2. Literature Review

2.5. Health Communication in Perspectives

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Table 1. Impacts of volunteer tourism (Wright, 2014).

A proper learning planning and facilitate in communication between the organization and voluntourists is mandatory; moreover, the collaboration with local communities to decide which needed services will be valuable as well as ensure the volunteers see

the experience in the proper sense, i.e., as an exploratory process (Guttentag 2009).

2.5 Health Communication in Perspectives

Communication in health can be defined in much the same way as communication has generally been defined: a transactional process (Corcoran, 2013).

Communication plays a critical role in promoting healthy choices through message delivery. However, what health communication is most dissimilar from the traditional communication is it being issue-specific, integrating fields from mass media, interpersonal network, public health, social psychology and development, medical science ( , 2008). Centers for Disease Control and Prevention (CDC, 2007) and The National Cancer Institute (2002) define health communication as ‘‘the study and use of communication strategies to inform and influence individual and community decisions that enhance health.’’

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Kreps (2003) summarizes that adding ‘health’ into communication definition as a

‘resource’ allows health messages, such as prevention, risk or awareness, to be used in the education and avoidance of ill health. It is also important to remember that health communication always takes place in a social and cultural context. Hence, health communication should be understood as a process viewed as a chain from the sender to receiver, with different situations within that may amplify or attenuate risks. Such situations can be social (e.g., news media), individual (e.g., attention filter), or institutional (e.g., political and social actions).

Imposing public health challenges, the studies by scholars and practitioners in a wide range of science and disciplines find the common goal of health communication and social marketing practices is creating social change by altering peoples’ attitudes, external structures, and/ or modify as well as eliminate certain behaviors if necessary (2007). What distinct health communication from other communication research is that field experiments are applied as a basic research design that include field experiments and focus group interviewing (Rogers, 1994). Health communication targets to improve not only understanding health problems, but also health improvement. This main discipline guides schools of researches of health communication promotions and practices, specifically in fighting AIDS, conduct effective strategy within multiple perspectives: human rights, governmental diplomacy, interpersonal network and community based studies.

In UNICEF’s human rights approach to programing, communication is explicitly acknowledged both a right and a means to claim other rights. Health communication from a human rights perspective is especially relevant to HIV/AIDS programming (Ford & Chorlton, 2003). The change could benefit local people (claim holders) in taking less risky ways of sex or safer means of parental care for infants. To Ford&

Chorlton (ibid), dialogues are chosen by claims holders for effective health

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communication process. And all the conversations should be continued extending to level up national forums for greater influences. Another way to fortify health communication in a diplomatic perspective is foster government’s health diplomacy.

Rely heavily on medical and monetary aids caused by political conflicts, Kenya has received HIV/AIDS care, treatment, and education from the United States (Cook, 2006). The WHO provided reports to help identify countries in need for help since determining what countries are in need and which countries could support the help sending country’s interests for good diplomatic relationship establishment is also important to boost health communication (Kumar & Karl, 2009). All levels of implementing and monitoring such activities are crucially important by involving communities, nongovernmental and civil society organizations and individuals in the planning.

The United Nations Population Fund (UNFPA) stressed that “it is men who usually decide on the number and variety of sexual relationships, timing and frequency of sexual activity and use of contraceptives, sometimes through coercion or violence.” To form a healthier and gender-equal society, ensuring women and girls’

access to sexual and reproductive health services and protection from gender-based violence can be facilitated more efficiently by involving men and boys. Sexual and reproductive health topics can be highly stigmatized and charged with emotion, shame, and fear among families or couples (Kumar, Hessini, & Mitchell, 2009) In Kenya, women have little to no decision-making power with their lives and health historically;

the use of family planning rest mainly with husbands and in-laws; let along women’s perceived nature “to give birth to children” by men. Henceforth, Rao and Svenkerud (1998) listed six concepts that are most relevant to prevent HIV/ AIDS in interpersonal network lens: Communication (channels of how message is transmitted from one to another), the innovation-decision (an over-time sequence process of how

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target audiences adopt the change), homophily (the extent of the two or more people who communicate perceive themselves to be similar), an attribute (characteristic of the innovation either to be positive or negative), adopter categories (classifying groups based on relative time they spent on adopting a new idea, technique, or process), and opinion leaders (people being respected for their knowledge and reputation on certain topic).

