An old Indian idiom says, ‘what you can win with a needle, you cannot with a sword.’ The crisis of corona times is emblematic of this truth — it’s a crisis of faulty communication strategies. The world woke up slowly to the corona crisis because China was not able to communicate quickly, the WHO did not do it convincingly, and in India, government health agencies are not doing it meaningfully.

Health belief models originated in the 1950s in the US, which describe how people make health-related decisions. According to the models, people’s perception of risk severity and their own efficacy are factors leading to preventive or corrective actions. Concentrated funding, validating, and programmes based on such models were done by international development institutions; the success stories include anti-smoking campaign and, in India, the vaccination programmes for TB and polio.

But many a time, money poured in, but never led to any measurable outcomes.

In India, like elsewhere in the world, the Covid pandemic risk is real — wearing a mask correctly can protect one from getting the virus, and getting vaccinated can reduce the severity of the illness. It’s simple enough as far as a message goes. So, what could be the problem with people masking up?

Tailored messaging

Local institutions are not taught to tailor the messages to context. Tailored messaging implies taking cognisance of the fact that people make informed decisions not based on global ideas but local factors. The absence of cultural context has been the hallmark of the US healthcare systems.

They spend a lot of NIH (National Institutes of Health) dollars on how to improve access to healthcare for minorities, immigrants, and diverse populations. The global mindset of large institutions, created by decades of believing in their own knowledge and expertise, translates into messages that reflect their own importance.

While in India people were not masking up, in the US, a large number, particularly the marginalised and who have distrusted the health system for long, did not show up for vaccinations. Last minute calls were made to fill up the empty slots. A large number of people don’t take flu shots because of the same reasons and the US also has anti-maskers and anti-vaxers, but these are a fringe group.

Decoding the population mindset is the key in fighting corona. A majority of Indians do not follow rules, nor do they listen to experts, which increases the risk and incidence of a disease that counts on people following rules and understanding instructions, especially in the short term. Those who live in dire poverty and extremely unhygienic conditions will have a low assessment of risk as compared to the middle-class and the wealthy.

Similarly, while lockdown became a dirty word, the communication about risk of corona to life lacked sting; fear of lockdown was communicated well by media outlets. Though India’s lockdown pushed contract labour into a crisis, it saved the country from total catastrophe.

Another phenomenon, drawn from non-Indian contexts, is using influencers. Communication research shows that if a popular film personality promotes a brand of clothes or a reputed journalist reports a crime/fraud, a certain demographic subset will be receptive. But how influential will a film star, doctor or friend be when it comes to asking one to mask up?

Finally, for a nation claiming a socialist mindset that leans on primary healthcare, Primary Health Centres (PHCs) haven’t been supported adequately, nor their staff trained in handling crises. TB prevention and BCG vaccine became central to our health policy, thanks to the intense directed public health communication from doctors and NGOs of free India.

It is time, therefore, to localise and re-appropriate cultural dimensions while messaging for better health. The message is always simple, but ensuring it connects with the audience is a complex process. This requires both knowledge and a deep understanding of the people one is addressing.

The writer is a change agent

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