[Music]
hi I am dr. Austin Denby deputy director
in the office of global health at the
health resources and Services
Administration at the US Department of
Health and Human Services as a founding
member of the Centers for Disease
Control and Prevention's global aids
program I have worked with teams to
establish aids education prevention
treatment and care programs in Ethiopia
Rwanda Tanzania Zambia and the
Democratic Republic of Congo during the
Ebola outbreak in West Africa our spot
of CDC's leadership team that worked
with international and domestic partners
to contain the outbreak in Sierra Leone
this lesson is health communications the
message the messenger and the audience
in this lesson will discuss the three
key pillars of reporting and
communicating health information we'll
talk about the importance of accurately
reporting health information and we'll
look at the consequences of distributing
and promoting inaccurate health
information accurately reporting on
health issues in a balanced way is
critical to improving health outcomes it
is important to report such health
information with due regard to the
impacted populations ensuring that the
reporting results in good outcomes and
does not result in stigmatization and
unforeseen consequences the absence of
reporting accurately on health issues
and in a timely manner creates an
acceptable room for rumors which when
allowed to have a foot hole may have
devastating consequences that may be
very difficult to reverse it can mean
the difference between someone seeking
the proper life-saving prevention care
or not reporting communicating health
information for appropriate action is an
issue that we should consider very
carefully it is indeed a partnership
between three fundamental pillars what
I'll refer to as the health
communications triangle the message the
messenger and the audience let us start
with the message for populations to take
health messages seriously messages have
to be important and relevant to the
impacted populations this should not
just be the opinion of the health
experts the population you're trying to
reach should be able to understand how
that health issues affect them as
individuals their families their
neighbors or others they care about the
timing of messages is very important as
it will determine the acceptance and the
urgency with which the population
response messages are not intended for
the benefit of the health experts but
instead are directed at specific
populations care must be taken to make
sure that the messages are not presented
in hard to understand medical jargon but
in Claire Success simple and
understandable language that people
could comprehend irrespective of their
knowledge of the issue in an era where
information could be obtained from many
sources especially unregulated social
media accounts it is important that the
source of health information for public
communications are credible reliable and
verifiable such information should be
based on data and plausible science
which a reasonable individual or
community could understand messages
should not create fear and panic or
stigmatize populations based on
Association geography or lifestyle most
importantly communities usually want to
know what they need to do to reduce the
exposures and risks and improve health
outcomes
every health message is therefore
incomplete without an appropriate
actionable component for your primary
audience consider that you are not just
relying information to your audience
you're also working to increase their
health literacy as well health literacy
is defined as the degree to which a
person has the capacity to obtain
communicate process and understand basic
health information and what services are
available to make appropriate health
decisions by crafting messages that
follow these guidelines individuals and
communities will be better able to make
informed healthcare decisions for
themselves let's talk next about the
messenger when we talk about the health
messenger we're referring to any
individual who attempts to relay health
information and I mean anyone a family
member a friend a colleague a neighbor
and of course properly trained and
licensed health care professionals
people share health messages with
friends and family because they feel a
communal responsibility with a relevant
timely and credible message the
community can become important advocates
for your efforts for effective health
communication the messenger is as
important as a health message itself the
messenger has to be a good listener
credible and trustworthy they should be
straightforward honest and
non-judgmental they must have a proven
track record of dealing with similar
issues and providing reliable
information in the past the messengers
credibility stems from an in-depth
knowledge or expertise in the subject
area no matter who they are
if the person serving as the primary
messenger does not have a proven track
record on the topic then their partners
on the project must either way you
should not expect audiences to listen to
your message if you cannot demonstrate
that you have the knowledge to speak on
the subject and for the messenger to
have the desired impact they have to be
approachable culturally sensitive using
appropriately Norns language and be
perceived as a dependable partner who
will be there for the long haul as
populations tend to be skeptical of
health messages in today's world of the
Internet where misinformation and rumors
are easily spread it is important that
there is a perception that the messenger
really cares about the health of a
population and has the knowledge and
expertise to be that messenger the
notion of a partnership between the
health communications expert and the
population working together towards
