1.

Health Journalism: Concept, Need and

Importance
1.0 Introduction

Healthcare is the world‟s largest growing industry, and has an impact on every
man, woman and child on the planet. It is a natural focus for journalists. In
almost every country health and healthcare are staple issues for media
reporting, yet very few journalists covering health and healthcare have any
specialist training in what is a potentially complex and wide-ranging area.

1.1 Health Communication: Meaning and Concept

Health communication is an evolving and increasingly prominent field in public

health sector. Because of the multidisciplinary nature of health
communication, many of the definitions may appear somewhat different from
each other. Nevertheless, when they are analyzed, most point to the role that
health communication can play in influencing and supporting individuals,
communities, health care professionals, policymakers, or special groups to
adopt and sustain a behavioural practice or a social or policy change that will
ultimately improve health outcomes.

One of the key objectives of health communication is to influence individuals

and communities. The goal is admirable since health communication aims to
improve health outcomes by sharing health-related information.

There are several definitions of health communication. For the most part, all of
them point to a similar role of this approach in the process of advocating for
and improving individual or public health outcomes.

“Health communication is a key strategy to inform the public about health

concerns and to maintain important health issues on the public agenda”.
(New South Wales Department of Health, Australia, 2006)

“Health communication is a process for the development and diffusion of

messages to specific audiences in order to influence their knowledge,
attitudes and beliefs in favour of healthy behavioural choices” (Exchange,
2006;Smith and Hornik, 1999).

“Effective health communication is the art and technique of informing,

influencing, and motivating individuals, institutions, and large public audiences
about important health issues based on sound scientific and ethical
considerations” (Tufts University Student Services, 2006).
“Health communication is an approach which attempts to change a set of
behaviours in a large-scale target audience regarding a specific problem in a
pre-defined period of time”. (Clift and Freimuth, 1995, p. 68)

The Centers for Disease Control and Prevention (CDC) define health
communication as “the study and use of communication strategies to inform
and influence individual and community decisions that enhance health” (2001;
U.S. Department of Health and Human Services, 2005).

Another important role of communication is to create a receptive and

favourable environment in which information can be shared, understood,
absorbed, and discussed by the program‟s intended audiences. This requires
an in-depth understanding of the needs, beliefs, taboos, attitudes, lifestyle,
and social norms of all key communication audiences.

Health communication relies on different communication activities or action

areas, including interpersonal communications, public relations, public
advocacy, community mobilization, and professional communications (World
Health Organization, 2003; Bernhardt, 2004).

It is evident that “sharing meanings or information,” “influencing individuals or

communities,” “informing,” “motivating target audiences,” “exchanging
information,” and “changing behaviours,” are among the most common
attributes of health communication.

Another important attribute of health communication should be “to support and

sustain change.” In fact, key elements of successful health communication
programs or campaigns always include long-term program sustainability, as
well as the development of communication tools and steps that make it easy
for individuals, communities, and other audiences to adopt or sustain a
recommended behaviour, practice, or policy change.

Although the ultimate goal of health communication has always been

influencing behaviours and social norms, there is a renewed emphasis on the
importance of establishing behavioural and social objectives early in the
design of health communication interventions.

1.2.1 Role of Health Communication

The aim of communication involves the study and use of communication

strategies to inform and influence individual and community decisions that
enhance health. The importance of communication in healthcare is
increasingly recognised as a necessary element of efforts to improve personal
and public health. (Calif, 2000). Health communication can accomplish:

• Change in the behaviour of people

• Change in the policy
• Change the language to alter the perceptions of problems and solutions
• Identify and support the people in need
• Professional trainings and improved providers for patients
• Organise stakeholders
• Implement programmes successfully

Effective health communication can help elevate the consciousness of health

risks and solutions and provide the enthusiasm and skills needed to lessen
these risks. It can help to find support from other people in similar situations,
and affect or reinforce attitudes.

Health communication can also increase the demand for appropriate health
services and decrease it for inappropriate ones. It can make the information
available to assist people in making complex choices, such as selecting
health plans, care providers, and treatments.

In the community, health communication can be used to influence the public

agenda, advocate policies and programmes and to promote positive changes
in the socio-economic and physical environment. It can also be used to
improve the delivery of public healthcare and services and for encouraging
the social norms that benefit health and quality of life.

1.2.2 Importance of Health Communication

Communication depends on who we are as human beings and how we

exchange information. It signifies our symbolic capabilities. The efforts or
interventions that are used with an aim to change behaviour are acts of
communication. By focusing mostly on the transmission function of
information exchange, these efforts or interventions often neglect the ritualistic
processes that are automatically engaged through communication.

While adopting the transmission view of communication, it is reasonable to

think carefully about the channels through which the intervention messages
are disseminated, to whom the messages are attributed, how the audience
responds to them, and the features of those messages that have the greatest
impact. These considerations reflect the essential components of the
communication process: channel, source, receiver and message,
respectively. In the ritual view, however, target audiences are conceptualised
as members of social networks who interact with one another, engage in
social ceremony and derive meaning from the enactment of habitual
behaviours. Three important considerations for intervention in communication,
as cited by the World Health Organisation bulletin 2009, are:
1. The realisation that communication interventions do not fall into a social
vacuum. Rather, the information is received and processed through the
social prism of an individual, which is determined by what people
encounter through processes of selective exposure. It is the meaning that
individuals derive from communication. This is known as selective
perception and it depends upon factors at the individual level, such as
prior experience, efficacy beliefs, knowledge, and so on, and at the macro-
social level, such as, interpersonal relationships, cultural patterns, social
norms, and so on.

2. It is reasonable to expect discrepancies between the messages

disseminated and received. They arise not only due to different exposure
to the intervention but also because of the differences in the interpretation
and decoding of information. Thus, a careful study of the correspondence
between messages, as they are sent and received, is of great importance
in order to avoid unintended, or worse, counterproductive effects.

3. Communication is a dynamic process in which sources and receivers of

information continuously interchange their roles. One of the central tenets
of health communication interventions is the need to conduct extensive
formative evaluation; audience needs assessment and message pre-
testing.

1.2.3 Challenges of Health Communication

The use of these health communication principles in public health presents

the following challenges:

1. The evaluation of interventions in communication, especially while

using national mass media, for example radio, does not usually lend
itself to randomised trials. Hence, innovative methodological and
statistical techniques are required for attributing the outcomes
observed to intervention efforts. The responsive and transactional
nature of interventions in health communication also means that
modification in intervention content may occur, adding an additional
challenge to the evaluation process.

2. The belief among behaviour scientists, that causes of human behaviour

reside at multiple levels and reinforce each other, poses difficulties in
designing and testing multi-level interventions. This complexity of the
determinants of health behaviour requires a multi-disciplinary approach
for effectively promoting change. Interventions need to incorporate
expertise from a variety of professional backgrounds.
 3. Because of the rapidly changing channels of communication,
interventions in health communication need to make extra efforts to
meet their audience at their level of technology use.

The field of health communication is gaining recognition because of its

emphasis on combining theory and practice in understanding communication
processes and changing human behaviour. This approach is pertinent at a
time when many of the threats to global public health, through diseases and
environmental calamities, are rooted in human behaviour. By bringing
together researchers and practitioners from diverse disciplines and by
adopting multi-level theoretical approaches, health communicators have a
unique opportunity to provide meaningful inputs in improving and saving lives.

1.2.4 Characteristics of effective Health Communication

Before learning the characteristics of effective health communication, let us

have a look at the following principles of communication:

 Shared perception: For an effective communication the perception of

the sender should be as close as possible to the perception of the
receiver. The extent of understanding depends on the extent to which
the two minds come together.
 Sensory involvement: The more senses are involved in communication,
the more effective it will be. For example, if I hear, I forget, if I see, I
remember, but if I do, I know.
 Face to face: Communication is more effective when it takes place face
to face.
 Two-way feedback: Any communication without a two-way process is
less effective because of the lack of opportunity for a concurrent, timely
and appropriate feedback.
 Clarity: ideas, facts and opinions should be clear to the sender before
communication starts. Communication should always use direct, simple
and easily understandable language.
 Correct information: The sender should possess correct, current and
scientific information before communicating it.
 Completeness: The subject matter must be adequate and complete.
This enables the receiver to understand the central theme or idea of a
message. Incomplete messages may result in misunderstandings.

