Use of Folk Media May be Effective Means of Disseminating HIV Prevention Messages in Africa

In a commentary in the October issue of the American Journal of Public Health, Solomon Panford of CARE International and colleagues describe the benefits of using folk media to disseminate HIV prevention information in Africa. Kwasi Ansu-Kyeremeh, a professor in the School of Communication at the University of Ghana, defines folk media as "any form of endogenous communication system which by virtue of its origin from, and integration into, a specific culture serves as a channel for messages in a way and manner that requires utilization of the values, symbols, institutions and ethos of the host culture." Storytelling, puppetry, proverbs, visual arts and crafts, drama, music and dancing are all forms of folk media that are generally practiced and accepted in rural African society. Using these methods to convey HIV prevention information is likely to be successful in Africa, where most rural people are illiterate or low-literate, because unlike most modern prevention campaigns that distribute literature or use methods that "require rural villagers to 'participate' in ways that are often incomprehensible to them," folk media often incorporate an oral tradition. Most African rural populations are "primarily listeners and speakers rather than readers and writers" and are more likely to respond positively to an approach that "embodies many of the activities, beliefs and customs" of their way of life, the authors state (Panford et al., American Journal of Public Health, October 2001). Folk media have been used in several countries to "promote healthy habits and lifestyles such as family planning, adoption of new farming techniques (and the) use of oral rehydration therapy," Panford said. "The importance of the 'fit' of the communication approach to the behavior change objectives cannot be overemphasized," he added (Mozes, Reuters Health, 10/10).

Creating a Model
CARE International and the CDC are working together to integrate folk media into two existing HIV prevention programs in western Ghana. The Wassa West Reproductive Health Project assists residents with family planning efforts and HIV and STD prevention, while the Ashanti Region Community Health Project, funded by USAID and the Bill and Melinda Gates Foundation, promotes "safer sex" -- sex that is "free from unwanted pregnancy, unplanned birth spacing, disease and sexual abuse." The Ghana project is still in the research and planning phase, but it will include folk media, combined with the broadcast of "long-running serialized radio dramas" that feature characters who will "evolve to adopt positive reproductive health behaviors, such as condom use, family planning practice, breastfeeding and early treatment of STDs." According to the authors, radio is a "powerful and credible information and entertainment medium in most developing countries." In addition, radios are affordable and can be found in most remote villages. The Ghana project also plans to augment the radio messages with public reenactments by drama troupes and through the incorporation of some of the themes of the broadcasts into songs and stories for community gatherings such as festivals. Although such techniques have not been "recognized in most Western literature as the most prominent means of education in all aspects of African social life, the effectiveness of folk media in changing negative social and reproductive health behaviors in rural Africa is clear," the authors conclude, adding that it is "therefore imperative for projects whose goals aim at behavior change and sustainability in rural African settings to recognize and use the potential of folk media for the benefit of the rural folk as well as project implementers and funding agencies" (American Journal of Public Health, October 2001).