In the wake of the COVID-19 pandemic, we witnessed an unprecedented surge in health communication efforts aimed at educating and mobilizing the public. While the importance of such #healthcommunication cannot be understated, there’s a growing concern of “health communication fatigue” as we risk overloading the public with information. In this article, I will explore the challenges of communication fatigue and offer strategies to ensure our messages effectively achieve public health objectives.
Much like the indiscriminate use of antibiotics can lead to unintended consequences, over-communicating health messages without a strategic approach can render our communication efforts ineffective. In the early days of the pandemic, organizations like WHO took centre stage in effectively communicating complex scientific knowledge. However, as we’ve continued to flood the public with information, we now risk a “HelDemic” of excessive health communication, both digitally and physically. The very “Infodemic” many health organizations aim to fight may be gaining from the indiscriminate health communication these organizations are indulging in.
Indeed, it’s time to address the ever-expanding plethora of health days. We’ve come a long way from marking general health awareness days, and it seems like we’re on the brink of celebrating the “World Day of the Right Kidney” or perhaps the “Day of the Arch of the Aorta.” While raising awareness about specific diseases, organs, and behaviours is crucial, we must strike a balance. The constant barrage of dedicated days can dilute the impact and lead to a sense of exhaustion among the public. We must prioritize key health issues, combining awareness with concrete actions. Let’s not forget that meaningful change in public health is more about sustainable, well-thought-out strategies than having a day for every tiny medical detail. After all, there’s only so much room on the calendar, and we should use it wisely to ensure our messages hit home effectively.
#BehaviouralScience offers compelling insights into #MessageFatigue resulting from overcommunication. The human brain is inherently wired to adapt and filter information to efficiently process an overload of stimuli. When individuals are consistently bombarded with health messages and information, their attention span wanes, and their receptivity to new messages diminishes. This concept is known as habituation, a fundamental principle in psychology. When people encounter the same information repeatedly without novelty or a clear call to action, they become desensitized, rendering subsequent messages less effective. Additionally, cognitive load theory highlights that excessive information can overwhelm the brain’s limited mental resources, decreasing message retention and comprehension. To combat #messagefatigue, it is essential to apply behavioural science principles, such as novelty, relevance, and clarity, in health communication strategies, ensuring that messages are frequent, engaging, resonant, and actionable.
The primary challenge is balancing the need for information dissemination and the risk of communication fatigue. To do this effectively, we must prioritize and strategically choose critical health days for communication. Rather than inundating the public with continuous events and messages, we should focus on a select few that have the most significant impact in the context of each country’s morbidity and mortality data.
Similarly, before choosing the health day to mark and encourage the population to take action, check if you have created the necessary infrastructure and trained the health staff. Only talking and having no facilities supporting action will reduce the audience’s trust in you as a communicator. Let’s take a page from the Singaporean playbook, a country celebrated for its strategic approach to health campaigns. Unlike the chaotic flurry of information that can overwhelm public health communication efforts, Singapore opts for a more measured strategy. They first build the necessary infrastructure, invest in training their healthcare staff, and only then launch well-thought-out health campaigns. This method ensures that the communication aligns with the country’s capabilities and resources. For instance, their successful ‘War on Diabetes’ campaign was launched after setting up a nationwide system for diabetes prevention, care, and treatment. It’s a testament to how governments can measure health communication, focusing on sustainable actions over flashy announcements.
For low-income countries heavily reliant on foreign aid, public officials may focus excessively on marking health days prioritized by donors. This diverts their attention from core responsibilities and risks undermining domestic ownership and sustainability. Striking the right balance is essential and requires local health leadership to have a spine and be incorruptible.
A shining example of this approach is the nation of #Rwanda, which, after experiencing a devastating genocide in 1994, has risen like a phoenix, demonstrating the power of local stewardship. The Rwandan government has taken control of its #DevelopmentAgenda and #HealthCommunication strategies, ensuring that international donors align with their priorities. As a result, they’ve seen remarkable improvements in healthcare access, education, and infrastructure, reducing child mortality and infectious diseases.
#StrategicHealthCommunication is critical, especially in low-income nations with limited resources. It involves profoundly understanding the local context, target audience, and the cultural factors affecting health behaviours. Effective strategies include audience analysis, evidence-based messaging, channel selection, deliberate message distribution, and rigorous monitoring and evaluation.