Effective health communication is essential because it equips the public

with the tools and knowledge to respond appropriately to health crises
such as Flu or Malaria outbreaks, prevention and management of
HIV/AIDS, and so on. Some features of effective health communication
include:
  Health communication, with a high impact, catalyses behavioural
changes at society level.
 It galvanises entire communities into action, prompting them to live
a healthy lifestyle by taking the necessary measures to prevent
diseases and to protect, maintain and improve their own health,
such as following good nutrition, regular exercises and responsible
sexual behaviour, eschewing destructive behaviours such as
cigarette smoking, drug abuse, and so on. (Hornik & Erlbaum,
2002)

For a health communication programme to have an impact, it should

disseminate appropriate content that satisfies the following criteria:

 Accuracy: The content is valid and without errors relating to facts,

interpretation, or judgment.
 Availability: The content, whether a message targeted at an
audience or any other information, is delivered or placed in such a
way that the audience can access it. The placement varies
according to the audience, message complexity, and purpose. It
can range from interpersonal and social networks to billboards and
mass transit signs, to prime-time TV or radio, to public kiosks, print
or electronic or to the Internet.
 Balance: Wherever appropriate, the content should present the
benefits and risks of potential actions or should recognise different
but valid perspectives on the issue.
 Consistency: The content remains internally consistent over time
and is also consistent with information from other sources. The
latter is a problem, especially when other widely available content is
not accurate or reliable.
 Cultural competence: The design, implementation, and evaluation
process should account for special issues for select population
groups, for example, ethnic, racial, or linguistic, and also for groups
with different educational levels and disabilities.
 Evidence-based: Relevant scientific evidence that has undergone
comprehensive review and rigorous analysis to formulate the
practice guidelines, performance measures, review criteria, and
technology assessments for the telemedicine health applications.
 Reach: The content gets to, or is available to, the largest possible
number of people in the target population.
 Reliability: The source of the content is credible, and the content is
kept up to date.
 Repetition: The delivery of, and access to, the content is continued
or repeated over time, both to reinforce the impact on a given
audience and also to reach new generations.
 Any effective health communication strategy must take a multi-pronged
approach, coupling with other interventions, such as policy changes,
improvements in health delivery systems, and so on. If a health
communication initiative does not have support at the policy level, its
efficacy and impact are much less predictable than the one with
institutional backing.

In developing health communication initiatives, it is crucial to consider

the socio-cultural scenario of the target audiences with respect to their
cultural characteristics, language preferences and media habits. For
instance, the health communication programme developer does not
want to design a health education website, only to find out later that his
target audience mainly comprises individuals who are either
technologically illiterate, or simply do not have access to the Internet.

1.2.5 Challenges in Rural Health Communication

There are many challenges to communication in rural areas. Low literacy

levels, poor media reach and exposure and vast, heterogeneous and
diversely spread rural audience characterised by variations in language,
culture and lifestyle – all these factors pose multiple challenges to health
communication in rural India. (Badi, 2006)

The growth in the conventional media has been quite significant; however, it
has not been substantial. The great portion of rural India is still do not come in
contact with any of the conventional media, like newspapers, TV, satellite,
radio or cinema. The limited reach of mass media imposes limitations on
universal communication to the rural population. These factors lead to poor
message comprehension and negligible impact, and eventually the
communication efforts fail to translate into public awareness and fail in
generating enough influence to change behaviours. (Gopalaswamy, 2008)

It should be acknowledged that a mix of different media is needed to convey

messages to rural consumers. There is a need to understand what appeals to
urban customers may not be appropriate for their rural counterparts owing to
their different lifestyle. Thus, the entire communication and also the vehicles
for the communicated message have to be different. It has been noticed that
„below-the-line communication‟ like alternative and innovative ways of
communication have played a key role in building reassurance and trust, so
they are vital.

Communication experts need to keep the following factors in mind when

creating advertisements for rural audiences:
  Understanding the mindset of the population, including their hopes,
fears, aspirations and apprehensions, by conducting a qualitative study
among the target audience; this would help to understanding better the
consumer mindset.
 Tricky, clever, gimmicky, or even suggestive advertising does not work
with rural audiences. „Flicks‟, using extensive computer graphics
without any human presence, go over the heads of rural audiences.
 Combining education with „entertainment is a good route to take when
targeting the rural audience. Using locally popular film stars or even
featuring religious events (melas) popular in the region, helps strike a
chord with the rural audience.
 Advertising agencies need to provide ample time and space to
communicate a message properly and effectively to the intended
audience. (K A Krishnamoorty, 2008; Lingham, 5/20/2013)

1.2 Health Journalism: Meaning and Concept

Journalism is a style of collecting, reporting, analyzing and disseminating the

information, consisting of facts, on occurrences with little attempt of
interpretation. Journalism is an idea which gives the public a balanced and
objective view. Journalism is about explaining things that everyone can
understand.

Health journalism is the dissemination of health and medical stories and

health related topics in mass media. It targets the public at large, rather than
specific professional groups, by providing health related information through
mainstream media outlets. Medical and health related topics are exciting and
diversified and are widely reported, as these topics influence awareness,
attitudes and intentions but may also contribute to change in behaviour, health
care utilization, clinical practices and health policies.

The developing interest of the public into health related information and its
latest development has resulted in continuous demand for good writing that
can understand scientific stories and convey them in an interesting way and to
facilitate the flow and dispersion of relevant medical research information to
the public and to bridge the gap between the wealth of expanding information
and the quality of public health.

Most inaccuracies and speculations in health news coverage can be attributed

to several barriers between the scientific community and the general public
that include lack of knowledge by reporters, lack of time to prepare a proper
report, and lack of space in the publication. Most news articles fail to discuss
important issues such as evidence quality, costs, and risks versus benefits.
However, health journalism is not only what is being commercialized and
covered by news and mass media. There is also another extensive, more
academic branch of health journalism which is based on evidence. Evidence-
based research is more accurate and thus it is a much more reliable source
than medical news disseminated by tabloids.

Although health news articles often deliver public health messages effectively,
they often convey wrong or misleading information about health care, partly
when reporters do not know or cannot convey the results of clinical studies,
and partly when they fail to supply reasonable context. This can result in
unrealistic expectations due to coverage of radical medical procedures and
experimental technology. Mass media news outlets can also create a
“communications storm” to shift attention to a single health issue. The lack of
health knowledge in the general public creates a situation where a person can
be easily swayed to a certain point of view that is cast in the manner in which
information is reported. Consequently, this can create a potentially unhealthy
focus on an illness that in actuality is relatively rare.

Health journalism can also influence an individual's quality of health care. Due
to the relative ease at which information can be obtained on the internet,
many people will now question doctors on new medications and treatments
for their conditions. In more extreme cases, people will compare their
symptoms, real or imagined, to various illnesses in attempts to diagnose
themselves. There have been a few recent studies that have tried to explore
the availability of health information as complement to health care or as a
substitute yet no direct relationships have been found. This is most likely
caused by a lack of knowledge or a lack of the ability in the individual to apply
the health information once found resulting in seeking health care.

Healthcare is the world‟s largest industry. It has a deep impact on every

human being of the world. Therefore, it is a natural focus for journalists. In
almost every country health and healthcare are staple issues for media
reporting. Very few journalists covering health and healthcare issues have any
specialist training in what is a potentially complex and wide-ranging area. This
course is aims to fill part of that gap in health and healthcare knowledge.
Health Journalism covers:

 Develop article ideas; write articles and features suitable for a range of
health-related publications.
 Source information, conduct research and carry out effective
interviews.
 Cover various events on health for electronic, digital and print media.
 Apply media law and ethics to the world of health journalism.
1.3 Need and Importance of Health Journalism

There are plenty of opportunities in health journalism to pitch and sell articles
to a range of print, electronic and digital media. As a health journalist, one
could engage in investigating the latest health trends, food supplements and
diet fads for a consumer magazine; reporting on the latest cutting-edge
scientific research and breakthroughs for the health section of a local or
national newspaper; interviewing the world‟s leading health, fitness and
lifestyle experts for a popular health blog; researching, reporting, writing and
editing informative features and articles that help people lead healthier lives
and manage their medical conditions more effectively; you could also work as
a communications advisor for health care organizations. You can also work as
freelance health writers. At times health journalist is also work as a health
communicator.

Creating Awareness about any meaning full aspect of life is a big challenge,
especially in the country like ours where a large part of population are illiterate
and without any access to mass media. And the crux of the problem is that
this population is more in need of awareness.

For the literate people, mass media is the best way to generate awareness.
Television, Internet, Newspapers etc. are very effective and doing a great
service in spreading message to masses. Be it good or bad. There is a need
to use these effective medium wisely and for the people good.

