child and adolescent health such as hand hygiene, other personal protection measures to prevent infectious disease transmission, and diet.
4. Current local health projects and the role of NGOs
Radio broadcasting can keep the community abreast of local health projects and services such as health support groups. It has the ability to encourage community involvement in these local activities. These projects are frequently supported by non-government organisations, which can be misunderstood by the community and be seen as intrusive. Radio has an informative role in providing clear facts about the roles of the NGOs in the community.
Individual lifestyle choices have significant impact on general health and wellbeing. Radio can provide important health messages and a venue for community discussion about issues such as smoking, alcohol, and diet.
Practical details and format
Community radio should be staffed by a broad cross-section of community members and should encourage local participation and social development (AMARC 2000).
The format should include interviews with health professionals, volunteers, government officials and other experts. Local staffing provides continuity and adds to community prosperity. Community debates and dialogue on the radio programme could even potentially allow quicker responses to community needs by the radio station and perhaps even policy makers.
Radio health initiatives can also be formatively analysed to measure their contributions to human development and wellbeing. This encourages better funding. For example, the multi-media outputs of Soul City, South Africa, which provide information in a range of formats on issues as diverse as HIV/AIDS and hypertension (Tufte 2001). Qualitative assessment about community awareness/debate rather than quantitative measures (such as mortality rates) is considered more effective.
It is widely accepted that health messages that raise community dialogue are the best formats e.g. through soap operas, magazine formats, mini-dramas, and radio phone-ins. These are seen as less target specific formats, such as routine news, short spots (a simple message conveyed quickly) and slogans. So efforts will be made to encourage audience feedback mechanisms (e.g. simple evaluation, letters, and phone-ins) within the budget limits. Audience involvement is important in reducing social and cultural distance of the producers of the radio programme from their audience. This will also avoid didactic or negative health message-giving which can encourage prejudice and stigma (Singhal and Rogers 2003). Positive and culturally sensitive messages and engaging the audience will allow more effective communication to empower the community to engage in healthy and health-seeking behaviour (Galavotti et al. 2001).
There will be a strong emphasis on maintaining the quality, accuracy and relevance of the evidence-based health messages transmitted by the radio station. It will be managed by volunteers to help prevent vested interests in manipulating the content of the programme. Assurances should be made to prevent the distribution of information that reflects biases, misconceptions, and inequalities.
The media alone is not capable of creating behavioural change, but it is a realistic means of raising community awareness and creating public dialogue about health issues. A community radio station in this Nigerian community could represent a crucial source for health information and its local impact could attract donors and non-government organisations to help continue its long term survival.