In a post-colonial world, #LeadershipCommunication plays a pivotal role in low-income countries, where building trust, mobilizing resources, influencing behaviour change, strengthening health systems, and managing crises are paramount. National health leaders must communicate effectively to instil trust, mobilize resources, drive behaviour change, and forge alliances to strengthen health systems. Above all, it requires national health leaders to be loyal to their mandate and not merely in the service of international donors.
For health leaders, national and international, talking selectively, concretely, and effectively may be better at preventing health message fatigue than generating endless noise using fluff and jargon to have their faces plastered over posts and posters.
As we move forward post-COVID-19, it’s crucial to recognize the potential pitfalls of health communication fatigue. Strategic health communication and effective leadership communication are essential to navigate this landscape successfully. By striking the right balance, prioritizing critical health days, and ensuring that public officials don’t lose sight of their core responsibilities, we can ensure that our public health messages effectively achieve our goals.
Global Development Strategist and Leadership Communication expert
The developmental experiences of Rwanda and their applicability to countries such as Nepal are explored in an interview with Dr Sunoor Verma.
The Kigali Global Dialogue Forum is a one-of-a-kind forum that brings together representatives from developing countries to discuss major global issues. It is organised by India’s Observer Research Foundation (ORF) and the Rwanda Governance Board. Set against Rwanda’s incredible growth and development, this selected event focuses on inclusive conversation, bringing varied perspectives, and supporting gender equity. The critical findings are the importance of open discussions, regional alliances, and issue-based collaborations among developing nations.
Welcome to Nepal News Agency. Dr Sunoor Verma will be with us today to discuss developing countries such as Nepal and Rwanda. You were recently invited to speak at the Kigali Global Dialogue; please explain your personal experience and impressions of participating in this unique event in Rwanda.
Dr Sunoor Verma: The Kigali Global Dialogue is a truly unique platform for debate that is convened by two highly credible organisations, the Observer Research Foundation, India and the Rwanda Governance Board, and it brings together a diverse range of voices from developing countries. This dialogue is known for ensuringa significant presence of women speakers, which is not always the case at international events.”
Another thing that makes the Kigali Global Dialogue special is that it’s held in Rwanda, one of Africa’s fastest-growing economies. It’s an inspiring place to be, giving us a glimpse of what’s possible for developing countries.
The topics discussed at the Kigali Global Dialogue are also very bold. They don’t shy away from complex issues; participants can express their views without worrying about pleasing donors or funding sources. This makes for a candid exchange of ideas essential for developing countries.
The Kigali Global Dialogue is an invaluable platform for developing countries to come together, discuss critical issues, and learn from each other’s experiences. I’m grateful for the opportunity to participate in this year’s event, and I look forward to returning.
Can you share some insights that you gained from participating in the dialogue?
Dr Sunoor Verma: One of the most significant insights I gained from the dialogue was the continued relevanceof dialogue between developing countries. Too often, the conversation about development is dominated by developed countries, who may not always understand the unique challenges and opportunities facing developing countries. The Kigali Global Dialogue was a refreshing change of pace, as it was a platform for developing countries to come together and share their experiences. This was incredibly valuable; we could learn from each other and build relationships. Another insight I gained was the importance of regional alliances and issue-based alliances. In today’s world, it is no longer enough to focus on national development simply. We need to work with our neighbours and countries facing similar challenges. This is the only way to achieve sustainable development. The Kigali Global Dialogue was a wake-up call for many. It is a sobering reminderthat developing countries have the power to shape their destiny. We must continue coming together, sharing our experiences, and building alliances. Together, we can create a better future for all as long as there are credible hosts, such as the Observer Research Foundation and the Rwanda Governance Board, whose intentions are trusted.
So the dialogue was held in Rwanda, and its Kigali Global Dialogue and such dialogues have helped the country garner international attention; so can you elaborate on how these dialogues have effectively promoted Rwanda’s achievements and helped foster global engagement?
Dr Sunoor Verma: The Kigali Global Dialogue is a powerful asset for Rwanda to showcase its achievements to the world without being a pony show. It brings together a wide range of influential people from all over the world who get to see firsthand Rwanda’s progress in recent years. This year’s dialogue, for example, brought together people from over 70 countries. They had the opportunity to learn about Rwanda’s economic growth, its commitment to good governance, and its progress in education and healthcare. They also had the chance to meet with Rwandan policymakers and business leaders and discuss ways to collaborate on future projects.