Cable and new radio options such as FM, satellite and Internet radio have
expanded the availability of news for many consumers, and the Internet in
particular has made information more widely and instantly accessible to
journalists and to the public. These new information sources could lead to an
unprecedented breadth and depth of health information for the news
consumer interested in seeking it.
 2. Roles & Responsibilities of a Health
Journalist

2.0 Introduction

Since its independence, India has become a world leader in medical

advancement due to its incredible medical education system and state-of-the-
art private medical facilities. It is now a major health services provider. Quality
healthcare, however, remains inaccessible for many undeveloped Indian
regions. Even when medical treatment is available, public hospitals are
frequently understaffed and undersupplied. The poor are forced to rely on
overburdened, unsanitary facilities as their only source of health care. In
addition lot of challenges are there like illiteracy, lack of awareness, traditional
healthcare practices, lack of modern medical facilities etc. Therefore, major
role and responsibilities are comes over the shoulder of health journalist to
make aware and popularise modern healthcare facilities and practices
amongst the masses especially in rural and backward area. Health journalists
must also work as bridge between government, administration and the public.

2.1 Health Journalism: Role and Responsibilities

Journalism is a form of writing that tells people about things that really
happened, but that they might not have known about already. Journalism is a
method of inquiry and literary style used in social and cultural representation.
It serves the purpose of playing the role of public service machinery in the
dissemination and analysis of news and information.

Journalist is a person who collects and presents information in the form of

news and articles. The journalists basically are the eyes and ears of the
society. The main role of the journalist is to present the information as news to
the readers of newspapers and magazines; audiences and viewers of radio
and television or via the Internet.

Health journalists educate and make aware the public about diseases, issues
and health events and how they affect their lives. They work as a bridge
between health professionals and the public. With the consultation of health
professional, health journalists tell the public about preventive and curative
measures about particular disease or health issue using various forms of
media such as newspaper, magazines, radio, television, internet or through
specialised health campaigns.
They spend much of their time interviewing health expert sources, searching
public health records and other sources related to health information, and
often visiting the area where a particular disease or issues or other
newsworthy occurrence took place. After they've thoroughly researched the
subject, they use what they uncovered to write an article or create a piece for
radio, television or the Internet.

Researching a story is often similar to conducting an investigation, and health

journalists must sometimes ask difficult questions. They may have to invest a
lot of time tracking down information and people relevant to the story.

Health Journalist decides what health issue or disease or event is news, and
of public interest. While doing so, they make many important decisions about
what a society says to itself, how it explains itself, what social order is
established and maintained, and how the problems and shortcomings of that
society are revealed.

5.1.1 Role of Health Journalists

The primary role of the health journalist is to question and uncover truths.

1. Discover and publish health related information that replaces myths,

rumour and speculation.

2. Resist or evade government control

3. Inform and so empower public

4. Undermine those whose authority relies on a lack of public information

5. Scrutinize the action and inaction of governments, concerned bodies and

public services.

6. Scrutinize businesses, their treatment of workers and patients and the

quality of services.

7. Comfort the afflicted and afflict the comfortable, providing a voice for those
who can‟t normally be heard in public.

8. Hold up a mirror to society reflecting its virtues and voices and also
debunking its cherished myths.

9. Ensure that justice is done, is seen to be done and investigations are

carried out where this is not so

10. Promote the free exchange of ideas especially by providing a platform for
those with philosophies alternative to prevailing one.
Broadly health journalists do the following jobs:

1. Health reporters gather information and present it in a written or spoken

form in news stories, feature articles or documentaries. Reporters may
work on the staff of news organisations, but may also work freelance,
writing stories for whoever pays them.

2. Sub-editors take the stories written by reporters and put them into a form
which suits the special needs of their particular newspaper, magazine,
bulletin or web page. They concentrate on how the story can best be
presented to their audience.

3. Photojournalists use photographs to tell the health news. They either cover
events with a reporter, taking photographs to illustrate the written story, or
attend news events on their own, presenting both the pictures and a story
or caption.

4. The editor makes the final decision about what is included in the
newspaper, magazine or news bulletins. They are responsible for all the
content and all the journalists.

5. Feature writers work for newspapers and magazines, writing longer stories
which usually give background to the news. In small organisations the
reporters themselves will write feature articles. The person in charge of
features is usually called the features editor.

6. Specialist writers may be employed to produce personal commentary

columns or reviews on specific things.

5.1.2 Responsibilities of Health Journalists

To play their role, the journalist must be committed to the society; they must
use the power of the pen for the well being of the society. More important than
social and moral issues, a journalist has to do a job. This involves many
responsibilities such as:

1. Responsibility towards the News Organization: A journalist has to confirm

to the character, style and policy of the newspaper or magazine or news
agency he is working for. But in a news organization with more dynamic
approach to news, you must develop the skills of an investigator.
Journalists also have the responsibility of maintaining the economic health
of their news organizations. Because these organizations are not
government sponsored or supported (except in rare instances), they must
make enough profit to continue operation and to have the resources to
practice the kind of journalism that is expected and necessary for society.
 2. Responsibility towards the Sources: Credibility with sources is a matter of
vital importance to a journalist‟s career. The responsibility of protecting the
sources need not be considered absolute.

3. Responsibility towards Legal: They should know their rights and the rights
of each individual, and they should be sure they are compliant with legal
issues. This will ensure there is no intrusion on matters of confidentiality
and privacy. Libelous and slanderous remarks can result in legal action
against journalists.

4. Responsibility towards the Readers and Society: “Good faith with the
reader is the foundation of all good journalism worthy of the name”, says
the code of ethics of the American Society of Newspapers Editors. It is the
responsibility of a journalist to make sure the information is presented in a
fair, balanced and truthful manner. Relating current events helps keep the
general public informed and provides it with entertainment. It is a
journalist's duty not to sensationalize any media event for their own
benefit.

5. Responsibility towards the Profession: A journalist has a professional

responsibility to present an accurate portrayal of events as they occur.
This usually is accomplished through excellent and thorough research. A
professional journalist will present only the facts, leaving out her own
opinions. They must maintain the standards of their profession as well as
the customs and conventions of the journalistic culture. These conventions
include gathering news and information, editing it for their medium, and
distributing it in ways that meet standards of fairness and accuracy.

6. Responsibility towards Ethics: Journalists are bound to a code of ethics.

An ethical journalist will provide the audience with meaningful information,
but they also must know when information is too sensitive to be reported.

Finally, journalists are charged with fostering and promoting the idea of an
open society in which information flows freely, people can think and speak
creatively and a variety of points of view about all topics is tolerated.

2.2 Qualities of Journalists

A journalist must possess certain basic qualities to be a successful

professional. Integrity of character, commitment to the truth and the reasoning
power are quintessential to building credibility. A good perception and
interpersonal skills to elicit news would stand him in good stead in reporting.

He should cultivate contacts in and out of his beat to get information. A perfect
talker, he should be able to handle difficult people and difficult situations. A
competent journalist anticipates news rather than be taken by surprise. This
ability is of great importance to face situations that arise suddenly. Good
journalists need to cultivate following special qualities and skills:

1. Nose for News: A journalist‟s primary job is discovering the new. The
ability to find news is called nose for news. But quite often, most of the
material before a news reporter may just be publicity matter or
advertisements in disguise.

2. An interest in life: They must be interested in the world around and must
want to find things out and share discoveries with readers or listeners.
They must have a wide range of knowledge to build upon and are always
prepared to learn something new.

3. Love of language: They must understand the meaning and flow of words
and take delight in using them. The difference between an ordinary news
story and a great one is the way in which the story tells those facts.

4. An alert and ordered mind: People trust journalists with facts, either the
ones they give or the ones they receive. They must not be careless with
them. With plenty of experience and practice, they should develop a
special awareness of what makes news. It is also the ability to sort through
a mass of facts and opinions, recognising which are most important or
interesting to your audience.

5. A suspicious mind: At times people will give information for all sorts of
reasons, some justified, others not. Journalist must develop the ability to
recognise when they are being given false information.

6. Determination: It is the ability to go out, find a story and hang on to it until

you are satisfied. Be like a dog with a bone - do not let go until you have
got all the meat off, even if people try to pull it out of your mouth.

7. Developing Contacts: A friendly and affable nature helps develop sources

that could provide precious information, clues, or other material for the
reporter in search of a story. The ability to win the confidence and respect
of the potential sources is an asset of the newsman.

