Why the Emphasis on Strategic in Health Communication?
Strategic design is the hallmark of successful health programs. Over the past 20 years, health communicators have come to realize that collaboratively designed, implemented, and evaluated health communication strategies will help achieve the goal of improving health in a significant and lasting way by empowering people to change their behavior and by facilitating social change. Sound communication strategies provide coherence for a health program’s activities and enhance the health program’s power to succeed. Strategic communication is the program’s steering wheel, guiding it towards its goals. Strategic communication is also the glue that holds the program together or the creative vision that integrates a program’s multifaceted activities.
Prior to this era of strategic design, health communication in the 1960s was largely characterized as the “medical era.” It operated under the assumption that, “If we build it they will come.” This medical monologue model is often represented by the image of a physician lecturing or talking to patients. The 1970s recognized the need to reach beyond the clinics. Borrowing mainly from the agricultural extension model, field work was mostly supported by print materials and visual aids. Mass media impact was considered modest due to limited reach. This period was mainly described as the “field era,” moving from monologue to dialogue (Rogers, 1973). The 1980s saw the proliferation of social marketing with a move from nonpaying clients to customers who ask and pay for services, and the use of integrated marketing communication approaches borrowed from the commercial sector. This period may be called the “social marketing” era. Health communication in the 1990s to the present has evolved into what may be called the “strategic era,” characterized by multichannel integration, multiplicity of stakeholders, increased attention to evaluation and evidence-based programming, large-scale impact at the national level, more pervasive use of mass media, and a communication process in which participants (“senders and receivers”) both create and share together (Rimon, 2001).
The new, strategic era of communication is distinguished by several other important characteristics:
- Previously separate services are more integrated. It is becoming more common to find a variety of services, such as family planning (FP), maternal and child health, and sexually transmitted disease (STD) treatment and prevention offered at the same location.
- Integration is also occurring among communication channels. Mass media, community-based, and interpersonal channels are being used strategically to reinforce one another and maximize impact.
- The role of the electronic media is becoming more prominent. New technologies are being added to the communication mix to reach more people in innovative ways.
- Decentralization has shifted control and decisionmaking from the central government to local communities.
- A multiplicity of stakeholders is involved at every step in the strategic communication process.
- Audience segmentation is becoming more sophisticated, which allows for more tailored messages to audiences.
- A recognition that households and communities are producers of health and play a different role in improving health than does the health service delivery system.
- Increased attention to evaluation and evidence-based programming is providing much-needed data upon which to base decisions (Rimon, 2001).