However, The Kigali Global Dialogue is not just about promoting Rwanda’s achievements. It is also about fostering global engagement. When policymakers and business leaders worldwide come together in Kigali, they can build relationships and share ideas. This can lead to new partnerships and new development opportunities.
Rwanda has made some significant improvement in development despite the genocide that occurred not long ago, so what are the factors or strategies that do you believe contributed to Rwanda’s transformation into current Africa’s fastest developing nation?
Dr Sunoor Verma: Rwanda’s transformation always inspires me; it is a remarkable story of how a country can overcome a horrific past and build a brighter future. Many factors have contributed to Rwanda’s success, but I believe the most important ones are visionary leadership, good governance, and investment in human capital.
President Paul Kagame has been a visionary leader for Rwanda. He has articulated a clear vision for the country’s future and has been committed to implementing it. He has also created a robust, stable government focused on good governance and transparency. This has created an environment where businesses can thrive, and people can live in peace and security.
Rwanda has also invested heavily in education and healthcare. This has led to a significant improvement in the quality of life for its citizens. The country now has one of the highest literacy rates in Africa and is also making progress in reducing poverty and malnutrition. Rwanda is also a leader in gender equality, with women making up more than half of the parliament. I am confident that Rwanda will continue to thrive in the future.
I speak passionately about Rwanda’s transformation because it is a model for other developing countries. The principles of visionary leadership, good governance, gender equity and investment in human capital are the same principles that I believe can be applied to other developing countries.
As you said, the society was torn from violence and ethnicity, and now it is embracing its unity; that transition is indeed remarkable for a landlocked country or small country like Rwanda, so what do you believe are the key factors that enable this transition and how can other countries with a similar situation, similar socio-economic problems can learn from Rwanda’s experience.
Dr Sunoor Verma: Rwanda’s transition from a country torn by violence and ethnicity to embracing unity is remarkable. It is a story of how a country can overcome a complicated past and build a brighter future. Many factors have contributed to Rwanda’s success, but the most important ones areleadership, reconciliation and gender equality.
Leadership is essential for any country that wants to achieve its goals. President Paul Kagame has understood the importance of Reconciliation in Rwanda and has taken steps to promote it. He has also committed to gender equality, and women now play a leading role in all aspects of Rwandan society.
Reconciliation is another essential ingredient for peace and unity. Rwanda has taken several steps to promote Reconciliation, including creating a system of local courts and local bodies to help people reconcile with each other. The country has also integrated the issue of Reconciliation into its school curriculums.
Gender equality is also essential for peace and unity. When women are empowered, they are more likely to be involved in decision-making and promote peace. Rwanda has made significant progress in gender equality; women now comprise more than half of the parliament.
Reconciliation is a difficult process, but it is critical in countries that have suffered genocide or other mass tragedies. It is the only way to fully move past the past and create a better future for everyone. Reconciliation does not imply ignoring the past. It is about remembering the past in order to create a better future. It is about acknowledging the grief and suffering inflicted and working together to find a way forward. It is a matter of forgiveness, not forgetting. It is about justice, but not about vengeance. It is a process of healing, not forgetting.
Rwanda has focused a lot on agricultural development to progress since the genocide. Nepal is also an agro-based country, so what methods used by the people of Rwanda can be applicable for Nepal to develop agriculturally?
Dr Sunoor Verma: Rwanda is a remarkable example of a country that has transformed itself from a low-income, post-conflict country to a high-performing economy in just two decades. One of the key drivers of this transformation has been Rwanda’s focus on agricultural development.
Rwanda has invested heavily in agriculture, both in terms of infrastructure and technology. The country has built a network of irrigation canals and dams and introduced new technologies such as drip irrigation and solar-powered pumps. This has helped to increase agricultural productivity and reduce vulnerability to drought.Rwanda has also invested in agricultural research and development. The country has established several agricultural research centres and partnered with international organisations such as the International Maize and Wheat Improvement Center (CIMMYT) to develop new varieties of crops resistant to pests and diseases.
In addition to infrastructure and technology, Rwanda has also focused on good governance and gender equity in agriculture. The government has put in place many policies to promote women’s participation in agriculture and has also made efforts to reduce corruption in the agricultural sector.
As a result of these investments, Rwanda has achieved significant progress in agricultural development. The country’s agricultural output has doubled in the past two decades, and poverty has been reduced by half.
