On 7 April, we celebrated World Health Day. Coordinated by the World Health Organisation (WHO), this year’s campaign (“Our Planet, Our Health”) explored the connection between environmental threats and health risks. The WHO wants all of us to work together and promote “urgent actions to keep humans and the planet healthy.”
Many of the actions the campaign proposes imply major changes to our lifestyles. The good news is that, as the pandemic has shown us, behavioural change is possible. It may be difficult to break habits, but citizens in all countries began washing their hands more often, using masks and respecting new rules for social distancing.
Of course, not everyone is convinced! As of March 2022, only around 4 in 10 French citizens say they are improving personal hygiene, for example by washing hands frequently or using hand sanitiser. After the devastating first wave of the pandemic in mid-2020, about 1 in 3 German and 1 in 4 US citizens still did not wear facemasks in public. Leaving aside the pandemic for a minute: did you know that almost 1 in 4 adults worldwide still smoke tobacco, regardless of the many studies proving how harmful it is for our health?
COMMUNICATIONS FOR BEHAVIOURAL CHANGE
More than most public institutions, health institutions are concerned with human behaviours, and, more than most communicators, health communicators are motivated by behavioural change. To achieve SDG 3 on Global Health, we all need to need to adopt and encourage healthy behaviours and discourage unhealthy ones.
Many health ministries have turned to the science of Behavioural Insights (BI) to inform their communications strategies. A recent OECD survey on public communication found that 24 out of 38 Centre of Governments and 13 out of 23 Ministries of Health had engaged with BI experts to inform the design and delivery of their communication efforts.
The aim is to better understand people’s biases, i.e. the deeply engrained mental habits that affect our behaviours and decisions, and that often prevent us from acting in our own best interests. With such insights, communicators can make better choices about how to frame messages, choose messengers and identify channels to get the message across to their target audiences.
COMMUNICATING IN COMMUNITIES
The first thing we learn from BI experts is that our biases are not entirely of our own making. Beyond our personality, specific background and mind-set, there are several larger spheres of influence:
- Our relationship with family, friends and peers.
- The broader community in which we live.
- General social, economic, cultural and political structures.
To promote behavioural change, communicators need to work in all of these spheres of influence, collaborating with partners at different levels. International organisations like the WHO need regional, national, local, public and private actors to translate their broad global messages into specific contexts. (Read about the benefits of strong partnerships in our toolkit.)
This may be why the “Our Planet, Our Health” campaign directs specific recommendations to different actors, ranging from governments over corporations, health workers and health facilities to mayors and individuals. For example, to help people eat more healthily, the WHO advises governments to tax highly processed foods; health facilities to provide sustainably grown local food for staff and patients; mayors to regulate the marketing of unhealthy foods in public spaces; and individuals to buy fresh groceries from local producers. Measures on all levels work together to change eating behaviour.
The broad approach that aspires to influence the entire social environment of individuals is often called SBCC – “Social and behaviour change communication”. There are many examples from which we can learn.
One initiative in Pakistan, carried out by the Pakistani NGO Human Resource Development Society (HRDS), sought to stop people from drinking water contaminated with arsenic. The organisers encouraged local officials, health workers, teachers and religious leaders to help spread health information and advice. They organised workshops to inform, mobilize and qualify these stakeholders, and ran community awareness sessions and a mass media campaign to reach a broader audience. A study on the initiative found that overall problem awareness had risen; school teachers and trained community organisers proved to be particularly effective in encouraging behavioural change in households and families.
The Ministry of Health of the Central African Republic took a similar approach for a polio vaccination campaign that included districts controlled by non-governmental armed groups. Together with key stakeholders, such as the Centre for Humanitarian Dialogue (HD) and the Organization of Central African Women (OFCA), the organisers were able to convince military and community leaders to support and participate in the campaign, which saw almost all parents bring their children in for vaccination. Their strategy included:
- Advocacy at several levels, including negotiation with the local leaders of the armed groups.