8. Reliability & Timeliness: In journalistic field it is especially valued where

both your employer and your audience rely on you to do your job. If you
are sent on an interview but fail to turn up or late for an appointment, you
offend a number of people: the person who is waiting to be interviewed;
your editor who is waiting to put the interview in his paper or program; your
readers, listeners or viewers, who are robbed of news.
9. Objectivity and Fairness: The reporter must be a sharp observer of events,
presenting the facts in a balanced and objective manner. Write the news
story properly to assure the reader that what he reads is news not the
reporter‟s opinion or some publicity matter in disguise.

10. Clarity of Expression: Clarity of thinking leads to clarity in writing and

however complex and specialized the subject; the reporter should have
the gift for simplification, reducing it to the layman‟s parlance. Explain
difficult terminology and simplify government press notes, notorious for
burying the new points.

11. Team Spirit: News-breaking stories of dramatic dimension, sometimes, call

for a team of reporters to handle them. Working in a team involves pooling
your talents, sources and contacts to achieve synergy.

12. Awareness about the subject: Health reporting is driven by a curiosity and
governed by a scientific temper. The first step to becoming a health
reporter is to develop well-grounded awareness of medical science by
reading good popular medical science books and journals. Keep watching
popular science programmes on foreign and Indian television channels.

13. Know Facts: Half-truths, bluffs and blisters are not part of health reporting,
which is based on verifiable technological facts. Verify facts from other
sources, reference books and journals before reporting. Credibility and
clarity are the catchwords in health reporting.

14. Glossary of Terms and Phrases: Specialists speak in technical language

popularly called jargons. Novices to the field of health reporting are
advised to prepare a glossary of technical terms and their equivalent in
common man‟s parlance so that the story could be better explained.

15. Befriend the leading health professionals and ask them about the latest
developments in their fields - inventions, applications and research. Attend
seminars and conferences regularly and write interpretative reports for the
knowledge-hungry readers.

16. Publishing interviews of eminent health professionals not enhances the

prestige of your newspaper/magazine but promotes health awareness in
the society.
 3. Sources of Health Reporting:
NFHS Reports, UNICEF Reports, WHO, Census
3.0 Introduction

News at a basic level is information presented in a particular way so as to arouse

the curiosity of readers. So the first task of health reporters is to collect
information. There are three ways of collecting information. These are
observation, interviewing, and referring to relevant documents.

Here it is important to mention that good news usually has a human touch. And
perhaps a very good way of attaining this human touch is through human beings.
So reporters interview people who are involved with an issue or event directly or
indirectly. These involved people are the primary sources. Sometimes, the places
where events and issues take place are also primary sources. Then there are
documents. From old newspapers, journals, books, official documents, Internet
sites; all these form important sources of information. These are called
secondary sources.

3.1 Concept of News Sources

News is happening all the time, every minute of everyday something newsworthy
is happening somewhere in the world. Even if you are a journalist working in a
small or remote area or a country, something newsworthy is probably happening
in your area or country at this moment. Your job as a journalist is to get
information on those events and present it to your readers or listeners. But you
cannot be everywhere all the time to see those events for yourself. So you need
other ways of getting information on all those hundreds (maybe millions) of
events you cannot witness yourself. When someone or something provides you
with information, we call them a source. The people or documents you use when
reporting a story are called your “sources.”

News reporters gather information in three ways:

 by interviewing people,
 by researching the written record and
 by observation.

The more ways you gather information, and the more information you gather, the
better your story will be. You will move closer to the "actual reality" of the event.
Remember your goal is to use any legal and ethical means to learn what's really
going on.

Sources of information can be people, letters, books, files, films, tapes in fact,
anything which journalists use to put news stories together. Sources are very
important if you want to report on events or issues and explain the world to your
audience. Journalists try to work as much as possible from their own
observations, but this is often not possible. In journalism, a source is a person,
publication or other record or document that gives information.

Examples of sources include: official records, publications or broadcasts, officials

in government, non government organizations, witnesses of issue/disease, and
most importantly affected people.

Most sources are not confidential. In many countries, most news organizations
have policies governing the use of anonymous sources. Critics sometimes cite
instances of news organizations breaking these policies. Research indicates that
anonymous sourcing undermines credibility; however, in some instances,
journalists may have no other recourse. When a source requests anonymity, they
are referred to as a "confidential source".

Communications between a source and a journalist can be governed by a

number of terms of use. These have developed over time between journalists
and their sources, often government or other high-profile sources, as informal
agreements. These agreements are regarding how the information will be used,
and whether the identity of the source will be protected. These terms may apply
to an entire conversation, or only part. Some of the terms are not clearly defined;
so experienced journalists use them with caution.

The phrase on the record is used to refer to making an audio or video recording,
making a transcription, or taking minutes. By analogy, it has also come to be
used by sources to indicate that the information they are giving may be freely
reported, and that they may be fully identified.

Off-the-record material is often valuable and reporters may be eager to use it, so
sources wishing to ensure the confidentiality of certain information are generally
advised to discuss the "terms of use" before actually disclosing the information, if
possible. Some journalists and news organizations have policies against
accepting information "off the record" because they believe it interferes with their
ability to report truthfully, or because they suspect it may be intended to mislead
them or the public.
3.2 Types of News Sources

Primary sources: Often the source is someone at the centre of the event or
issue. We call such people primary sources. It might be a man who affected a
serious communicable disease and lived to tell the experience; or a government
or non-government bodies. They are usually the best sources of information
about their part of what happened. They should be able to give you accurate
details and also supply strong comments. A word of warning here: If any of your
sources, however reliable, gives you information which is defamatory, you can
still be taken to court for using it. You are responsible for deciding whether or not
to publish the defamatory material.

Secondary sources: Secondary sources are those people who do not make the
news, but who pass it on. They are usually written after a lot of research by the
authors; they have been checked for accuracy and are usually published with
official approval. However, just because information is printed, that does not
mean that it is reliable. With typewriters, computers and modern technology, it is
relatively easy to produce printed material. This is especially important with
information on the Internet. Anyone can put information onto the Internet and
unless you know how trustworthy they are you cannot judge the reliability of what
they write.

Leaked documents: You may occasionally be given documents which have not
been officially released to the press. They may be given to you by someone in a
company or government department who does not want to be seen giving them
to the media. We call these leaked documents. Documents are often leaked by
people who believe that the public should know the contents, but who are unable
to reveal it in public themselves. In some cases, documents are leaked by a
person to gain an advantage over someone else, perhaps someone who is
criticised in the report. Leaked documents are often excellent sources of news
stories because they can contain information which someone wants to keep
secret.

3.3 Sources of Information

Various sources of information can be categorised as under:

1. Local Sources: Through newspapers‟ own reporters who gather the

information from meetings, seminars, conferences, incidents, events,
press conferences, public gatherings, confidential sources/personal
contacts, direct from famous/eminent personalities, public, eye-witnesses,
regular beats etc.
 2. National and International Sources: Through the various international and
national wire services, syndicates, feature agencies, news agencies like PTI,
UNI, BHASHA, UNIVARTA, REUTERS, ASSOCIATE PRESS etc.

3. State and Regional Sources: Through local correspondents and stringers

they may be local health workers or others.

4. Various Individuals and Organisations: They directly send their information

to newspapers office through email or other methods.

5. Government and Other Organisations: Hospitals, Government officials/

authorities, Press Information Bureau, and Media/PR departments of various
central and state govt. ministries and departments.

6. Mutual Sharing of information – with other newspaper offices, news

agencies and feature agencies.

7. Libraries, Internet, print material etc. which are already available.

8. Unidentified sources

9. Off the record and on record news

3.4 Sources for health reports

1. Primary Data

a) Health Centers and organisations: Hospitals, dispensaries, clinics, primary

health centers, local administration bodies i.e. Panchayats, Gram
Pradhan, Nagar Palika, Municipality Corporations etc.

b) Health Professional: Doctors, Medical Officers of Govt. Health Centers,

Health workers, NGOs etc.

c) Observations: Affected sites of rural and urban areas

d) Events: Health conferences & seminars, health melas & exhibitions, health
camps etc.

e) Contacts: Public opinions, success stories, affected persons etc.

 2. Secondary Data

a) Reports of various national and international health organisation: Ministry

of Health & Family Welfare, Ministry of AYUSH, Census, UNICEF, WHO,
NFHS (National Family Health Survey), and many other organisations.

b) Health publications: Health Journals and Magazines, new innovations and

research articles, online information etc., press releases on health

c) National and International news agencies, feature agencies and press

releases.

3.5 Key Organisations as a source of information

3.5.1. WHO (The World Health Organisation)

The World Health Organization (WHO) is a specialized agency of the United

Nations that is concerned with international public health. It was established on 7
April 1948, headquartered in Geneva, Switzerland. The WHO is a member of the
United Nations Development Group.