Nepal can learn a great deal from Rwanda’s experience in agricultural development. Nepal is also agro-based, facing many of the same challenges as Rwanda. However, Nepal has the potential to achieve similar results if it invests in infrastructure, technology, good governance, and gender equity in agriculture. I am confident that Nepal can follow in Rwanda’s footsteps and transform into a high-performing economy. It is only a matter of commitment and determination.
For a country like Nepal which is quite similar to Rwanda as it has faced many transitions in the political system, it is now a democratic country experiencing several changes in the political system. So in your view, what aspects of Rwanda’s governance leadership and policies can benefit countries like Nepal facing similar political changes
Dr Sunoor Verma: I have been impressed by Rwanda’s progress in recent years, and I believe that the country has much to offer other developing countries facing similar political changes.
One of the most striking things about Rwanda is its political vision. The government has a clear and long-term plan for the country and has been able to implement this plan effectively. This is in contrast to many other developing countries, which often have frequent changes of government and lack a clear vision for the future.
Another critical aspect of Rwanda’s governance is its political stewardship. The government has channelled international support and technical assistance in a way that has benefited the country as a whole. This contrasts with many other developing countries, where international aid is often fragmented and does not reach the people who need it most.
Finally, Rwanda has made significant progress in gender equality. This contrasts with many other developing countries, where women, including Nepal, are still underrepresented in decision-making roles.
I believe these three aspects of Rwanda’s governance can benefit other developing countries facing similar political changes. If these countries can create a clear vision for the future, channel international support effectively, and promote gender equality, they can achieve significant progress in their development.
I am particularly passionate about the issue of gender equality. I believe that when women are empowered, they can make a real difference in the development of their countries. Rwanda is an excellent example of a country that has benefited from gender equality. I hope other developing countries will follow Rwanda’s example and allow women to lead their societies.
As you said before, Rwanda has garnered a lot of tourist attention. Nepal is also a little bit inclined towards tourism development. It is trying to develop more tourism in the country. It has more tourist attractions than Rwanda, but still, it is not as successful as Rwanda. So what could be the cause behind it and what steps can Rwanda take, and what methods that Rwanda has applied can be applicable in Nepal in developing the tourism sector?
Dr Sunoor Verma: Nepal is a beautiful country with a lot to offer tourists, but it has not been as successful as Rwanda in attracting tourists. If we analyse how Rwanda has achieved this feat of attracting high-value, high, spending tourists, we will find that the answers lie in good governance, branding, and infrastructure.
Good governance: Rwanda has a reputation for being a well-governed country with low levels of corruption. This is important for tourism, as tourists want to feel safe and secure when they travel. Lesson number one- Corruption deters high-spending tourists from visiting a country.
Branding: Rwanda has done an outstanding job branding itself as a tourist destination. The country is known for its gorillas, beautiful scenery, and friendly people. The lesson, Two: Political and economic instability is not conducive to solid branding.
Infrastructure: Rwanda has invested heavily in infrastructure, such as roads, airports, and hotels. This makes it easy for tourists to get around the country and enjoy their visit. Lesson, Three: infrastructure for safe connectivity and secure accommodation is critical.
In addition to these three areas, Nepal can also improve its tourism sector by addressing the following issues:
Gender equality: Nepal has a long history of gender inequality. This can deter female tourists from visiting the country. Nepal needs to do more to promote gender equality and to create a more welcoming environment for female tourists.
Tourism education: Nepal needs to invest in tourism education. This will help to create a more skilled workforce in the tourism sector and will also help to raise awareness of the importance of tourism.
Sustainable tourism: Nepal needs to develop sustainable tourism practices. This will help to protect the environment and to ensure that tourism benefits the local community.
I believe that Nepal has the potential to become a significant tourist destination. However, it needs to address its challenges to realise its full potential.
Lastly, what do you think, methods or formulas Rwanda used to be this successful within two decades? And how would you compare their political system and their development with Nepal’s development?
Dr Sunoor Verma: I have been working in international development for over 20 years and have seen many countries progress, but Rwanda is one of the most impressive success stories. In just two decades, Rwanda has transformed from a country ravaged by genocide to a thriving and prosperous nation.
Many factors have contributed to Rwanda’s success, but I believe that the following are the most important:
Evidence-based decision-making: Rwandan leaders have committed to using evidence to guide their decisions. This means that they have invested in research and analysis and are willing to change course if the evidence shows that they are on the wrong track.
