Documenting and Sharing Learning in Health Communication for Development - Section I

A typology of evaluation resources and lessons learned, including areas that have been neglected, or poorly documented


Trends in evaluation processes show a set of characteristics that are becoming more and more mandatory for any evaluation of health communication programmes for development. While there might be a variety of approaches to characterise evaluation processes, a set of criteria might be as follows:

1. Focus in social change as opposed to, but not excluding, behavior change: Greater use of community norms and social change indicators should increase further understanding of the impact of health communication programmes, beyond the traditional focus on individual behavior change. Recent works by UNAIDS (1999, Communications Framework for HIV/AIDS: A New Direction) and by the Rockefeller Foundation (2000, Communication for Social Change) call for greater attention to the context in which communications for social change takes place. Esentially, programme evaluation should extend beyond individual behavior change and include results or change at the community and societal levels, particularly community and social norms.
2. Emphasis on triangulation: Evaluation of health communication programmes can strongly benefit from the combination of both quantitative and qualitative data. More and more experiences in health communication show that use of both approaches can offer a richer view of the impact that a health communication programme can have at different levels. The use of qualitative data collection techniques can help further understand aspects that could escape quantitaitve measurements, which tend to pay greater attention to knowledge, approval, intention and individual behavior change. For instance, qualitative research may uncover unintended consequences in programme evaluation, which typically do not appear in predetermined quantitative evaluation instruments.
3. Increasing use of qualitative methods, particularly ethnographic research, to assess impact of health communication programmes. In-depth evaluation of health communication programmes can be more easily achieved through greater use of ethnographic techniques, which provide a richer understanding of how individuals and communities process, internalise and use health information provided via interpersonal or mass communication channels. While in the past researchers with background in cultural and reception studies focused primarily in cultural aspects of media, more recently there is evidence of greater attention paid to health communication issues from cultural and reception studies. For instance, Thomas Tufte (University of Copenhagen) is undertaking health communication research projects using ethnographic techniques. Johns Hopkins University's Center for Communication Programmes plans to evaluate its programmes in Nicaragua using field experiments that draw upon ethnographic research. A study conducted by Maritza Lopez, Jesus Martin-Barbero & others in Colombia drew upon reception studies concepts to understand how children make sense of several issues, including health issues, in their relationship with television programming. Finally, a research project sponsored by the Pan American Health Organisation is integrating media effects and reception studies theoretical concepts to study the relationship between media, adolescents and public health issues.