achieving a common goal of good health
outcomes with both parties contributing
in their respective ways is vital let us
now talk about the audience the intended
audience is an equal partner in this
communications triangle for them to
participate effectively they have to
feel that the health issue affects them
or has the potential to affect them
their families or their communities
directly or indirectly it is important
that they don't feel blamed for the
health effects that are being addressed
but more as partners in bringing
solutions to the health problem a key
component of this is ensuring that the
audience understands and agrees that
their views will be factored in to
developing solutions in addition for
many community members knowing that
their low
leadership is on board with a particular
message and messenger can help build
trust and they may be more willing to
listen and act accordingly because the
audience may have different backgrounds
beliefs or cultures and different groups
may receive and react to messages
differently every effort should be made
to direct messages to the different
groups within an audience considering
factors such as age gender tribe and
socio-economic status since these groups
will tend to ask about what actions they
should take to influence health outcomes
delivery efforts should be made to
provide actionable messages relevant to
a specific group based on these same
factors this communications triangle is
best illustrated by efforts that started
in 2011 to get pregnant women in Malawi
to test for HIV and if they tested
positive for the virus to immediately
access lifelong treatment to protect
their health and the health of their
unborn child we launched a new campaign
that focused our message on protecting
the health of both the mother and her
baby the new program was a deviation
from prior prevention of mother-to-child
transmission programs that just focus on
protecting the baby would little or no
consideration for the mother the new
program appealed to and motivated the
mothers to actively participate new
messengers were recruited to supplement
the health care workers and to work with
the pregnant women as peers these new
messengers were mothers themselves some
of whom were HIV positive and had
benefited from the treatment program and
had delivered healthy babies
despite their HIV status these women
were very effective believable and
trustworthy messenger
her research had shown that fathers were
a major impediment to having their wives
tested for HIV and getting treatment in
Malawi for this program to be effective
it was important that fathers understood
the program and the benefits it brought
to their families male counselors were
recruited and included in the program at
every step of the way in determining the
primary audience for delivering the
message of a healthy mother and healthy
baby pregnant women and their husbands
was specifically targeted the net result
of this program were the carefully
crafted message effective messenger and
targeted audience was very impressive
for the first 12 months of the program
there was a dramatic increase of 700
percent in the number of pregnant women
in Malawi who got tested learned their
status and enrolled in the national
treatment program in another example to
illustrate this phenomenon during the
2014-2015 Ebola outbreak in West Africa
the initial efforts at getting community
cooperation to contain the outbreak
failed because messages with scientific
facts that were not tailored to the
audience's impacted by the virus the
initial messengers were not trusted and
the tools used to deliver messages were
inappropriate the message then was Ebola
is the deadliest viral disease in the
world over 95 percent of infected people
die there is no vaccine or medicine to
treat the virus yet communications
experts ask people to go to hospitals
when they were ill and when nearly 100
percent of people who presented to
hospitals died
health care workers were surprised when
the communities revolted and accused
them of killing patients who presented
to hospitals reversing that perception
was a major challenge for us to achieve
success we needed to create a
partnership between the healthcare
providers and the community's impacted
to do so meant understanding the
community's concerns identify entrusted
subject matter experts and utilizing
preferred medium for message delivery
which in this case was radio broadcast
by the healthcare workers together we
develop actionable and appropriate
messages for various target audiences
the net result of those actions in
Sierra Leone was a hundred percent safe
burials a sharp increase in reported
cases early referral to treatment
centers higher survival rates and a
final containment of the outbreak health
communication and reporting to achieve
desired health outcomes should not be a
single event it should be an ongoing
activity that utilizes all available
tools such as mobile applications social
media print radio text messaging and TV
these are powerful tools when combined
with the correct message adapted to the
right media and delivered by the right
messenger whose message is directed at
the appropriate audience to ensure
effectiveness measurements have to be in
place to guarantee that the messages are
delivered appropriately the intended
audience received the credible message
and then took actions to address the
health
this dynamic process should result in
adjustments to each pillar of the health
communications triangle the message the
messenger and the intended audience
until the desired health outcomes are
achieved after you have completed all
the lessons in this course at
yali.state.gov
you can test your knowledge and earn a
Yali Network certificate