Communication for Healthy Living (CHL)

Premised on the idea that health information can be a source of empowerment, the project aims to reach out to families in an effort to help reduce family size, improve maternal health, promote breastfeeding, improve nutrition and hygiene, prevent blood-borne diseases such as HIV/AIDS and Hepatitis C, and decrease cigarette smoking. CHL's communication strategy is built on 3 guiding principles:

1. Households as producers of health: communication can empower and inform individuals, families, and communities to protect their own health by carrying out simple behaviours and seeking appropriate services.
2. Integration of health content: messages from all the major health areas are delivered under the umbrella of the "healthy family".
3. The life stage approach: the family is segmented according to the age- or stage-appropriate needs of each member. This approach is meant to address the needs of each family member while at the same time promoting behaviour changes relevant to the population as a whole. Two groups that are a particular focus of CHL are unmarried youth (aged 15-24) and young married people with 0-2 children.

CHL implements projects in the public, private, and NGO sectors on a national and local level. In the public sector, CHL is working with all directorates of the Ministry of Health and Population (MOHP) as well as with the State Information Services (SIS). CHL supports the "Healthy Family" umbrella campaign in the following areas:

• Developing a national integrated communication campaign including TV, radio, and press advertising and public affairs programming.
• Producing print materials for health providers, clients, and outreach workers.
• Marketing the health services of over 4000 public clinics nationwide through the "Gold Star" quality symbol, after quality assessment and certification.
• Mobilising communities on a local level through 500 MOHP outreach workers and 64 SIS/Local Information Centers.

Activities in the NGO/Community Development Association (CDA) sector are designed to improve health outcomes through community mobilisation approaches that include:

• Providing newlyweds with health information.
• Monitoring the well-being and nutrition of pregnant women to ensure a healthy outcome.
• Supporting safe delivery procedures through increased awareness and improved practices of pregnant women and their families.
• Increasing awareness among pregnant women and new mothers of key messages, especially those related to breastfeeding, weaning, nutrition, and family planning.
• Improving health awareness and healthy behaviours through increased communication among family members and between community and health care providers.

Private sector activities focus on building a network of over 10,000 private pharmacies and 3000 private physicians through the "Ask-Consult" ("Isaal-Istashir") programme. Organisers claim that over half of Egypt's pharmacies have been trained in the latest contraceptive technologies as a step towards affiliation in the Ask-Consult network. Strategic activities for the programme include:

• Production of public awareness brochures, advertisements, social drama theatre, and radio and TV programmes for local and national audiences.
• Scientific symposia to present key advances in health care products and public health.
• Large-scale publicity events to raise awareness of specific health issues, such as contests and group wedding celebrations.

One illustration of the CHL approach is the NewlyWed Initiative. This project is based on the notion that marriage is the foundation of family life - and that, by extension, the marriage event is the strategic entry point for family health information. Mass media activities (TV and radio spots with entertainment-education and talk show formats, press inserts, media contests, and media coverage of special events) are led by a TV campaign. This campaign uses marriage as an emblem of family life that starts off a chain of events: starting a family, pregnancy, labour and delivery, postpartum infant health and family planning, and birth spacing and a healthy family. Each sequence in the chain becomes a focal point of health messages.

Publicity events and community outreach activities are also central to the NewlyWed Initiative. Group wedding celebrations will be held in focus areas throughout the project. Couples will be congratulated on their marriage and receive a package of health messages on behaviours they can adopt to ensure a healthy family. The first such event was scheduled for September 2004 in Minya, with invitations going to approximately 100 couples and their families. According to organisers, celebrities will be in attendance, and a popular singer will perform. The celebration will be covered by national and local media. Specific NGO/CDA activities supporting the Newlywed Initiative in focal villages of Minya and other USAID focal governorates include:

• Home visits with newlywed and young couples to distribute information, education, and communication (IEC) materials and to invite them to participate in community activities developed to support empowerment and strengthened civil society.
• Dawar meetings for male leaders at the village level to identify community health problems and solutions.
• Arab Women Speak Out (AWSO) sessions for young women leaders at village level. (Click here for more information on AWSO.)
• Structured pregnancy classes, post-partum home visits, family planning counseling, and infant care classes.
• Themed "Family Health Weeks" engaging community leaders and the public on specific health topics.
• Theatrical presentations to specialised audiences, such as security camps.

As in the NewlyWed Initiative, entertainment is used as a strategy for health education and awareness in CHL's related campaign Sahatek, Sarwetek (Your Health, Your Wealth). In 2004, CHL collaborated with the popular television variety show Al Afdal (The Best) during Ramadan to promote this campaign. As part of the show, the crew set up in a different neighbourhoods in Cairo, Giza, or Alexandria each evening to throw a party outside the home of a newlywed couple, complete with decorations, a band, wedding cake, and a gift. During the programme, which aired every evening at 11 pm, celebrity host Tarek El Allam teased the couples and quizzed them on their plans for the health of their future family. He particularly emphasised messages on birth spacing, asking "What is the ideal number of years to space your children?" The host closed each newlywed segment by reminding the couple to care for their health, using the campaign slogan, which taps into a deeply held cultural belief that health is a gift to be cherished and protected. The show's format encouraged viewers to call in for a chance to win prizes and to participate in future shows. Over the 30-day period that the show ran, the call tracking system logged 8.5 million calls.

Information and communication technologies (ICTs) are also being used as a tool to share information. As part of CHL, Egypt's State Information Service/IEC Resource Center houses an archive of media materials produced by the Resource Center as well as materials produced by health communication programmes throughout the region. The archives are being made available to researchers, policymakers, journalists, scholars, and all others via an online database, searchable in Arabic and English. Click here to access this website.

Family Planning, Nutrition and Child Health, Infectious Diseases, HIV/AIDS, Tobacco, Maternal Health, Youth.

"Healthy living is an investment. Positive behaviors learned at an early stage affect the life-long health of not only the individual, but of his or her family and community," said Dr. Samir El Alfy, Technical Deputy Director of the project.

Surveys indicated that in 2002, over 90% of the public in Egypt recognised the "Ask-Consult" logo as a symbol of quality service. Both qualitative and quantitative evaluations of CHL will be carried out.

HCP is a global communication initiative led by JHU/CCP in partnership with the Academy for Educational Development, Save the Children, the International HIV/AIDS Alliance, and Tulane University's School of Public Health and Tropical Medicine. HCP also works with Southern-based health communication organisations and global programming partners from the corporate sector, international media, academic institutions, and faith-based organisations.