Health communication involves modifying cultural tradition, which may differ from each community, including ways of thinking, behavior, and practices-social, economic, and political-that are deeply ingrained in the vast majority in the culture, whereas villagers or political leaders do not think of anything goes wrong (Pillsbury, Mayer, 2005). Limitations NGOs faced in community-based health communication are limited capacity to communicate effectively about the problems. “Grassroots and community-based organizations have relied on a various form of “traditional”

media-from posters, brochures, and newsletters to folk drama and t-shirt, to get their messages out to local and rural audiences” (Pillsbury, Mayer, 2005). Insufficient and imprecise research is conducted to understand what people in different communities believed or the reasons of their behaviors. This leads to the failure of evaluation for how well the target group understood or changed with the desired effect. A given example explained the abovementioned circumstance well,

If a donor gave money for work on HIV/AIDS, an organization might design a poster or brochure telling people not to have unprotected sex. Often this poster or brochure was printed without finding out what people really knew and thought about AIDS or pregnancy, and without studying what would convince people to accept new information or think about changing their behavior. As such, these materials were not relevant and did not resonate with the local community.

Far too often they ended up stacked on shelves in clinics or used for everyday

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needs such as wrapping purchases in a market (Pillsbury, B., & Mayer, D. 2005).

Appropriate means to design media campaigns, referred in communication research, can affect knowledge, attitudes, and behavior (Graeff, Elder, & Booth, 1993). Thus, to know what the target audience believes is critical of making a persuasive argument.

Having target communities participate in the design and implementation of campaign matters much as well since the authoritative top-down campaign activities is often ignored by the target communities (2005).

The collaboration between health communication scholars and marketing specialists has provided important ideas in communicating health and numerable research topics in its health applications. Social marketing (SM), the most widely used strategy, is a planning framework that ‘‘applies commercial marketing technologies to the analysis, planning, execution, and evaluation of programs to improve the personal welfare of intended populations’’ (Andreasen, 1995). By providing tailor-made marketing plan in a systematic way, SM is applied by plenty of NGOs, NPOs’ health promotion campaign to boost attitude or behavior changes in preventing diseases. The frequently used social-marketing strategy in health communication is segmentation, partitioning a total audience into sub-audiences that are each relatively homogeneous in the segmentation variable (Evans, 2006). The core concept of SM contained 4P:

Product, Price, Place, and Promotion, (Positioning or Partner) is also borrowed into health communication applications (Corcoran, 2013), like the testimony of an experienced voluntourists shared in supporting HIV-positive sufferers accepted in the Kenyan community:

We put flyers around town and called patients of the clinic who were HIV-positive. Within a week, our free HIV-positive support group was up and running. I would speak in English and my supervisor would translate into Kiswahili so that discussions were held in Kiswahili in order to increase

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participation and comfort. I ran the meetings similarly to a group-therapy model, geared toward fostering support. To relieve stress and cultivate friendships between group members, we played a game of volleyball.

Laughter and smiles filled the courtyard and at the time I was very pleased with the results (Kass, J., 2013, p41).

More effective health messages can be created for each audience segment than for the entire audience. In recent years, health communication scholars have used focus groups to pretest communication messages, to design health communication interventions, and to evaluate the effects of health campaigns. Furthermore, Africa’s health systems are designed with a bias toward primary care leading to the difficulties of coping with the cost and complexity of AIDS treatment, especially in rural communities. To mitigate and overcome the barriers socially, culturally, and legally allows more Kenyans, especially women and girls, the key affected groups from accessing correct information, to increase the provision of HIV prevention via efficient and effective health promotion. Hopefully in the near future, more efforts of sustainable methods will be developed for reaching both the top-down and bottom-up communicative channel that could also reduce the country’s reliance on keep exhausting international donating funding.

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