Farha Marfani

Photo of Farha Marfani

Account Executive
Washington DC
Posts: 6

Farha is a former Account Executive at Ogilvy PR.

The Fight Against Polio: Health Communication Lessons from India’s Success

Apr 24

“Polio can be stopped when countries combine the right elements: political will, quality immunization campaigns and an entire nation’s determination. We must build on this historic moment and ensure that India’s polio program continues to move full-steam ahead until eradication is achieved.” – Bill Gates

Indian child receiving oral polio vaccine dropImage credit: Gates Foundation, Flickr

Earlier this year, the global health community was witness to a huge achievement, which involved overcoming one of the world’s historic public health challenges. This past January, India recorded a full year without a new case of polio, moving it one step closer to being officially removed from the list of four countries where the disease remains endemic. The other three countries are Nigeria, Afghanistan, and Pakistan. As a Pakistani-American and with a family member who has a form of polio, I am personally fascinated by this public health success and the lessons that we, as social marketers and public health communicators, can glean from this monumental effort.

Polio is a highly infectious viral disease, mainly affects children under five years of age, and leads to irreversible paralysis. While it cannot be cured, it can be prevented through drops of oral polio vaccine given to children under five years of age. As long as a single child remains infected, children in all countries are at risk of contracting polio.

In 1988, at a time when the virus was paralyzing 1,000 children around the world every day, half of them in India, the World Health Organization, Rotary International, the US Centers for Disease Control and Prevention, and the United Nations Children’s Fund launched the global campaign to eradicate polio.  In 1995, after garnering political will, support and manpower, India began its mass vaccination campaign, but volunteers were faced with skeptics and rampant rumors that the polio vaccine caused illness and infertility and that the vaccination campaign was a Western conspiracy to curb the growth of Muslims. Thus began a massive public education and advocacy campaign that focused on building confidence and credibility in the polio eradication initiative.

Early on in the initiative, it became clear that information alone is not sufficient to encourage behavior and social change. A paper in the Bulletin of the World Health Organization outlines key strategies and lessons learned from polio eradication efforts in India and Pakistan, which continue to tackle deep rooted religious, socio-cultural and political resistance to eradication:

  • Engage influencers as spokespeople. The polio campaign gained the support of religious and community leaders, who became strong community allies and were able to convert their communities. Messaging was infused into religious sermons and mosque announcements to reach community members, and Imams (religious leaders) welcomed families to vaccination booths.
  • Carefully segment the target audience and reach them through interpersonal communication. With the backing of community leaders, the campaign targeted women and female caregivers, the primary decisionmakers on child health. Trained female health workers were able to convey the safety, efficacy and benefits of the vaccine.
  • Location, location, location. Take the product to the audience.
    In addition to a house-to-house strategy, vaccination booths were set up across the country. Taking into account constant migration, booths were also set up at train and bus stations and border posts to ensure that hard-to-reach children, including those of migrant workers, were vaccinated.
  • Constantly monitor and track data. A disease surveillance system facilitates case reporting and enables swift responses if a case is found. Volunteers set out every day to examine babies and collect stool samples for testing. Health centers, doctors and even spiritual healers are trained to report the first sign of symptoms that might indicate polio.

 
The routine monitoring of epidemiological data and disease surveillance is especially important to ensure full eradication of the virus. India will not  be certified completely polio-free until it goes at least three full years without a case. On the race to wipe out a fatal disease ingrained in the country’s history, it is nearly at the finish line.

Although the campaign has been successful — testament to its strategic and synergistic communication efforts — it has also been controversial. Some argue that the campaign is narrow-minded; that it is only focused on eradicating polio, to the detriment of other pressing public health issues in the region, such as malaria, malnutrition, and maternal health.

Still, India’s success serves as a blueprint for other countries, motivating them to use the same model to tackle other critical public health challenges. The world awaits for Nigeria, Afghanistan and Pakistan to follow in India’s footsteps and achieve a similarly successful outcome.

