1996_4_harnessing the media

Sexual Health Exchange, 1996 - no. 4

PROGRAMME FEATURE
Harnessing the media to promote health

Michelle Galloway

Mass media are a powerful communication tool that, if used to distribute positive, health-enhancing messages, can have a far-reaching impact. In late 1994, under the auspices of the Institute for Urban Primary Health Care in South Africa, a multimedia package took health promotion messages to South Africans throughout the country. As approximately 92% of South Africans have access to radio, 76% to television and 55% to newspapers, the country was ideally suited to benefit from the use of the media as a tool for health promotion and development.

964Soulcity Ad for Soul City - on the back of a bus

The strategy for developing the multi-dimensional project, called Soul City, involved forming partnerships with media owners, newspapers, radios and the national television service. The aim was to get the health promotion materials to the widest possible audience. As newspapers benefit from TV and radio advertising, they were prepared to carry materials for free and give editorial coverage. The radio service was given a script and produced plays for a minimal charge.

Formative research and pre-testing

Due to apartheid, there are sharp class divisions in South Africa along race lines. The project identified the previously disadvantaged black South Africans - especially young women in lower income groups - who had had poor access to the country's resources, includin

Reaction from a Soul City audience member

"I have a daughter who is 12 years old and she was the one who started listening to the story before I knew about it. She said, 'Mama, I feel sorry for Kenilwe', and I asked her who is Kenilwe?' 'She is a girl who is afraid of her father because he is doing silly things to her.' That is when we all started listening.

Then I said to my daughter, 'Kenilwe is supposed to tell her mother about her father and this also teaches you to tell me if anyone does any silly things to you, and if anyone calls you and shows you money, you must run away, don't get near him.'

This is how I discussed this story with my daughter...her father also told her that if somebody does silly things to her she must come and tell him. I realized that her father was also concerned. He was not shy...I trusted him because he was open to his daughter."

g information and education, as the primary target audience. One important aspect of this decision was the choice of language in which the materials were produced.

International and local research had identified lack of consultation with stakeholders and target audiences as the key reasons for the failure of many mass media interventions. A year-long consultative research process was therefore undertaken to ensure that the material for Soul City was of the highest standard and designed appropriately. With this in mind, an advisory group with skills in media research, health promotion and adult education was established. Literature reviews, audience research, local and international consultation and 50 focus groups, composed of target group members, were conducted to define needs and ascertain levels of knowledge, attitudes and practices as well as points of resistance.

Before scriptwriting progressed, focus groups and target communities previewed pilots of the first episode. Health advisors, educators, dramatists and scriptwriters were interviewed in depth. This information was then fed back into the scriptwriting process; synopses for each episode were reviewed by the advisory group and developed into scripts. The scripts had to be true to life and yet contain enough dramatic elements to keep the viewers' attention, especially as Soul City would compete with other popular drama series. The TV and radio scripts were pre-tested with residents of a large township in Johannesburg and in a rural area with the country's highest rate of HIV infection.

Multi-dimensional media package

The cooperation of the various media resulted in the following:

Television: a weekly half-hour drama series aired during prime time. The series used the soap format to produce "edutainment", entertainment with an empowering health promotion message.

Radio: a 15-minute daily serial aired in Zulu, Xhosa and Sotho on South Africa's three largest radio stations.

Newspapers: a 36-page, full-colour booklet was serialized in the major newspapers over three months; 600,000 booklets were distributed in the newspapers. Additional copies were distributed by clinics and at petrol stations countrywide.

PR and advertising campaign: the glue that held everything together was the public relations and advertising strategy that included editorials, competitions, and a range of actuality programmes to popularize the series and to use the actors as advocates, placing health issues on the public agenda.

Education package: Soul City was combined into an education package using audio, video and written materials for formal and informal educational settings.

Soul City concentrated on eight priority maternal and child health topics: safe motherhood, breastfeeding, infant nutrition, diarrhoea, respiratory disease, child abuse and accidents (paraffin poisoning, burns, motor vehicle accidents). Other sub-themes integrated into the stories included female and community empowerment, stigma, social issues such as co-parenting, community action, nation building, communication about sexuality and HIV/AIDS awareness.

Funding

Instead of appealing to media owners' sense of social responsibility, Soul City planned to become a commercially attractive venture. In its initial phase, however, it received contributions from both commercial and international donors. The producers hope that the series will attract more commercial funding in the future and will come to rely less heavily on donors.

Evaluation

The Community Agency for Social Enquiry (CASE) conducted an in-depth evaluation of Soul City I. Due to limited resources the evaluation focused entirely on the identified target group and not the whole South African population.

Pearl Connie

Pearl Gongxeka and Connie Masilo, two popular actresses who appear in Soul City

The evaluation showed that Soul City was particularly successful in reaching its target audience. The campaign reached an estimated 8.1 million people, 46.8% of black South Africans over the age of 15. Of these 58% were female, 67% were below the age of 35 years, and 45% earned less than 1000 Rand per month (below the South African breadline). Thirty-one per cent of rural and 71% of informal settlement dwellers in the sample had accessed one or more of the materials. The dramas competed favourably with established popular dramas and the evaluation showed a significant increase in knowledge among viewers and listeners compared to those who had not been exposed to Soul City.

Given the successful results of Soul City I, the producers launched Soul City II in July 1996. Its main themes are HIV/AIDS and sexuality, TB, smoking, housing and land. Soul City III is scheduled to be launched in mid-1997. Evaluation of Soul City I resulted in changing some of the characters and a Search for a Star competition. There was also an undertaking to ensure that the health messages come from the most appropriate people. The biggest change was to include a youth component because of the huge youth audience.

The initial evaluation was so positive that Soul City has now been scheduled for broadcasting in Botswana, Kenya, Namibia, Zambia and Zimbabwe in the belief it has the potential to be a valuable resource for the entire sub-continent.

Michelle Galloway, Managing Editor, AIDS Bulletin, Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa; tel: 27-21-938-0911; fax: 27-21-938-0200; e-mail: mgallow@eagle.mrc.ac.za.

Note: This article is based on discussions and input from Shereen Usdin, Sue Goldstein and Garth Japhet of Soul City.