Communication or confusion?

The Covid-19 pandemic has exposed our individual, societal and state level capacity gaps like never before.

A cross-cutting gap has been with respect to communication, the single most important factor, with its implications almost across all other aspects of Covid-19. Not to any surprise, like polio and family planning, here too we are witnessing a debacle.

To say the least, Covid communication has resulted into confusing citizens, rather than enabling and motivating them to take the right decisions about the choice of their behaviours. We even disastrously failed to make the nation adhere only to two simple behavioural changes – wearing masks and maintaining social distancing.

While as a society we are experts in complicating things, in this case, our governments lead the way. The whole Covid-19 prevention communication, from its start till now, presents a quagmire in messaging tactics. The ‘darna nahi larna hai’ (let’s not be scared, but fight instead) message/slogan ended up misleading the nation. With respect to epidemics, experts argue that fear is the most impactful appeal for behaviour change. Unfortunately, we attempted to reverse it.

The results are clear. A very small segment of society is adhering to preventive behaviours – probably they did not listen much to the popular communication; the majority that listened to the leader developed a complacency to not adopt any preventive measures.

A rather simple act of wearing a mask was made complicated. One can recall that in the beginning our health minister was seen wearing a mask, while the message that was relayed to the people was that only the sick needed to wear the masks.

Of course, one can argue that reference agencies such WHO etc have been changing their approaches and stance, and so did we. But what a pity for us as a nation if we don’t have the ability to rationalize learnings in the context of our society. What underpins this are the chronic and acute health communication capacity gaps in our system.

A careful look at our health system will reveal that health communication in general has been dealt through ad-hoc and stop-gap approaches. To say the least, there is not a single independent government institution that deals on a regular basis with the design and implementation of health communication in our entire health system.

The health communication budget is almost non-existent. Whatever little appears to have been done in this regard is mostly donor driven. Even today, we will see that the person or two dealing with health communication within the federal or provincial setups and in any of the health programs are on posts funded by some donor agency. It has become a norm that, while there will be a person ‘designated’ for communication from the regular structure, s/he will be supported with one or two communication persons from donors who will be actually doing the work for him or her. What else can we do when we don’t have the relevant skills and understanding, and when we don’t even understand its need?

One may argue that Lady Health Workers have been an important communication investment. This also needs to be seen carefully. Their communication software and hardware came from donors. Post 18th Amendment, the LHW Program lost that support, only to witness them not being able to deliver this desired function for the system.

We occasionally see some health campaigns on screens. These have also been carried out by donors or development partners, sometimes co-branded with the government and sometimes with only government branding. And why would it not be so when the government’s own communication funds (if any) will be used to please the big names of the government through print media advertisements that have large photos of these leaders and a small health message like a sale price tag.

An interesting aspect here is that one will find a number of communication strategies in the entire health system on any subject you can name – but only to sit in the archives. In the last 20 years, several communication trainings have also been organized by donors and partners to address the communication capacity gaps but to no avail. We need to realize that strategic inputs to the system cannot bear fruits unless they are institutionalized and dealt as foundation for long-term changes. To our dismay, like many other instances, the communication inputs to the system have also met the fate of stop-gap arrangements owing to lack of attention to this very important area.

Covid-19 has provided us an opportunity. The communication capacity needs have come to the fore. Communication is key to prevention not only of pandemics but for overall public health. We cannot leave it to only ad-hoc arrangements.

Those at the helm of affairs need to realize that even their individual power of influence cannot be put to best use for public goods if not guided and supported by a health communication system that is abreast of knowledge, skills and advancements.

Mind it, health communication does not mean playing to the gallery. We need to treat communication seriously and work on institutional strengthening in this regard. Many things can be done with little resources when you have acumen. Communication is one such area.

The information ministry has a lot to offer, state channels can come handy, donors are there, corporate social responsibility can be leveraged – but for all this we need a communication unit or institution in the system which can tap these resources and put them to best use. In the absence of such an institution, we will keep using communication for confusion.

The writer is director of Policy Watch.