Political will: Rwandan leaders have shown a strong commitment to development. They have made it a priority to improve the lives of their citizens, and they have been willing to make difficult decisions to achieve their goals. There appears to be an agreement among the politicians of Rwanda on a common minimum national interest agenda.
Gender equality: Rwanda has made significant progress in gender equality. Women comprise more than half of the parliament, leading in all aspects of society. This has helped to create a more just and equitable society, and it has also contributed to economic growth.
Public participation: Rwandan leaders have committed to public involvement. They consult with citizens regularly, and they are responsive to their feedback. This has helped build trust between the government and the people, making it easier to implement reforms.
Finally, the Rwandan leadership has maintained stewardship of its National Development agenda and has not allowed foreign interference while being open to considering global best practices.
Leadership communication skills are essential for any leader who wants to be successful. They involve the ability to speak clearly and concisely, to connect with an
audience, and to persuade them to your point of view. By analyzing speeches broadcast on audio-visual mediums, we can gain insights into how leaders communicate and use their communication skills to persuade and connect with others. This can be helpful for anyone who wants to improve their #leadershipcommunication skills.
India’s Prime Minister, Mr Narendra Modi, delivered a master class in political #LeadershipCommunication in parliament on August 10, 2023, when a no-confidence resolution was presented against his administration. Mr Modi accused the opposition of having no faith in India, believing those who mocked the country, and being arrogant and incompetent. He also stated that the more they tried to stop him, the more successful he became.
Here is my analysis of Mr Modi’s masterclass.
A combo of leadership & strategic communication
Mr Modi’s speech was effective in several ways. First, Timing: First and foremost, it was well-timed. The no-confidence resolution was introduced two days after Mr Modi’s party, the BJP won the municipal by-elections in Gujarat. This allowed Mr Modi to capitalize on the BJP’s momentum and depict the opposition as out of touch with the country’s spirit. As a result, this speech can also be classified under #StrategicCommunication.
Second, Arguments: Mr Modi’s speech was well-thought-out. He emphasized the government’s accomplishments in the economy, infrastructure, and social welfare sectors. He also accused the opposition of being to blame for many of the country’s problems, such as corruption and communalism.
Third, Delivery: Mr Modi addressed his remarks with passion and conviction. He addressed the people personally and stated unequivocally that he would not back down from the opposition’s challenges. This added urgency and enthusiasm to his address, which helped energize his followers.
How He Used Rhetorical Devices to Connect with the Audience
Mr Modi utilized a variety of rhetorical tactics in his speech. Here are some concrete examples:
Ethos: Mr Modi appealed to the audience’s patriotism by discussing India’s accomplishments and accusing the opposition of being unpatriotic.
Pathos: Mr Modi played on the audience’s emotions by speaking about the difficulties that regular people endure and blaming the opposition of being to blame for these difficulties.
Logos: Mr Modi used facts and data to support his statements about the government’s accomplishments.
Mr Modi also used other rhetorical tactics in his address, including humour, repetition, and contrast. He effectively employed these techniques to connect with the audience and present his point of view.
Modi’s Hindi Skills Gave Him an Advantage in the No-Confidence Motion
Mr Modi’s grasp of Hindi was a significant asset in the no-confidence vote. Despite being a non-native speaker, he could communicate with his audience in Hindi fluently and confidently. In contrast, his opponents were not fluent in Hindi and frequently made errors. This enhanced Mr Modi’s credibility and intelligence, giving him an advantage in the argument.
How He Synced His Body Language with His Verbal Messages
Mr Modi’s body language, in addition to his rhetorical abilities, contributed to the effectiveness of his speech. He conveyed confidence, authority, and determination through various nonverbal cues.
Eye contact: Mr Modi made intense eye contact with the audience throughout his speech. This showed that he was confident and in control.
Posture: Mr Modi stood tall and upright throughout his speech. This gave the impression of strength and power.
Gestures: Mr Modi used several gestures to emphasize his points. For example, he would often point his finger to make a point or spread his arms wide to show his confidence.
Facial expressions: Mr Modi smiled often and looked friendly and approachable. This made him seem more relatable to the audience.
Mr Modi’s body language matched his spoken statement, resulting in a dramatic and compelling effect. His determination and confidence were contagious, and they rallied his parliamentary group.
Here are some specific examples of how Mr Modi’s body language worked in his favour:
When he talked about India’s accomplishments, he would proudly lift his palms in the air and smile. This demonstrated his pride in India’s success and optimism about its future.
