Communication in Support of Child Survival: Evidence and Explanations From Eight Countries

Hornik, R., McDivitt, J., Zimicki, S., Yoder, P. S., Contreras-Budge, E., McDowell, J., & Rasmuson, M. (2002). Communication in Support of Child Survival: Evidence and Explanations From Eight Countries. In R. Hornik (Ed.), Public Health Communication: Evidence for Behavior Change (pp. 219-248). Mahwah, New Jersey: Lawrence Erlbaum Associates.

METHODS: The HealthCom project sheds light on the potential for large-scale health communication in developing countries to reach target populations and achieve substantial behavior change. Sixteen interventions supported by HealthCom addressed vaccination, diarrheal disease treatment, and other child survival-related practices. Evaluations of 10 national or regional public health communication programs in 8 developing countries asked whether such programs, carried out on a large scale, influenced health practices.

FINDINGS: Evidence from paired before and after surveys, supplemented in some sites by time series or control area data, demonstrated substantial success in 9 of the 16 evaluated outcomes, with absolute increases of from 12% to 26% of the population adopting recommended behaviors. Evidence points to the inference that observed changes were the result of the communication interventions. Both cross-site evidence and results from individual programs suggest explanations for why some programs did or did not work. They include the match between intervention goals and structural opportunities for behavior change; the use of communication channels that reach much of the audience; and the choice of specific messages that address, from the audience's perspective, the barriers to and the benefits of the target behavior.