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Developments in the Use of the Mass Media at the National Level for HIV/AIDS Prevention in South Africa: Concept and Strategy

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Summary

There are a plethora of models and schools of thought that public health specialists can useto inform the development of public health communication campaigns. These models includethe founding vision for health promotion captured in the 1986 Ottawa Charter which representsa fundamental shift away from individualistic health education behaviour change models toacknowledge the profound impact physical and social environments have on people's opportunityfor health and their health behaviour. The five pillared action strategy outlined in the OttawaCharter is still the predominant framework for much health promotion activity internationally.The five action areas are summarised in the box below.


The five action areas found in the Ottawa Charter for Health Promotion

  • The development and implementation of healthy public policy
  • The creation of support environments – this can be social as well as physical environments
  • Community action and mobilisation
  • The development of personal skills
  • The reorientation of health services



Mass media work in health promotion traditionally focused more on the individualistic modelsof behaviour change. This is because most health messages are targeted to individuals. For example, "Use a condom"; "Go for an HIV test"; "Be faithful". However, the utilisation of the mass media in health promotion has progressed beyond narrow interpretations of behaviourchange. New concepts such as media advocacy which aim to use the media to shape or change policy affecting health are being successfully applied. Increasingly, public health specialists are examining how the media can be applied to impact on the community and on society bystimulating community action and promoting changes to the physical and other environments.


An African strategy


UNAIDS have sought to establish an improved strategy for HIV/AIDS communication in theAfrica region. They identify five interrelated domains of context that should be the focus indeveloping future communications strategies for HIV/AIDS prevention, care and support.[4]These domains are:


Government policy: The role of policy and law in supporting or hindering intervention efforts.


Socio-economic status: Collective or individual income that may allow or prevent adequateintervention.


Culture: Positive, unique or negative characteristics that may promote or hinder preventionand care practices.


Gender relations: Status of women in relation to men in society and community and theinfluence on sexual negotiation and decision-making.


Spirituality: The role of spiritual/religious values in promoting or hindering the translation ofprevention messages into positive health actions.



These domains are intended to be used to contextualise people's lives and encourage targetingof individuals within the context of their interaction with a domain or combination of domains.


For the Africa region, it was concluded that a community-based approach is critical. This approach has three broad strands.


  • The involvement of communities in supporting outreach and peer education activities andan emphasis on culturally appropriate strategies.
  • Education should happen within the context of development, for example in the workplace,and should address the impact of HIV/AIDS on agriculture and industry.
  • The application of quantitative and qualitative research to gauge success, uncoverweaknesses and close the communication gaps.



In their discussion of national communications frameworks, UNAIDS identify that mediacampaigns and interpersonal communication must complement each other in the developmentof communications interventions for HIV/AIDS prevention. An example of effective interpersonalcommunication is oramedia (traditional network of oral communication channels in the Africancontext). Although the success of interpersonal communication is often under-researched,practitioners report that interpersonal communication has been successful in addressing sensitiveissues of sexual behaviour in Africa. In the recommendations, edutainment and humour arehighlighted as one method of promoting open discussion among couples, peers and friends.


4 UNAIDS/Penn State University. Communications Framework for HIV/AIDS: Anew direction, 1999.