When he accused the opposition of being unpatriotic, he would shake his head and point his finger at them. This demonstrated that he was angry with them and did not trust them.
He would drop his voice and sound worried when discussing the difficulties that everyday people experience. This demonstrated that he was sympathetic to their situation and determined to assist them.
How He Used His Attire to Project an Image of Power and Confidence
Mr Modi’s outfit also contributed to his image of power and confidence. The white kurta-pyjama represents purity, but the Nehru jacket represents power and authority. This confluence of symbols aided Mr Modi in projecting an image of a strong and capable leader who was in touch with the people. His formal dress made him appear more powerful and in charge when he accused the opposition of being out of touch with the people. Similarly, as he discussed India’s accomplishments, his immaculate dress made him appear proud and confident. On the other hand, his projected opponent wore a white half-sleeve shirt that conveyed informality and casualness.
How He Played on the Weaknesses of His Opponents
In addition to Mr Modi’s own rhetorical abilities and body language, his opponents’ poorly constructed speeches also aided him in defeating the no-confidence motion. The opposition leaders spoke in a rambling and nonsensical style, making them appear weak and ineffective. They did not attempt to engage with Mr Modi’s views. This gave their speeches the appearance of rage, undermining their credibility and making Mr Modi’s speech appear more persuasive.
The reason why Mr Modi’s speech in the Indian parliament on August 10, 2023, was a masterclass in political #leadershipcommunication is because ultimately the proof is in the pudding- Mr Modi defeated the no-confidence motion with a compelling margin.
Dr Sunoor Verma is an expert in advocacy and strategic leadership communication. During the COVID-19 pandemic, Dr Sunoor provided in-person crisis, risk, and leadership communication training to over 300 Nepalese parliamentarians on behalf of WHO. He also coached four Ministers of Health and four Ministry of Health spokespersons in strategic and crisis communication.
Dr Sunoor has advised WHO, UNICEF, UNHCR, UNDP, ECMI, and their leaders in developing sophisticated coalitions, successfully communicating, and inventing out-of-the-box solutions in development and humanitarian settings. He has also collaborated on international relations, global health, and conflict resolution programmes with Boston University, the University of Geneva, and Cambridge University. Dr Verma coaches and advises elected officials and technocrats in practical science and crisis communication as part of his leadership communication practice.
A call to active lifestyle by Singapore health authorities.
How can a small island nation with a multi-ethnic and multilingual citizenry and four official languages become a global champion in health communication? The answer is to use scientific evidence effectively, to be proactive in responding to evolving trends, to employ many communication channels, and to tailor messages to diverse audiences. And the country with this extraordinary feat will be 58 on August 9, 2023. It’s #Singapore!
Singapore’s demographics are rapidly shifting, posing significant challenges for the country’s health systems. The population is ageing, with the median age anticipated to reach 49 by 2030, as is the proportion of people suffering from chronic diseases. While many chronic diseases can be avoided or delayed, they are expensive to treat when they do develop. Singapore has a higher suicide rate than many other countries, and mental illness is stigmatized. Similarly, the prevalence of obesity rates in Singapore is rising, especially among children and adolescents. And Singapore is addressing all these head-on.
During my visits to Singapore, I can’t help but see behaviour change signals everywhere, some subtle and some direct. Singapore’s health authorities appear to be working on a war footing to confront emerging health concerns by investing in exceptional health communication.
As a strategy and leadership communication professional, I consider Singapore’s approach to be an accurate implementation of “Health is a Human Right” and “Health in All Policies.”
When I decipher Singapore’s magical public health communication formula, I discover the following precious principles:
One, Audience: Understanding your audience is essential to any public health communication strategy. Who are you targeting? What are their concerns? What drives them? After knowing your audience, you may personalize your message. However, this requires leaving your cosy offices and connecting with people in their homes or workplaces. Public health authorities must likewise give up the idea that they know what’s best for people.
Two, Relevance: your message should address your audience’s worries. They should care about it and recognize how it affects them. In contrast to Singapore, which determines its agenda with limited foreign intervention, low-income countries frequently follow the priorities of their international donors.
Third, Credibility: your message should be founded on solid evidence and originate from a reliable source. As in Singapore, this is made possible by multi-sectoral collaboration. Four, Engagement: your message should be engaging and thought-provoking to captivate your audience. It should inspire curiosity and action. Five, Simple messaging: Your message should be easy to understand and avoid jargon and technical terminology.
