Dr. Ravia Gupta
Mistrust in medical system is on the rise and this became evident due to COVID. Reports suggest that due to poor health literacy in India it will be difficult to achieve even half of the set targets towards Sustainable Development Goal 3 – Good Health and Well-being for all.
According to Amartya Sen, social facilities should provide opportunities to increase the well-being of people. Sen’s idea of ‘Development As Freedom’, suggests that human development is possible by expanding the capabilities of people and by giving them access and opportunities to the things they can value.
In a study conducted to observe health literacy score among patients it was found that most of them failed to understand information related to health care such as consent form, diet advice or even investigations, etc. The study further suggested that doctors and nurses must educate patients to get better understanding especially of difficult medical terms. Health literacy can help in capacity-building of individuals to access, process and understand basic health information and service for taking appropriate health decisions.
Indian Science Communication Congress (ISCC) report reveal that there is a communication gap between the scientific community and common masses which must be addressed. In an era of technical revolution scientific temper and rational belief are needed the most. Health literacy is a bridge between literacy and the ability of an individual in context with health. Thus, attention must be paid towards two important aspects – communication and health literacy. As they both are interlinked and can help in bridging the existing gap. The reason for less progress in the field of health communication is due to lack of sufficient funds and enormous pressure to show results.
Understanding Health Communication
Health communication links the domain of communication and health to improve personal and public health. It is the process of communication that applies communication strategies to disseminate information to the target audience. The purpose of health communication is to influence knowledge, attitudes and beliefs of the target audience in order to motivate them towards a healthy behaviour. National Cancer Institute and the Centre for Disease Control and Prevention defines health communication as use of communication strategies to inform and influence individual and community decisions that enhance health. The role played by health communication in mitigating health risks as well as in improving the overall health status is also emphasized by institutions like the United Nations, World Health Organization and Centre for Disease Control and Prevention.
Communication scholars like Melvin De Fleur and Sandra Ball-Rokeach in 1976 studied the psychological and social factors that prevented media from exercising their control over audience. According to them there are three important needs – to belong to society, to understand society and to keep up with society which increases our dependency on media. Due to this dependency media enjoys certain powers. Wallace (1999) suggested that new technologies define how individuals gain knowledge, think, react, feel and behave which impacts society and culture. In present times, social media and its users have become central actors in news production and distribution. Social media can be used as a tool to create health awareness far and wide across communities.
Another communication scholar Everett Rogers (1983) categorized individuals on the basis of their tendency to explore new innovations. Diffusion studies in Indian context show the importance of developing an understanding of the social systems with the adoption of technology. Research findings show that apart from political and institutional factors in support of technology there are other socio-economic factors that decide the adoption of technology such as status, age, gender, caste, religion and education. Lack of understanding of social system can be an obstacle in the effectiveness of technology adoption. Access to new ideas and practices may lead to changes at social, institutional and even at individual level. Diffusion of innovation helps a society not just have a better adoption but it also helps in predicting the future of a society.
Need In Indian Context
According to the report of expert committee on tribal health, Indian has over 104 million tribal population (8.6% of its population) spread across 705 tribes. The data shows that even after several years of India’s Independence, tribal people suffer from inequity in health-care as compared to others. Bridging this gap will be a stepping stone towards sustainable development goal. Communication is the nervous system of any society. It can play an important role in facilitating a social change and thus improve the quality of life. Health literacy is less researched in Indian context. However, a few studies conducted in this area in the past indicate low level of health literacy especially disease-specific literacy in rural and tribal areas of India. There are a lot of factors that cause low health literacy in India and among them poverty is at the top. People belonging to minority sections are prone to chronic ailments due to limited access to education, better medical facilities and other socioeconomic barriers. Inclusive health communication can contribute towards health equity and well-being of the society.
Significance Of Communication For Public Health
Health literacy is needed for better use of health-care resources. Poor judgement due to lack of information can have adverse effects on the health and well-being of individuals.
Literature suggests that communication in the field of health is an important aspect. For a long time communication and information were considered a common sense by both public and policy makers. Due to the emergence of modern medicine, communication was mostly informal. Information related to folk medicine was communicated through primary means of communication and revolved around the usage of natural ingredients. Inter-generational communication was the next step in which critical information was passed on to the immediate heirs within the clan followed by discourse of medicine by a certified doctor and then people put their faith in the treatment and the doctor. During this period communication between doctor and patient was considered a great healer than the medicine. Doctors with greater communication skills along with their medical techniques earned goodwill and also became famous.
Changing Trends In Health Communication
Health communication has undergone various changes. In 2003, Piotrow and others studied changes in health communication and divided them into 4 different stages – (1) clinic era focused on availability of product or services. The target audience was aware of the availability of service or product and used it. This approach was considered to be passive, (2) field era involved IEC (information, communication and education) programmes by outreach workers and communities. Radio broadcast, posters, leaflets and mobile units were designed and applied to disseminate information on health issues. This era was criticized for not using multimedia strategies, programme planners had inadequate knowledge about the communication needs of the target audience and had limited evaluation strategies, (3) social marketing era applied the techniques of commercial marketing for analyzing, planning, executing and evaluating health programmes. Lack of community participation and considering beneficiaries as mere consumers set the stage for a change, (4) strategic behaviour change and communication era used behaviour science models and stressed on the need for motivating people towards a healthy behaviour. Social norms and policy environments were changed to bring out a change at an individual and social level.
Channels And Challenges Ahead
The new era of strategic health communication is characterized by integration of various channels of communication such as mass media, interpersonal channels, community-based channel and segmentation of target audience. The channels of communication are important for the success of communication. Different communication vehicles such as mass media, interpersonal communication and counselling can be used. A health communication approach alone won’t be able to substitute for people’s access to health-care services. Issues like gender, socio-economic status, literacy rate, media reach, media environment, reliability of information and favourable policy environment are also needed. Information, education, communication, and motivation not just by government but also through active participation of people is perhaps the need-of-the hour.
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