Mass Media and Health Practices Project

The programme, which operated in a carefully chosen site that included a representative population of 400,000 individuals, began by providing 900 health care workers with four to eight hours of Oral Rehydration Therapy (ORT) training. The training programme concentrated on teaching the proper mixing and administration of ORT salts and instructing other village assistants, who would ultimately have to conduct the same exercises directly with rural families. The health workers and village trainees then began instructing mothers and grandmothers in ORT and other health behaviours such as breastfeeding, infant food preparation, and person hygiene. When rural families completed their ORT training, a flag was posted at their house to let other mothers in the area know where they could obtain health advice and instruction.

As the training programme was being carried out, a media campaign was implemented to reinforce the health care instruction effort. The campaign developed print materials and radio advertisements to issue basic messages related to ORT and the associated training programme. The messages emphasized the correct administration of the oral rehydration salt "Litrosol" and the continuation of breastfeeding during infant diarrhoea periods, while also encouraging mothers to seek medical assistance if a child's condition deteriorated. Posters and flipcharts were also created to illustrate ORT and to deliver reinforcing messages. The radio advertisements were placed in 30-60 spot announcements and often included some form of jingle, slogan, or song. Many of the ads included a familiar announcer, Dr. Salustiano, the programme's spokesman for technical information, who subsequently became a nationally known figure.

The product was differentiated in two test sites: home-mix sugar, salt and water in Africa and pre-packaged salts in Latin America (Honduras). In Africa, a mass mobilisation strategy was adopted, driven by the use of a radio course that involved thousands of women learning and then practicing to mix the home-mix safely. In Honduras, the programme evolved from the provision of packaged salts to a broader product that supported children suffering from diarrhoea.

Children, Health.

In 1978, the World Health Organization, UNICEF, and the US Agency for International Development (USAID) embarked on a crusade to combat infant mortality in the developing world, which during that time averaged more than 200 per 1000 live births. Children in developing countries were dying in large numbers from such preventable diseases and illnesses as diarrhoeal dehydration, measles, and respiratory infections, all of which had long been under control in the rest of the industrialised world. Inadequate medical resources and facilities and the lack of effective immunisation programmes in developing countries allowed diseases such as these to persist, and kept infant mortality inordinately high.

Before the start of this USAID-funded programme, diarrhoeal dehydration accounted for 24% of all infant deaths in Honduras and represented the single leading cause of infant mortality. In 1977, the year preceding the programme's commencement, diarrheal dehydration caused the deaths of 1,030 infants. Treatment during this time was expensive and limited both in scope and availability. The only treatment available to Hondurans for diarrhoeal dehydration was intravenous (IV) therapy, which requires trained medical personnel and a sterile environment and is offered exclusively in fixed health facilities serving only a small percentage of the country's rural population.

The campaign promoted a mother-craft concept in which a mother's current actions and beliefs are supported, with the programme's health techniques an added complement to her caregiving regimen. ORT training was presented as a new development in modern medicine: the latest remedy for lost appetite and a recovery aid. With a high rate of literacy (87% of each household with at least one literate member), and 71% of all households owning a functional radio, the media campaign became an effective communication and education tool. In Latin America, infant mortality due to diarrheal dehydration dropped from 47.5% to 25% in the first year of the programme.