Updated HIFA Strategy 2022-2024: Strategic shift: Convene stakeholders for a Global Action Plan on Universal Access to Reliable Healthcare Information (7)

30 August, 2022

Dear Neil, [ https://www.hifa.org/dgroups-rss/updated-hifa-strategy-2022-2024-strateg... ]

I should precise that my post [ https://www.hifa.org/dgroups-rss/updated-hifa-strategy-2022-2024-strateg... ] was about public health information/communication, not health information provided to patients.

I don’t think that rumors about polio vaccination have been caused by health information providers. Health information from health care workers and health institutions is, of course, accurate... yet it can be unsuitable, not addressing the real issues, not preventing the rise of rumors, or even indirectly and unwillingly fueling them.

The difficulties met by the Global Polio Eradication Initiative, launched in 1988, is a good example. You wrote that the CIA killing of Bin Laden caused the rumors on polio vaccination. When Bin Laden was killed in May 2011 these rumors had already been around for ten years. The initial polio eradication target (2000) was not met because of resistance to vaccination in two areas of the world: northern Nigeria and India/Pakistan/Afghanistan (mainly in Muslin communities). The rumor was the same: the vaccine is a way to sterilize children to limit the population.

In 2006, The Lancet reported about polio mass vaccination campaigns in India: “Largely ignored by state and national governments, the village has no clean water, no sanitary systems, and no proper roads. (…) But last month, a government health official paid a visit, wanting to give your children some drops he said would protect against a disease you have neither seen nor heard of—polio. The village head insists that the drops contain antifertility drugs; a government ploy, he explains, to eliminate the burden of poor communities on the state. He warns you to keep your children safe. Whom would you believe?” ( https://doi.org/10.1016/S0140-6736(06)69082-X )

In 2007, PLOS Medicine reported about the same campaigns in Nigeria: “From a Nigerian's perspective, to be offered free medicine is about as unusual as a stranger's going door to door in America and handing over $100 bills.

It does not make any sense in a country where people struggle to obtain the most basic medicines and treatment at local clinics”. ( https://doi.org/10.1371/journal.pmed.0040073 ) Northern Nigerian states banned polio vaccination for a few years, stating they were an attempt from the American government to limit the Muslim population, following the World Trade Center attacks. In 2010, HJ Larson and DL Heymann wrote: “The crisis could have been averted with a much earlier efforts to engage communities and build trust in the areas where overall levels of mistrust were well known.” (https://doi.org/10.1001/jama.2009.2023)

As Venus Mushininga posted (HIFA, August 6): “Research is required to map information needs for target populations so that communication can be relevant and effective. There is need to consider sociocultural dynamics and also behavioral science issues.” [ https://www.hifa.org/dgroups-rss/updated-hifa-strategy-2022-2024-strateg... ] This is necessary not only to disseminate appropriate information, but especially to design effective communication strategies, which includes messages conception, type of information to provide, choice of the message carriers (physicians, nurses, religious or traditional leaders, etc.), timing of communication, etc.

The HIFA Strategy could promote an approach based on the reality of the target populations, as opposed to top-down communication approaches. The “needs” that are mentioned in the HIFA strategy need… to be analyzed.

Bernard Seytre



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HIFA profile: Bernard Seytre is a Consultant at BNSCommunication in France. Professional interests: Health communication and education. Email address: seytre AT bnscom.fr