The constitution of the World Health Organization had been signed by 61

countries on 22 July 1946, with the first meeting of the World Health Assembly
finishing on 24 July 1948. It incorporated the Office international d'hygiène
publique and the League of Nations Health Organization. Since its creation, it
has played a leading role in the eradication of smallpox. Its current priorities
include communicable diseases, in particular HIV/AIDS, Ebola, malaria and
tuberculosis; the mitigation of the effects of non-communicable diseases; sexual
and reproductive health, development, and aging; nutrition, food security and
healthy eating; occupational health; substance abuse; and driving the
development of reporting, publications, and networking.

The WHO is responsible for the World Health Report, a leading international
publication on health, the worldwide World Health Survey, and World Health Day.

WHO came into force on 7 April 1948 a date we now celebrate every year as
World Health Day. The goal of WHO is to build a better, healthier future for
people all over the world.

The main areas of work are Health systems, promoting health through the life-
course, non-communicable diseases, communicable diseases, corporate
services, preparedness, surveillance and response.
WHO support countries as they coordinate the efforts of multiple sectors of the
government and partners including bi and multilaterals, funds and foundations,
civil society organizations and private sector to attain their health objectives and
support their national health policies and strategies.

WHO in India

India became a party to the WHO Constitution on 12 January 1948. The first
session of the WHO Regional Committee for South-East Asia was held on 4-5
October 1948 in the office of the Indian Minister of Health. It was inaugurated by
Pandit Jawaharlal Nehru, Prime Minister of India and was addressed by the
WHO Director-General, Dr Brock Chisholm. India is a Member State of the WHO
South East Asia Region. The WHO Country Office for India is headquartered in
Delhi with country-wide presence.

WHO is staffed by health professionals, other experts and support staff working
at headquarters in Geneva, six regional offices and country offices. In carrying
out its activities and fulfilling its objectives, WHO's secretariat focuses its work on
the following six core functions:

1. Providing leadership on matters critical to health and engaging in partnerships

where joint action is needed;
2. Shaping the research agenda and stimulating the generation, translation and
dissemination of valuable knowledge;
3. Setting norms and standards and promoting and monitoring their
implementation;
4. Articulating ethical and evidence-based policy options;
5. Providing technical support, catalysing change, and building sustainable
institutional capacity; and
6. Monitoring the health situation and assessing health trends.

3.5.2. UNICEF (The United Nations Children’s Fund)

The United Nations Children's Fund (UNICEF) is a United Nations (UN) program
headquartered in New York City that provides humanitarian and developmental
assistance to children and mothers in developing countries. It is one of the
members of the United Nations Development Group and its executive committee.

UNICEF was created by the United Nations General Assembly on 11 December

1946, to provide emergency food and healthcare to children in countries that had
been devastated by World War II. The Polish physician Ludwik Rajchman is
widely regarded as the founder of UNICEF and served as its first chairman from
1946.

In 1953, UNICEF's mandate was extended to address the needs of children in

the developing world and became a permanent part of the United Nations
System. Originally it was named as United Nations International Children‟s
Emergency Fund. But in 1953 the words "international" and "emergency" were
dropped from the organization's name, making it simply the United Nations
Children's Fund, or popularly known as "UNICEF".

UNICEF relies on contributions from governments and private donors.

Governments contribute two-thirds of the organization's resources. Private
groups and some six million individuals contribute the rest through national
committees. It is estimated that 92 per cent of UNICEF revenue is distributed to
program services. UNICEF's programs emphasize developing community level
services to promote the health and well-being of children. UNICEF was awarded
the Nobel Peace Prize in 1965 and the Prince of Asturias Award of Concord in
2006.

Most of UNICEF's work is in the field, with staff in over 190 countries and
territories. More than 200 country offices carry out UNICEF's mission through
programs developed with host governments. Seven regional offices provide
technical assistance to country offices as needed.

UNICEF's Supply Division is based in Copenhagen and serves as the primary

point of distribution for such essential items as vaccines, antiretroviral medicines
for children and mothers with HIV, nutritional supplements, emergency shelters,
family reunification and educational supplies. A 36 member executive board
establishes policies, approves programs and oversees administrative and
financial plans. The executive board is made up of government representatives
who are elected by the United Nations Economic and Social Council, usually for
three-year terms.

3.5.3. NFHS (The National Family Health Survey)

The National Family Health Survey (NFHS) is a large-scale, multi-round survey

conducted in a representative sample of households throughout India. Three
rounds of the survey have been conducted since the first survey in 1992-93. The
survey provides state and national information for India on fertility, infant and
child mortality, the practice of family planning, maternal and child health,
reproductive health, nutrition, anemia, utilization and quality of health and family
planning services. Each successive round of the NFHS has had two specific
goals: a) to provide essential data on health and family welfare needed by the
Ministry of Health and Family Welfare and other agencies for policy and program
purposes, and b) to provide information on important emerging health and family
welfare issues.

The NFHS is a collaborative project of the International Institute for Population

Sciences (IIPS), Mumbai, India; ORC Macro, Calverton, Maryland, USA and the
East-West Center, Honolulu, Hawaii, USA. The Ministry of Health and Family
Welfare (MOHFW), Government of India, designated IIPS as the nodal agency,
responsible for providing coordination and technical guidance for the NFHS.

NFHS was funded by the United States Agency for International Development
(USAID) with supplementary support from United Nations Children's Fund
(UNICEF). IIPS collaborated with a number of Field Organizations (FO) for
survey implementation. Each FO was responsible for conducting survey activities
in one or more states covered by the NFHS. Technical assistance for the NFHS
was provided by ORC Macro and the East-West Center. The funding for different
rounds of NFHS has been provided by USAID, DFID (Department For
International Development), the Bill and Melinda Gates Foundation, UNICEF,
UNFPA (United Nations Population Fund), and MoHFW, GOI.

The First National Family Health Survey (NFHS-1) was conducted in 1992-93.
The survey collected extensive information on population, health, and nutrition,
with an emphasis on women and young children. Eighteen Population Research
Centres (PRCs), located in universities and institutes of national repute, assisted
IIPS in all stages of conducting NFHS-1. All the state-level and national-level
reports for the survey have already been published (48 reports in all).

The Second National Family Health Survey (NFHS-2) was conducted in 1998-99
in all 26 states of India with added features on the quality of health and family
planning services, domestic violence, reproductive health, anemia, the nutrition
of women, and the status of women. The results of the survey are currently being
published.

The Third National Family Health Survey (NFHS-3) was carried out in 2005-
2006. Eighteen Research Organizations including five Population Research
Centres carried out the survey in 29 states of India. The National AIDS Control
Organization (NACO) and the National AIDS Research Institute (NARI) were
provided technical assistance for the HIV component.

The third report of NFHS emphasizes on household population and housing

characteristics; characteristics of respondents; fertility and fertility preferences;
family planning; other proximate determinants of fertility; infant and child
mortality; maternal health; child health; nutrition and anaemia; HIV/AIDS related
knowledge, attitudes and behaviour; HIV prevalence; morbidity and healthcare;
women‟s empowerment and health outcomes and domestic violence.

3.5.4. Census

A systematic and modern population census, in its present form was conducted
non-synchronously between 1865 and 1872 in different parts of the country. This
effort culminating in 1872 has been popularly labeled as the first population
census of India However, the first synchronous census in India was held in 1881.
Since then, censuses have been undertaken uninterruptedly once every ten year.

The Census of India 2001 was the fourteenth census in the continuous series as
reckoned from1872 and the sixth since independence. The gigantic task of
census taking was completed in two phases. In the first phase, known as House-
listing Operations, all building and structures, residential, partly residential or
non-residential were identified and listed and the uses to which they were put
recorded. Information on houses, household amenities and assets were also
collected. In the second phase, known as Population Enumeration, more detailed
information on each individual residing in the country, Indian national or
otherwise, during the enumeration period was collected. At the Census 2001,
more than 2 million (or 20 lakh) enumerators were deployed to collect the
information by visiting every household. The Indian Census is one of the largest
administrative exercises undertaken in the world.

The 15th Indian Census (2011) was conducted in two phases, house listing and
population enumeration. House listing phase began on 1 April 2010 and involved
collection of information about all buildings. Information for National Population
Register was also collected in the first phase, which will be used to issue a 12-
digit unique identification number to all registered Indian residents by Unique
Identification Authority of India. The second population enumeration phase was
conducted between 9 and 28 February 2011. Census has been conducted in
India since 1872 and 2011 marks the first time biometric information was
collected. According to the provisional reports released on 31 March 2011, the
Indian population increased to 121 crore with a decadal growth of 17.64%. Adult
literacy rate increased to 74.04% with a decadal growth of 9.21%.

