Entertainment-Education for Better Health

• Key Points
• Why Use Entertainment- Education?
• How Can Entertainment-Education Influence Behavior?
• From Drama to Games: A Range of E-E Formats
• Budgeting for Entertainment-Education
• Investing in Mass Media: Getting the Most for the Money
• An Approach to Managing Production
• Checklist for Producing an Entertainment-Education Drama
• Web Table 1: Results of 11 Entertainment-Education Radio and Television Dramas for Family Planning/Reproductive Health, 1993-2004
• Bibliography
• Subscription and Ordering Information
• Credits

Country, Program & Year (Ref. No.)

Family Planning/Reproductive Health Messages

Description

Selected Results

Bangladesh

Shabuj Chhaya (Green Shadows)
TV serial drama,
13 30-minute episodes

2000

(8, 30, 76)

• Use clinics, especially those displaying Green Umbrella logo
• Newlyweds should consider using family planning
• Care for people with HIV/AIDS
• Treat female health workers with respect

A doctor helps people in a village fulfill hopes and deal with crises while introducing health issues such as immunization, antenatal care, treatment for diarrhea, family planning, HIV prevention, and compassionate treatment of people with AIDS.

More than 25 million viewers

Use of family planning, visits to clinics, and knowledge of HIV/AIDS higher among viewers than among nonviewers.

More than 600,000 fan letters received.

Ethiopia

Yeken Kignit (Looking Over One’s Daily Life)
radio serial drama,
257 episodes

2002–2004

(11, 87)

• Prevent HIV/AIDS
• Motivate family planning use and communication between spouses
• Discourage marriage by abduction
• Encourage education of daughters

One storyline follows a young woman whose father keeps her from school and arranges her marriage. She is raped and abused by her husband. She leaves him and remarries. She uses family planning to recover her strength. Some family members approve of this. Others object.

Among married women of reproductive age, listeners were more likely to be using a modern contraceptive than nonlisteners.

The drama helped to motivate women and men to be tested for HIV. Among men, 28% of listeners had been tested compared with 7% of nonlisteners.

Ethiopia

Journey of Life
radio serial drama,
26 20-minute episodes

2001-2002

(33, 43, 76)

• Plan families
• Prevent HIV infection
• Quality of life is better for small families
• Treat women as equals

Askale, a policewoman, and her husband use family planning despite pressure from relatives for more children. Subplots deal with HIV risk faced by a married couple and by a single woman, Askale’s sister, who is attracted to several men.

90% of regular radio listeners heard the drama.

79% of people who heard the drama correctly recalled storylines.

93% of people who recalled content reported changed behavior, such as accepting and caring for people with AIDS and becoming active in the community to help prevent HIV infection.

Índia

Tinka Tinka Sukh
(Happiness Lies in Small Pleasures)
radio serial drama,
104 episodes, twice a week

1996-1997

(70)

• Small families live well.
• Women should be treated equally and allowed equal participation in work and community affairs.
• Dowry and child marriage are harmful to women.

Traditional life in a village is upset by two deaths. A child bride dies giving birth, and a recently married woman kills herself when her husband’s family abuses her because of a small dowry. One family portrays an ideal of gender equality, and another, the traditional practice of favoring sons over daughters.

About 40 million people listened in the broadcast area of north India.
Social change found in one village of 7,500 people chosen as an evaluation site: A group formed to stop dowry and child marriage, and education of girls increased.
Half of listeners surveyed said they had talked to their spouse about family planning (44 of 88); more than half (55 of 88) talked about gender equality.

Índia

Jasoos Vijay (Detective Vijay)
TV drama series,
120 30-minute episodes

2002-2003

(96, 102)

HIV prevention:

• Be informed about HIV
• Use condoms
• Talk to your spouse
• Treat women equally
• Practice healthy life skills

Each month “Detective Vijay” solves a case, provides information about HIV/AIDS, and addresses a related issue such as the status of women, domestic violence, or alcohol abuse.

Significantly better scores on questions about HIV knowledge, perceived risk of HIV, and interpersonal communication among people who recalled drama compared with those who did not.
No difference in score for positive gender attitude.
Significant difference in condom use: 11% of people who recalledthe drama used condoms consistently compared with 6% of those who did not recall the drama.

