BBC WST - Health

A New Collaborative Approach to World Health

Over the past 3 years, the BBC World Service Trust has developed a unique form of co-production with local broadcasters in a number of countries. National radio and TV stations have the greatest reach and have huge potential to shift attitudes. Yet that potential is often untapped due to insufficient linkage between Ministries of Health. The BBC has credibility with both parties: we take the agenda of the Ministry and convert it into a series of incentives for local broadcasters.

The Trust aims to transform health programming from worthy but dull output (as it exists in most parts of the world) into dynamic, entertaining media that engages audiences in matters of crucial importance to them. It can be done - and once media executives see the results, they are motivated to retain the programming we design, making the project sustainable. Further, by giving the partners technical and editorial training we build capacity and skills. Finally, by bringing resources and sheer energy into the project, we can generate momentum around health issues (in India, for example, 10 organisations have been enthused into donating over £1.58 million of resources to our leprosy campaign).

In return, our media partners offer airtime, staff facilities and their own expertise. Given that our output focuses mainly on entertainment (drama, music, sports, comedy) we are heavily dependent on their staff's cultural sensitivity, scripting skills and imagination. Together we make a far better campaign than either of us could produce alone.

We also aim to engage the media in a dialogue with its audience. All our campaigns are informed by independent audience research. Attitudes are measured by a baseline survey which feeds into our creative plans. Messages are then tested on focus groups; and once the campaign is complete we commission an independent evaluation survey.

Below we have outlined just some of the projects:

The World's Biggest-Ever Campaign to Combat Leprosy Cures 176,000

In September 1999, DfID awarded the Trust a £1.1 million grant to carry out the world's biggest-ever media campaign to help eliminate leprosy. The campaign has focused on five Indian states over a 12 month period. The aims of the project are twofold: to persuade people to come for treatment, and to reduce the stigma associated with the disease.

The project has been a striking success (see below), and this is largely due to volumes of production that are unprecedented in a health campaign. Some 27 TV spots and 146 radio spots have been produced in 20 languages, plus 13 TV dramas and 53 radio dramas. In total, during 2 campaign phases, they will have been broadcast 808 times on TV and 5,545 times on radio. For media-dark areas, we are conducting 2,175 song and drama performances, 5,455 video van screenings and producing 150,000 posters.

These extraordinary quantities, far in excess of the numbers we promised, could not have been possible without very strong partnerships with Doordarshan TV and All India Radio, the national broadcasters. We have also worked very closely with the Ministry of Health, different sections of the Ministry of Information and Broadcasting, plus a number of NGOs. Crucially, the goodwill and energy that has surrounded the campaign has been outstanding. No airtime payments have been made to Doordarshan, no charges have been made by the Ministry of Information for more than 7000 public performances, and private organisations such as MTV ran their own special “leprosy week” and provided airtime free of charge.

The results The results have been very satisfying. As well as helping to induce some 176 000 patients to come forward for treatment, there has been a real impact on attitudes. The reach and effectiveness of the campaign in each state has been measured independently by the ORG Centre for Social Research. The results of their evaluation of the first six months of the project are summarised below :

• The radio and TV spots were seen by 48% of the total population of the 5 states (i.e. 224m people) Of those seeing the spots, 79% correctly recalled one or more messages.
• The impact on stigma was dramatic: the % of the total population believing leprosy is hereditary fell from 56% to 32% (i.e. a total of 112m people changed their attitudes on this issue between November and March).
• In two states the fall was extraordinary: from 81% to 36% in Bihar, and from 71% to 26% in MP
• The % of people unwilling to sit beside a leprosy patient fell from 47% to 33% (65m people)
• The % of people correctly believing that leprosy is not communicable by touch rose from 52% to 63% (51m people).
  
  Vietnam's first ever radio phone-in show (4 month project; cost $90K-$150K)
  
  In 1999 we produced Vietnam's first-ever national radio phone-in show, in partnership with Radio Voice of Vietnam. Funded by UNFPA, it aimed to enable young people to ask questions, and express their feelings about reproductive health. The show has been a striking success. In 12 months, some 30 000 letters and 4000 phone calls have been received. It is also fully sustainable: the BBC left this project 9 months ago, yet the show goes from strength to strength. Just two months ago, the Bangkok Post carried a headline “Talk show breaks sex taboo in Vietnam”. It's an excellent model in terms of cost-effectiveness and sustainability and its interactive format is particularly valuable for issues of sexual health.
  
  Combating Trachoma in Tanzania (4-6 months project; cost $130K and up)
  
  In areas where radio or TV do not reach, community media can play an essential role. In Tanzania in 1999 we helped the International Trachoma Initiative conduct a village-level campaign about the prevention of blindness. We used street theatre, posters, and “health animators” – entertainers with health messages, armed with vibrantly-coloured flip charts, children's songs and cassette players. Independent audience research showed that peoples' understanding of how to prevent trachoma increased by 150%. A note of caution must be struck here, though: community media is much more expensive in terms of people reached per dollar than electronic media, and is more difficult to sustain.
  
  A national radio campaign has been launched for the second phase of this health project in Tanzania in order to combat Trachoma - an easily treatable condition which can cause blindness. In addition, a 60-minute drama has been produced in Swahili for village screening. The film has been made by a Nepali Director and only has 3 professional actors out of a cast of 20.
  
  Nepalese comedians flood the airwaves (5 months project, small country - cost $130K)
  
  In Nepal in 1998/99 we launched a leprosy campaign, funded by the WHO. The aim was to saturate the radio and TV airwaves with spots and dramas based on comedy and music. The campaign was led by the two most famous Nepalese comedians, with huge popular appeal. No less than 100,000 people reported for diagnosis, and some 11,700 people were treated as a result. Just as significantly, the level of stigma (measured in terms of people who would refuse to sit next to a patient with a leprosy deformity) fell by 25% after the campaign: proof that media can shift even attitudes that have been entrenched for centuries. This highly focused approach (the broadcasts lasted just 30 days) was an ideal complement to the week-long outreach campaign by health workers.
  
  For more information on the BBC World Service Trust Health initiatives:
  
  Contact: Roy Head roy.head@bbc.co.uk