The motto of census 2011 was 'Our Census, Our future'. Spread across 28
states and 7 union territories, the census covered 640 districts, 5,767 tehsils,
7,933 towns and more than 6 lakh villages. Information on castes was included in
the census following demands from several leaders.
 4. Role of Media in Public Healthcare Campaign:
Polio, HIV/AIDS, Reproductive Child Health

4.1 Introduction

The primary role of media in public health care campaign is to make aware and
educate the public on a particular health issue through extensive campaign using
newspaper, magazine, poster, brochures, hoardings, bus/ pole panels, radio,
television, personal face to face contact, camps and most popular traditional
mediums like popet shows, nukkad natak etc. It motivates the public to change
their behaviour and adopt new practices towards preventive and curative
measures against the disease.

Polio eradication Campaign was one of the most successful Health

Communication Campaign in India. The WHO in 2012 had announced India as
Polio free Nation. Success of this campaign lies deep rooted in villages where
mass media as well as personnel efforts of vaccinators had contributed towards
its success. Before 2002-2003, Polio cases were reported on large scale in India,
but suddenly decreased after the year 2003 and then finally counted to zero in
2012. Extensive campaign was run by the government of India to make aware
about the HIV/AIDS motivating the public its preventive measures rather than
curative measures. Likewise government also run in-depth campaign related to
mother and child health to control the maternity mortality rate and child mortality
rate and to adopt family planning methods to control the increasing population
rate of India.

4.2 Polio Eradication Campaign

Pulse Polio is an immunisation campaign established by the government of India

to eliminate poliomyelitis (polio) in India by vaccinating all children under the age
of five years against the polio virus. The project fights poliomyelitis through a
large-scale pulse vaccination programme and monitoring for polio cases. The
Pulse Polio dates in 2016 were 17 January and 21 February on Sundays.

History in India, vaccination against polio started in 1978 with Expanded Program
on Immunization (EPI). By 1984, it covered around 40% of infants, giving three
doses of OPV (Oral Polio Vaccination) to each. In 1985, the Universal
Immunisation Program (UIP) was launched to cover all the districts of the
country. UIP became a part of child survival and safe motherhood program
(CSSM) in 1992 and Reproductive and Child Health Program (RCH) in 1997.
This program led to a significant increase in coverage, up to 95%. The number of
reported cases of polio also declined from 28,757 during 1987 to 3,265 in 1995.
In 1995, following the Global Polio Eradication Initiative of the World Health
Organization (1988), India launched Pulse Polio immunisation program with
Universal Immunization Program which aimed at 100% coverage. On 27 March
2014, the World Health Organization (WHO) declared India a polio free country,
since no cases of wild polio had been reported in for three years.

The Pulse Polio Initiative (PPI) aims at covering every individual in the country. It
aspires to reach even children in remote communities through an improved social
mobilisation plan. Not a single child should miss the immunisation, leaving no
chance of polio occurrence.

Publicity was extensive and included replacing the national telecoms' authority
ringtone with a vaccination day awareness message, posters, TV and cinema
spots, parades, rallies, and one-to-one communication from volunteers.
Vaccination booths were set up, with a house-to-house campaign for remote
communities.

The campaign was supported by organisations including the Indian federal and
state governments, international institutions, and non-governmental
organisations. It is part of the Global Polio Eradication Initiative, spearheaded by
Rotary International, the World Health Organization, UNICEF, and the U.S.
Centers for Disease Control and Prevention.

Rational Appeals used in Polio Eradication Campaign. It involves logical

arguments and strong factual evidence to persuade target audience about the
desirable consequences of the recommended adoption. The factors for analyzing
rational appeal based on literature study are:

• Strategic actions to increase coverage to increase awareness

• Logical Reasoning: the logic behind the campaign

• Quality arguments: Arguments backed by logic to influence the mass

• Compelling strategies: To force people to agree to a certain argument

• Conclusive based on premises: Premise is formed for drawing conclusions.

• Claim: To create awareness in a manner that people tend to identify themselves

with the campaign.
Changing strategic actions to increase coverage and to increase awareness:

After 2003, Amitabh Bachcahn was launched as brand ambassador and his ads
were heard everywhere 10 days before the January and February rounds of
Immunization. To increase coverage, the ads were carried on all major national
and regional dailies in 18 languages. Campaign posters, advertisements,
pamphlets mainly focused on effect of polio drops in making child healthy.

Announcement of Polio Ravivaar (one Sunday of every month) was made.

House to house approach was conducted to reach the remotest of population
and reminding of National Immunization Day (NID) by reaching the people to
their houses.

„Transit vaccination‟ strategy was launched, with teams stationed at bus stands,
railway stations, highways, markets and at congregation sites and provided polio
vaccine to eligible children. For targeting higher strata of society, airport baggage
tags which said 'End Polio Now' were popularized. Females were targeted
because they were mainly responsible for taking the child to polio booths.

Families were persuaded through logic, arguments and emotional appeal.

Through interpersonal communication, the volunteers personally persuaded the
family members by giving them quality arguments and reasons for the need to
vaccinate.

An emotional appeal is designed to arouse emotions of audience and use the

emotions as bases for persuasion. Emotional appeal includes fear appeal (fear is
generated among target audience by showing the undesirable consequences of
adopting or non adopting a particular practice or technology), anger appeal (a
person who is well recognized by target audience shows anger for inactivity of
target audience for adopting a particular practice or technology), hope appeal
(hope is generated among target audience by showing them the desirable
consequences which can be achieved after adopting a particular practice or
technology), trust and team spirit (power of team work is shown to evoke the
emotional response of target audience), joy and happiness (happiness which
target audience can achieve after adopting a particular practice or technology, is
shown and positive emotions are aroused).

UNICEF brought Bollywood celebrity Amitabh Bachchan to impose anger appeal

to those parents who have not yet taken their child to polio booth. His
advertisement appeared in four TV spots, with a similar recording for four radio
spots, duplicated into 13 languages. Anger appeal was shown as follows:
Spot 1: “Bring your children to the booth” showed the charismatic father figure
walking up to a nearly empty booth. He asked the audience angrily: “Why have
you stopped coming?

Spot 2: “Why polio keeps coming back” – Amitabh Bachchan looked at a wall
plastered with polio posters, and pointed to the audience disapprovingly. “Polio
keeps coming back because you don‟t vaccinate your children anymore,” and
urged them to not listen to rumours.

Spot 3: “Pulse Polio Immunization is for everyone.” – opened with Amitabh

Bacchan reading a newspaper. He threw it away in disgust and talked to the
camera: “The poliovirus knows no bounds, does not discriminate between caste,
creed and race. It hurts a Hindi child as much as it hurts a Muslim child. No child
should be excluded from polio vaccination; every child in India has the right to be
protected from polio disease.”

Spot 4: “Applauding the people who get their children immunized” – opened with
the tall, bearded Bachchan standing by a booth, facing the camera. “They are
doing the right thing by coming back,” raising his hand to salute the crowd that
was queuing up for polio drops.

Each ad ended with the star raising two fingers with the message: “Pulse Polio
Immunization, two drops for life,” followed by the two dates recorded separately
on sound.

Amitabh Bachchan asking people to go to polio

Source: UNICEF, Working Paper ‘A Critical Leap to Polio Eradication in India’ June 2003

This appeal aroused parents because Amitabh Bachchan had high credibility
among parents of all age. It also increased trustworthiness of the campaign. TV
spots were broadcasted four thousand times to over 80 million homes on
Doordarshan and radio spots were transmitted another thousand times to 54
million homes, including 30 million in rural areas.

Trust and team spirit for building trust, Rotary and UNICEF have engaged a
number of other celebrities, including Preity Zinta, Rani Mukherjee, Jaya
Bachchan, Hema Malini, Aishwarya Rai, Shah Rukh Khan, Amir Khan, Soha Ali
Khan. Popular national and regional celebrities such as Farooq Sheikh and an
actor/singer from Bihar – Manoj Tiwari – visited and interacted with communities
in the toughest refusal areas to garner support for the vaccination programme.