Singapore’s health communication formula also includes using a variety of mediums to engage people, such as print, television, radio, social media, and public events. Use humour and storytelling to connect with your audience. Track your public health communication campaign’s performance to see what works and what doesn’t, as this helps campaigns improve over time.
Collecting feedback from audiences on health messaging is critical to improving campaigns.
Singapore has many public health successes. Singaporeans’ rising Type Two Diabetes rate prompted the 2016 “War on Diabetes” campaign. The 2015 “National Steps Challenge” to promote physical activity saw fivefold participation by 2018. The government has created an extensive initiative to support firms of all sizes in obesity prevention and management, chronic illness management, mental health, and smoking cessation.
Singapore’s health initiatives’ interconnectedness is their beauty. The government works with the urban planning sector to design localities that encourage physical activity; with the transportation sector to promote public transportation and make it easier for people to walk, cycle, and use active modes of transportation; with the education sector to promote health education in schools and create a healthy school environment; and with the workplace sector to encourage healthy workplaces.
By linking its public health programs with other vital sectors, Singapore has created a more holistic approach to health promotion that benefits the entire population.
Understanding that communication is a means to an end is critical to Singapore’s health communication success. Singapore’s health communication programmes are proactive, evidence-based and serve measurable health objectives—infrastructural investments back health campaigns. To give Singaporeans a place to exercise, relax, and mingle this “Planned City” features government-built 59 regional and 271 community parks. They usually have running, cycling, and inline skating paths that link to nearby parks. Parks have many outdoor workout stations. The government also provides healthcare subsidies. This guarantees quality health care for all.
Leadership by example is also a part of Singapore’s health communication strategy. It sends a strong message to the public that healthy living is essential when Singaporean leaders and top civil servants follow what they preach. This encourages better choices. Singapore’s leadership communication strategy frequently includes health and lifestyle messages, demonstrating their importance as a national priority.
What also helps is that Singapore has traditionally had stable governments with enough majority to expedite health-related legislation. The other significant and rare advantages that Singapore enjoys are – one, Singapore has a long history of electing highly educated and trained science political officials, due in part to the country’s emphasis on education and its commitment to developing a knowledge-based economy and two, the presence of an impressive number of self-made female professionals in high-decision making roles. This is recognized to lead to better representation of women’s interests, more diversity of thought, and more decisive leadership.
Why are so few Asian countries able to reproduce the basic recipe for effective health communication a la Singapore? Because corruption, nepotism, or political and bureaucratic greed come in the way.
Singapore’s public health ambassadors are chosen for their health advocacy, not political connections. Singapore’s health promotion platforms are not chosen for personal profit. Similarly, posters and brochures are printed in proportion to audience size instead of commission. Health authorities in many developing Asian nations have piles of obsolete printed material rotting in their warehouses.
Singapore’s performance suggests good governance and low corruption are necessary for effective health communication. Transparency International‘s Corruption Perceptions Index 2022 ranks Singapore fifth least corrupt country out of 180 nations. In 2023, the Chandler Institute of Governance ranked Singapore top in good governance, ahead of Switzerland, Finland, Denmark, Norway, Sweden, the Netherlands, Germany, the UK, and New Zealand.
International development and philanthropic health programmes in low-income countries need to learn from Singapore’s health communication excellence. In the absence of national-level good governance and the presence of high corruption perception among the population, investing in public health communications is bound to yield poor returns.
Donor funding for health communication is highly susceptible to corruption, causing anger over “failed” health promotion efforts and raising questions over donor credibility. So, unless international donor-development agencies want to mainly boost a country’s t-shirt, flex, and poster printing business or provide politicians with a health platform for self-promotion, the funding of health communication portfolios should be carefully reviewed.
Dr Sunoor Verma is a global health diplomat-practitioner specializing in strategic partnerships, high-level advocacy, and strategic leadership communication. He has supported the work of WHO, UNICEF, UNHCR, UNDP, ECMI and their leaders in building complex coalitions, communicating effectively and devising out-of-the-box solutions in development and humanitarian settings. He has also worked with Boston University, the University of Geneva and Cambridge University on programs that intertwine international relations, global health and conflict resolution.
Over-communicating health- can it ever be counterproductive?