- Enabling social partners to participate in the campaign’s development.
- Community dialogues in various localities to identify cases of vaccine refusal.
- Launch of ceremonies to mobilise all stakeholders.
- Interpersonal communication to raise awareness of the need for vaccinations.
- Mass communication to inform the population about the campaign quickly.
CONVEYING THE FACTS & FIGHTING MIS- AND DISINFORMATION
Health issues are often complex and getting across basic information – for example on childhood immunisation – can be a challenge. This becomes even more difficult when communicators face waves of misinformation or – even worse – intentional disinformation campaigns. During the pandemic, large numbers of citizens around the world have relied on alternative and dubious sources of information, leading them to underestimate the seriousness of the virus and reject the strategies of their governments.
To prevail over disinformation, communicators need to build trust. They need to ensure that their messages remain clear and consistent, and they need to choose credible messengers. For instance, in Switzerland, social media campaigns such as #soschützenwiruns (“that’s how we protect ourselves”), engaged trusted influencers to share information on their own channels. Supported by USAID, the Rooted In Trust initiative works in nine countries, supporting journalists and activists in tracking and debunking myths about the virus and the ways to stop it.
In Colombia, during the COVID-19 pandemic, the Ministry of Health developed a communications strategy to bring trustworthy and scientific information to the most vulnerable parts of the population. The Ministry adapted its campaigns to different local contexts, working with Colombian artists, celebrities and scientists to fight misinformation, for example related to religious beliefs. They also partnered with one of the most important music festivals in the country to promote vaccination.
GOING BEYOND AWARENESS-RAISING
Yet, providing accurate information is rarely enough to change behaviours. BI research suggests that communicators need to instil a sense of “ownership” of new behaviours among their target audiences, creating an intrinsic motivation to change. Here are some ideas on how to achieve more ownership:
Tailor Campaigns to People’s Lives
Communicators need to adapt messages to their audience’s specific circumstances. Indeed, they can become part of people’s lives. Anti-smoking campaigns in Switzerland and Ireland have reached individuals by sharing regular motivational emails or text messages, offering customized access to websites, and allowing people to track their progress through a personalised “Quit Plan”, smartphone app, or even coaching sessions.
Communicators can offer rewards for behavioural change. In Canada, for example, one campaign set up by the Public Health Agency of Canada reached 98,000 people by rewarding them with air miles if they signed up to a physical activity programme. Encouraging people to fly more often may not be in line with the people-and-planet objectives of World Health Day 2022, but the campaign’s results suggest that rewards can work, at least in the short term.
Relate to values
People are more likely to change their behaviours if the changes align with their personal values. In another example from Canada during the COVID-19 pandemic, the government was able to promote physical distancing by framing this behaviour as a moral responsibility and civic duty to protect others.
To keep humans and the planet healthy, we need communications strategies that target behavioural change. Setting these up is a complex and multi-faceted task, engaging a large and diverse group of stakeholders and citizens. It requires us to provide trustworthy and reliable information, and to promote a great sense of ownership among our audiences.
What can give us hope is that most people already know what needs to be done for a #HealthierTomorrow. They just need help getting started.
If you are interested in behavioural insights, then check out the following resources:
- The World Health Organisation’s overview on how to design a behaviour change campaign.
- The OECD’s Observatory of Public Sector Innovation (OPSI) has a collection of toolkits designed to help us make use of behavioural insights when designing and communicating policies.
- In Tools and Ethics for Applied Behavioural Insights, the OECD explores how to integrate behavioural insights into policymaking and communication.
- For a large collection of behavioural insights case studies check out the OECD publication about “Behavioural Insights and Public Policy” .
This post is published in partnership with Engagement Global, a German service agency working on behalf of the Federal Ministry of Economic Cooperation and Development (BMZ) to engage civil society on issues of development co-operation.