For generating team spirit Thomson Social launched a puppet show, which was
shown at village haats, market places, panchayat grounds, seminars and other
public meetings. The puppet show was created around the conversation of four
people: Jumman (Muslim), Balwanta (Sikh), Ramprasad (Hindu) and Dr. Saab (a
medical practitioner). Humour was woven into three segments of a continuous
dialogue between the four, which served to educate and entertain on: 1. Why
repeated doses even though everyone was tired of OPV; 2. The “science of
eradication”, which was akin to spraying insecticide on the entire potato field; 3.
OPV would not cause sterility or make children grow a tail, the virus was
spreading as fast as rumours, and it would indiscriminately attack children of any
caste or creed, of any socio-economic status.

Thomson special puppet show poster for generating team spirit

Source: UNICEF, Working Paper ‘A Critical Leap to Polio Eradication in India’ June 2003

As the campaign gradually moved towards success, various posters, ads and
pamphlets were launched which showed that happiness and joy of those parents
who gave polio drops to their child. This institutionalized the campaign in minds
of people, and parents accepted the arguments that polio drops are „two drops of
life‟.

Promotion of Polio eradication campaign through buses

Source: Polio Booklet 2012, World Health Organization

Amitabh Bachchan Posters with Polio Campaign tag line ‘Do boond Jindagi Ki’

Source: Polio Booklet 2012, World Health Organization

 Source:http://communicationandhealth.ro/upload/number5/GIRIJESH-MAHRA.pdf

4.3 HIV/AIDS

Acquired Immune Deficiency Syndrome or acquired immunodeficiency syndrome

(AIDS) is a disease caused by a virus called human immune deficiency or human
immunodeficiency virus (HIV). The disease alters human immune system,
making people much more vulnerable to infections and disease. Major signs of
this disease are weight loss more than or equal to 10% of the body weight;
chronic diarrhea that lasts for more than a week, prolonged fever for more than
one month (intermittent or constant); persistent cough; chronic progressive or
disseminated herpes simplex infection; generalised lymphadenopathy (enlarged
lymph nodes) for more than one month generalised pruritic dermatitis.

India reported its first case of HIV among the commercial sex workers in 1986.
From 3-5 million infected cases in India the government‟s efforts have led to a
declining trend in recent years.
Strategies adopted for control of HIV/AIDS

National AIDS Control Programme (NACP)

The overall goals of NACP-III is to halt and reverse the epidemic in India by
integrating programmes for prevention, care, support and treatment. This will be
achieved through a four-pronged strategy:

 Prevention of new infections in high risk groups and general population

through - Saturation of coverage of high risk groups with targeted
interventions (TIs); Scaled up interventions in the general population
 Providing greater care, support and treatment to larger number of People
Living with HIV/AIDS (PLHA);
 Strengthening the infrastructure, systems and human resources in
prevention, care, support and treatment programmes at the district, state
and national level; and
 Strengthening the nationwide Strategic Information Management System.
 Surveillance and clinical management
 Control of STIs
 Ensuring blood safety
 Prevent new infection
 Care support and treatment
 Public awareness and community support
 IEC and social mobilization

Initiatives taken by the Government of India

Soon after the first cases emerged in 1986, the Government of India established
the National AIDS Committee within the Ministry of Health and Family Welfare.
This formed the basis for the current apex Government of India body for HIV
surveillance, the National AIDS Control Organisation (NACO).

In 1992, the Government of India demonstrated its commitment to combat the

disease with the launch of the first National AIDS Control Programme (NACP-I).
The programme, implemented during 1992-1999 with an IDA Credit of $84
million, had the objective to slow down the spread of HIV infections so as to
reduce morbidity, mortality and impact of AIDS in the country. To strengthen the
management capacity, a National AIDS Control Board (NACB) was constituted
and National AIDS Control Organisation (NACO) was set up for project
implementation.
The Phase II of the National AIDS Control Programme was launched in 1999. It
was a 100% centrally sponsored scheme implemented in 32 States/UTs and 3
Municipal Corporations namely Ahmedabad, Chennai and Mumbai through AIDS
Control Societies.

The government designed and implemented NACP III (2007-2012) with an

objective to "halt and reverse the HIV epidemic in India". All these efforts helped
in a steady decline in overall prevalence and decrease in new infections over last
ten years.

Aiming for „AIDS Free India‟ the strategy and plan for National AIDS Control
Programme Phase-IV (NACP-IV) has been developed through an elaborate
multi-stakeholder consultative planning process for the period 2012-2017. NACP-
IV aims to accelerate the process of reversal and to further strengthen the
epidemic response in India through a cautious and well defined integration
process over the five years. Its main objectives are to reduce new infections and
provide comprehensive care and treatment services for all those who require it.

The main strategies include intensifying and consolidating prevention services,

increasing access and promoting comprehensive care, support and treatment,
expanding IEC services, building capacities at national, State, district and facility
levels and strengthening Strategic Information Management Systems.

HIV infection is entirely preventable through awareness raising campaigns.

Therefore, awareness raising campaigns about its occurrence and spread is very
significant in protecting the people from the epidemic. It is for this reason that the
National AIDS Control Programme lays maximum emphasis on the widespread
reach of information, education and communication on HIV/AIDS prevention.
Changing knowledge, attitudes and behavior as a prevention strategy of
HIV/AIDS thus is a key thrust area of the National AIDS Control Programme.

NACO has been conducting regular thematic Mass Media campaigns on TV and
Radio to cover issues of condom promotion, ICTC/PPTCT, STI treatment and
services, stigma and discrimination, vulnerability of youth to HIV, ART, HIV-TB
and blood safety.

The AIDS Bhedbhav Virodhi Andolan (AIDS Anti-Discrimination Movement) had

prepared many citizens reports challenging discriminatory policies, and filed a
petition in the Delhi High Court regarding the proposed segregation of gay men in
prisons. A play titled 'High Fidelity Transmission' has focused on discrimination
the importance of the condom as compared with abstinence and illegal testing of
vaccines.
Role of the media in HIV/AIDS Prevention and Management

The primary aim of mass education on HIV/AIDS is to reach those whose HIV
status is negative to encourage them to retain this status; to support those whose
status is positive to urge them to be careful so as not to spread the virus and to
maintain hope through positive living; and generally to educate society as a
whole to develop sustainable structures that will contribute to the preventive and
effective management of HIV/AIDS.

In communication, the focus has been on identifying methods of communicating

messages on HIV/AIDS that will motivate individuals to change their attitudes
and behaviour. Ways in which the media can support educational efforts on
HIV/AIDS prevention present a vital question in these educational efforts.

The media have been viewed as being influential in building awareness across
different sectors of society on HIV/AIDS and the importance of being careful in
sexual behaviour and practices. While the media have been termed as having
limited effects in attitude and behaviour change, there are experiences which
have shown that their contribution can be invaluable and indeed highly powerful
in determining behaviour change.

The strength of the media has been viewed as that of agenda setting, meaning
that the sustenance of a topic for long in the public forum will lead to extensive
and hopefully intensive discussions that spur some action on a given topic.
Besides the traditional role of the media, other functions are also be categorized
as providing accurate, factual information on HIV/AIDS on a regular basis.

The media can assist by consistently referring to the transmission patterns of

HIV/AIDS and the importance of going for testing and proper care of those who
are infected with the virus.

Since the discovery of the disease, most governments have attempted to put in
place programmes that will contribute to its prevention and effective
management. These programmes have been established under the auspices of
national AIDS and STD‟s control bodies and there has been tremendous work
aimed at improving the capacities of hospitals and clinics in testing for the virus
and in intensifying and developing better educational projects. The media
promotes these efforts by frequently following up on cases of HIV/AIDS and on
the experiences that individuals and communities have had in the programmes.

The desperation on the part of HIV/AIDS patient in seeking treatment for their
infection has given rise to a sharp increase in “medical experts” who claim to
have a cure for the disease. The media brings out into the public arena for public
debate such issues. For instance, it would be interesting to investigate whether
pharmaceutical companies, which import combination therapy treatment, can be
exempt from taxation by governments to make them cheaper for the public.

Example on AIDS campaign

Case Study: Balbir Pasha campaign

An innovative communication campaign to reducing HIV/AIDS prevalence

through targeted mass media communications in Mumbai, India.(Hybels &
Weaver, 1998)

This report experiences a communication campaign executed by Population

Services International (PSI) in Mumbai, India between November 2002 and
February 2003 as part of an integrated behaviour change and HIV/AIDS
prevention programme called „Operation Lighthouse‟. The campaign was based
on consumer research analysis that suggested that the daunting HIV infection
rate, coupled with a flawed risk perception, was widely prevalent, especially
among the poorest section of society in Mumbai.