• Cost per person who:
• Increased condom use: US$2.49
• Increased HIV knowledge: US$2.25
• Increased interpersonal communication: US$2.78

India

Taru radio serial drama,
52 episodes;
folk theater;
listening groups

2002-2003

(97)

• Treat women equally
• Consider the benefits of a small family
• Protect your reproductive health
• Accept different castes
• Work to improve your community

Taru is a young woman working for an NGO that promotes reproductive health. She is upper caste and is friendly with a lower-caste man.

20 to 25 million listeners.
Percentage of listeners intending to change behavior because of Taru increased from 61% in April 2002 to 83% in November 2002, demonstrating cumulative effect of exposure to the series.

Nepal

Cut Your Coat According to Your Cloth radio serial drama,
52 15-minute episodes in 4 series

• Use modern family planning methods—especially couples with unmet need
• Spouses and health care providers should pay more attention to women’s health and treat women with more respect

A couple plans the size of their family so they can provide food, shelter, health care, and education for their children. The couple receives help from a health care provider. Husband and wife model skills in communicating with each other and with the community.

Significant increase in contraceptive use, 1994-1997: Women: 36% to 43%; men: 44% to 53%

Women with greater exposure to series were more likely to be using contraception than unexposed women.

Service Brings Reward radio serial drama providing distance learning for health care providers

Radio spots
Jingles
Print materials

Locally organized listening groups, street theater

1995-1996

(109, 110)

Health care providers model good counseling in drama and distance learning.

Health care providers improved knowledge, attitudes, and skills: for example, knowledge of counseling techniques increased from 5 correct questionnaire answers at baseline to 13 of a maximum 24. Listeners demonstrated better counseling skills than nonlisteners.

Tanzania

Twende na Wakati (Let’s Go With the Times) radio serial drama broadcast twice each week
1993-1998

(11, 86, 94, 118)

• Plan your family
• Protect yourself against HIV

Characters model good and bad behaviors for family planning and HIV prevention. For example, a couple discusses family planning and decides together to use a method. A promiscuous truck driver does not use condoms and becomes infected with HIV.

Among listeners surveyed in 1997:

• 61% said they had discussed the program with others, up from 48% in 1994
• 24% said they had started using family planning as a result of the drama, up from 20% in 1994

12% had adopted an HIV/AIDS prevention behavior after listening to the drama (compared with 1% of nonlisteners in a comparison area).

Cost per person who:
--Started using family planning: US$0.80
--Adopted an HIV prevention behavior: US$0.08

Zinduka! (Wake Up!) radio serial drama, 52 episodes broadcast twice each week
1993-1994

(4, 41)

• Family planning is good for your health
• Have the number of children you can afford
• Talk to your spouse about family planning
• Contraceptives are effective and safe

A man is unable to provide for his eight children, parents, wife, mistress, and the mistress's child.

• Women who heard Zinduka were significantly more likely than nonlisteners to have discussed family planning with their spouses, visited a family planning clinic, and to be currently using a method.

South Africa

Soul City IV
13-part TV drama
45-part radio serial drama
Booklets distributed in newspapers

1999

(36, 107, 115)

• Wife abuse is wrong
• Communities should not tolerate wife abuse
• Condoms help protect against HIV infection.
• Communities should accept and care for people with HIV or AIDS
• Young people can control their sexual urges and still be healthy.

• An abusive husband beats his wife so severely that she miscarries.
• Neighbors bang pots when they hear a man beating his wife.
• A women finds that she has HIV despite being faithful to her husband.

• 17 million people saw TV, radio, or print materials. Compared with people who had not seen the campaign, they were more likely to say that communities should not tolerate abuse.
• More exposure to the series had a significant effect on condom use and discussion of HIV with spouse and friends.

South Africa

Tsha Tsha
Weekly TV serial drama

2003-2004

(39, 49)

• Improve attitudes towards people living with HIV/AIDS and reduce stigma
• Increase HIV-prevention practices
• Increase use of voluntary counseling and testing services

Two story lines: A young man nurses his mother, who is dying of AIDS. A pretty, wealthy woman finds that she has HIV and struggles to tell her friends and family and to adopt a positive attitude.

• Estimated 1.8 million viewers
• Viewers with good recall of the drama were compared with matched group with low or no recall. Significantly higher percentage of good-recall group reported HIV-prevention practices such as abstinence for a month or more, monogamy, having sex less often, condom use to prevent HIV, and condom use at last sex.
• Cost per person reached: US$0.55