We seem to be over-communicating health in the aftermath of COVID-19 and now run the risk of making our communication ineffective the next time a health emergency arises. The miracle of antibiotics, when prescribed appropriately, is best known to the patient whose condition starts improving quickly. However, this does not mean antibiotics are the solution to every illness. If given indiscriminately, the damage can be vast and irreversible. Similar is the case with health communication.
The risk of communication fatigue
While the pandemic showed the necessity of public health communication, it may now be causing communication fatigue among the public. It is essential to review the frequency and volume of health communication. COVID-19 taught governments, health organisations, and public health professionals how to communicate complicated scientific knowledge to the public in an understandable and actionable manner.
In the public interest, centre stage was provided to the World Health Organisation (WHO) to be the lead UN spokesperson on COVID-19. The UN Secretary-General showed admirable discipline in ensuring that Dr Tedros, the Director General of the WHO, leads the UN in critical communication during the pandemic. Health has been at the heart of every important policy debate over the last two years. The audience’s attention gained on the importance of human and animal health can be easily lost if strategic choices are now not made on how much to communicate and what to communicate on health.
In 2020, WHO coined the word Infodemic to describe an outbreak of information, disinformation, rumours, and fake news. Now it seems critical that international health actors do not turn into perpetrators of Infodemics, especially in the context of countries.
Endless marking of health days- risk of losing public trust and credibility
The point is that for each of these special days, we see events being organised with elaborate ceremonies, the printing of banners, posters, selfie stands, speeches, t-shirts, standees and most troubling- an avalanche of social media posts with reminders on the importance of whatever is being celebrated. This country level health-Infodemic which I call “HelDemic”, is not limited to the digital space but is also sucking up the valuable time of policymakers and health workers and generating tons of plastic waste.
A lack of interest and compliance is one of the critical concerns of communication fatigue in public health communication. When people are continually bombarded with a lot of information and messaging, they may get desensitised and tune it out. This might lead to a lack of incentive to adopt healthy behaviours or follow public health norms, perhaps increasing disease spread.
Corrective action and celebration triage is needed urgently!
Disease burden and national strategic plans should guide the choice of three to five health days to mark in a year. An uninterrupted barrage of visuals of inaugurations, closing ceremonies and speechmakers on social media is not the best health communication investment and risks reducing the credibility of those seen engaging in this. Effective communication strategies, such as using a variety of communication channels and formats, can help prevent communication fatigue and promote healthy behaviours. Choosing to tone down communication and spacing is also a wise strategy.
Between the devil and the deep sea- tough choices for the poor
This is easier said than done, especially in countries that rely heavily on foreign aid to fund critical services like healthcare. Public employees in these countries are often needed to attend meetings and such events with international donors to seek financing, manage projects, and report on progress. While working with international donors is vital to get funding and promote development programs, there are significant risks involved with public officials becoming overly focused and exposed to ceremonial roles and not being seen in critical policymaking.
Post-COVID-19, the way countries have rolled back special measures like mandatory mask usage, pre-departure forms, and media briefings, it is time to tone down public health communication. The audience needs a breather. There is an urgent need to shift to strategic health communication to achieve focused public health objectives. This approach requires a deep understanding of the local context, the target audience, and the social, cultural, and economic factors that impact health behaviours. Unfortunately, most international health actors are in shortage of talent with the capacity to do this. Worse is the fear that they may not see this need until the next health emergency knocks at our doors.
Time to cut down the noise and deliver solid results!
The globe is falling short of meeting the targets for the health-related Sustainable Development Goals 2030. However, if governments are to meet these targets, they must prioritize policies and execution while reducing general health communication surrounding health days, events, and celebrations. It’s time to turn down the volume and avoid health communication burnout!
Dr Sunoor Verma is a global health practitioner. He has advised WHO, UNICEF, UNHCR, HUG-Geneva and Cambridge University on Strategy, Leadership Communication, Advocacy and Resource Mobilization. He is credited with setting up WHO’s communication portfolio from scratch in Nepal in the midst of COVID-19. He has set up and led the country and regional operations for the European Centre for Minority Issues in the Balkans. He has supported track two peace processes in Macedonia, Kosovo and Sri Lanka and emergency response to the Tsunami, Avian Influenza and COVID-19. He has taught Global Health at Boston University. He has curated partnership initiatives with Macedonia, Kosovo, Germany, Switzerland, Australia, and Nepal parliamentarians. He divides his time between the foothills of the Jura Mountains in France and Buddhanilkantha in Nepal.
Interview with Dr Sunoor Varma