The bedrock of the campaign was the principle that people can learn by
observing the behaviour of others. The campaign was a mixture of strategically
placed outdoor communications, hard-hitting television and radio messaging, and
comprehensive newspaper exposure. A fictional character named Balbir Pasha
was portrayed in various scenarios, serving as a behavioural model for the
consumers of Mumbai mass media to relate to, learn from, and empathise with.
By gradually unravelling each of the Balbir Pasha‟s scenarios in an approachable
and familiar manner, the campaign succeeded in building interest, personalising
the risk of HIV, and in bringing the topic of HIV/AIDS into the public sphere.

The indicators of success for the Balbir Pasha campaign included:

• An increased perception of risk among those exposed to the campaign

• An increased tendency to discuss HIV/AIDS with others
• An increase in the number of people accessing products and services meant for
HIV/AIDS prevention
The elements of the campaign that contributed to its success included:
• It was based on an in-depth study of the target consumer
• It built up an interest through an escalating teaser campaign
• A variety of communication media were utilised
• Each phase of the campaign was linked with on-the-ground activities
• The infiltration of Balbir Pasha into street-talk, independent art projects, other
advertising campaigns, and so on, provided a „hook‟ for the target consumer to
relate to and personalise with the risk of HIV. Although criticised by some for their
relative frankness, PSI managed to deliver messages on HIV/AIDS in a way that
spoke directly to the target consumer.
A few behaviour change media material used by the media campaign are:

TV Ad 1 TV Ad 2

https://www.youtube.com/watch?v=N41pGKlQZtU https://www.youtube.com/watch?v=d8mthqXNh7E
Balbir Pasha Ad Campaign - Bar Condom Film HIV/AIDS: NACO Prevention Music Video

TV Ad 3 TV Ad 4

https://www.youtube.com/watch?v=anft5mGkihU https://www.youtube.com/watch?v=dVMw0VR91R4
TeachAIDS (Hindi) HIV Prevention Tutorial NACO Promoting HIV testing among pregnant women
 A Brochure

Source: Google Image

A Hoarding

Source: Google Image

 A Poster

Source: Google Image

4.4 Reproductive and Child Health (RCH) Programme

The RCH programme incorporated the earlier National Family Welfare

Programme and Child Survival and Safe Motherhood Programme (CSSM) and
added two more components – one relating to sexually transmitted diseases and
the other to reproductive tract infections. The programme was formally launched
on 15 October, 1997.

The first phase of the programme was started with following aims:

 To bring down the birth rate below 21 per 1,000 population

 To reduce the infant mortality rate below 60 per 1,000 live births
 To bring down the maternal mortality ratio <400/1,00,000 live births.
 80% institutional delivery, 100% antenatal care and 100% immunization of
children were other targeted aims of the RCH programme.

In RCH-I, one of the interventions was IEC activity on sexuality, gender and
counseling on contraceptives. In RCH II there was further improvement in
approaches to provide reproductive health.

The 5-year RCH phase II was launched with a vision to bring about outcomes as
envisioned in the Millennium Development Goals, National Population Policy
2000 (NPP 2000), 10th Five-Year Plan and the National Health Policy 2002. It
envisioned minimizing the regional variations in the areas of RCH and population
stabilization through an integrated, focused, participatory programme. RCH
Phase II intended to meet the unmet needs of the target population by providing
assured, equitable, responsive quality services.

Reproductive health approach

This approach takes the vision that people have the ability to reproduce and
regulate their fertility, women are able to go through pregnancy and childbirth
safely, the outcome of pregnancies is successful in terms of maternal and infant
survival and well-being and couples are able to have sexual relations free of fear
of pregnancy and contracting diseases.

The focus is on rights of men and women to be informed of and to have access
to safe, effective, affordable and acceptable methods of fertility regulation of their
choice. This approach also focuses on the right to access appropriate healthcare
services that will enable women to go safely through pregnancy and childbirth
and provide couples with the best chance of having a healthy infant. (“National
Rural Health Mission,” 2010)

Components of RCH

Health communication is required to deliver all the following components of RCH:

1. Population stabilisation: It is done by providing a choice of contraceptives to

all eligible couples, social marketing and training of health workers in
providing family planning services. It has strong need of health
communication so that the couple is empowered to take their own decision for
fertility and reproductive health.
2. Maternal health: Provision of essential and emergency obstetric care
services.
3. RTI/STI control programme: Identifying patients with Reproductive Tract
Infection and Sexual Tract Infection and their referral, strengthen services for
diagnosis and treatment at PHCs, CHCs and FRUs. It also aims at promoting
syndromic approach to treat RTI/STIs.
4. Newborn and child health: It will be implemented through IMNCI, IMNCI plus
strategy, Baby-friendly hospital initiative and Navjaat Shishu Suraksha
Karyakram (NSSK). It also includes diarrheal control and oral rehydration
salts (ORS) programme, treatment of acute respiratory infections (ARI) and
promotion of breastfeeding.
5. Prevention and control of anaemia: Focus on treatment of anaemia which is
highly prevalent in India.
6. Prevention and control of vitamin A deficiency: A total of 9 doses of vitamin A
to be given to children to prevent deficiency of vitamin A and its consequent
complications.
7. Universal immunisation programme: Regular quality immunisation services,
surveillance of vaccine preventable diseases and training of staff.
8. Cold chain system: To protect vaccines against high temperatures and
maintaining quality of cold chain system.
9. Pulse polio programme: Timely and complete reporting of acute flaccid
paralysis, conducting routine immunisation sessions and national
immunisation days.
10. Adolescent health: Through implementation of Adolescent Reproductive &
Sexual Health (ARSH) strategy. There is also a sanitary napkin programme to
promote menstrual hygiene.
11. Urban health: To provide integrated and sustainable primary healthcare
service with emphasis on family planning and child health services in urban
areas.
12. Tribal health: It will be promoted through providing basic health services in
tribal areas, promoting community participation and human resource
development and public-private partnership.
13. Mainstreaming gender and equity in RCH-II: Training of service providers,
sensitization about status and needs of women.
14. Inter-sectoral and donor convergence: Inter-sectoral coordination between
various departments like education, women and child, rural development,
labour, railways, agriculture, etc to achieve holistic health.
15. Behaviour change communication (BCC): Priority was given to Empowered
Action group (EAG) states to create awareness about prevention of diseases
and promotion of reproductive and child health.
16. Community participation: To promote participation of community members
directly in decision-making about development activities.
17. Public-private mix: Social marketing to be promoted and contracting out
approaches to be developed and promoted.
18. Procurement and logistics: Address supply management arrangements at
state, national and district levels.
19. Monitoring, evaluation and health management information system: For
collection, storage, analysis of data for monitoring of services at all levels.

Programme implementation

The programme was implemented through network of Sub-centres (SC), Primary

Health Centres (PHC), Community Health Centres (CHC) and District hospitals.
First Referral Units (FRUs) present at sub-district level provide comprehensive
healthcare.

 Improved facilities for obstetric care, medical termination of pregnancy

(MTP) and intrauterine contraceptive device (IUCD) insertion in PHCs and
IUCD insertion at the sub centre level were stressed upon.
 Emphasis was laid on involvement of NGOs, Panchayati Raj members
and functionaries from other development organisations as well as Indian
system of medicine and homoeopathy (ISM&H) and private practitioners.
 RCH programme is implemented using differential approach based on
needs and requirement of different districts.

IEC activities under Reproductive Child Health

Although IEC activities have been a part of India‟s Family Welfare programme for
several decades, under the RCH programme IEC underwent a paradigm shift.
There is now focused approach for behaviour change communication (BCC)
rather than creation of awareness only. Following steps has been taken for
effective health communication:

 Under the RCH programme, planning for IEC goes hand in hand with
decentralized planning approach.

 Combination and mix of media is used for addressing the different target
audience at different levels.

 IEC activities to be planned at the primary health centre level after

identifying service and communication needs in the area.

 Locally available communication channels to be identified and utilized.

 Interpersonal counseling skills of health workers are strengthened so that

they are able to effectively motivate clients to avail of services.
A few behaviour change media material used by the media campaign are:

TV Ad 1

MHS- Freedays: Sanitary Napkins: Phase 1

Source: http://nrhm.gov.in/mediamenu/video-gallery.html

TV Ad 2

MHS- Freedays: Sanitary Napkins: Phase 2

Source: http://nrhm.gov.in/mediamenu/video-gallery.html
Poster 1 Poster 2

Source: http://nrhm.gov.in/mediamenu/iec-material/iec-print-media.html