What are your thoughts on this global health communication effort? What other lessons can we learn?

Utilizing Digital Channels to Reach Those “‘80s Babies”

Feb 07


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Utilizing Digital Channels to Reach Those “‘80s Babies”

No matter what we call them, we are reaching out to them more and more, especially in social media. Who are they? What are they doing online? What is the best way to reach them?

Minorities Favor Government Using Social Media

Aug 19

I recently came across a study by the Pew Internet and American Life Project, which discusses how Americans use government Web sites, and how social media can be integrated into the government’s online presence. The study is over a year old, but given that in the past year alone, social media has sparked social, cultural, and in particular, political revolutions, the findings are still timely. According to this study (which is loaded with information), the government’s role in the online space, and in particular, the social media space, is sure to resonate with its constituents, and especially its minorities.

One finding which particularly struck me was the conclusion that minorities are equally likely to get government information using digital platforms and furthermore, that African Americans and Latinos, compared to whites, are more likely to express positive attitudes towards  government engagement in social media.  Check out this video by study author Aaron Smith, Research Specialist at the Pew Internet and American Life Project, who briefly explains.

While the study does note that the average government Web site user is affluent, highly educated and White, minorities do still use the internet and social media to obtain government information. In fact, minority Americans were more likely than Whites to believe that government social media outreach makes the government agencies and officials more accessible.

For social marketers who search for the best ways to reach their audiences, and for those of us who work on government campaigns, we can use studies like this to reassure, and encourage, our clients that social media is a viable and valuable option to reach our minority audiences.

The findings are not too surprising, given recent studies that mention that the digital divide is now decreasing, and that more people are now able to get online.  But, what’s interesting is the extent to which we embrace social media, so much so, that we’re encouraging our government to collaborate with us in this way. And, according to the report, Americans don’t believe the government is wasting money by using social media. (Surprising, I know).

So, what are some ways that the government can strike a chord with minorities? Well, for starters, begin blogging, friending, and tweeting.

New USDA Food Plate Replaces Pyramid

Jun 07

Last week, the USDA unveiled its new visual nutrition guide – a food plate, which replaced its obtuse and often hard to understand food guide pyramid. According to the food guide pyramid, servings of grains should make up the most of the food that we eat. This is no longer the case in USDA’s new nutrition guidelines.

Grains make up only a quarter of the food plate. Fruits and vegetables make up half of the food plate, protein is a smaller quarter of the plate, and dairy is placed off to the side. This suggests that most of the food we eat should be fruits and vegetables. This wasn’t so clear in the original food guide pyramid, which placed fruits and vegetables in the middle of the pyramid. Moreover, the pyramids assumed that we would know what a “serving” actually means. Who would have thought that a serving of meat equals the size of a deck of cards and a serving of fruit is the size of a tennis ball? The newer version of the food guide pyramid, which showed a person running up the side, didn’t make things any clearer.

Other messages, which accompany the food plate, refer to portion sizes, low sodium, sugar, and fat:

  • Enjoy your food, but eat less.
  • Avoid oversized portions.
  • Make half of your plate fruits and vegetables.
  • Make at least half of your grains whole grains.
  • Switch to fat-free or low-fat (1%) milk.
  • Compare sodium in foods like soup, bread, and frozen meals – and choose the foods with lower numbers.
  • Drink water instead of sugary drinks.

The new food plate has been well-received so far, compared to its precursor pyramid. Some mention that it is so simple that even children can understand its message. Also, the plate is a symbol which makes more sense as a visual guide referring to food.  It is now easier to “see,” just by looking at our plates, if we are following the nutritional guidelines. In fact, USDA invited Americans to post pictures of their individual food plates on Twitter, by using the hash-tag #MyPlate.

What are the implications of these new dietary guidelines and new visual for social marketers?

Well first off, this changes the nutrition messages that we promote, especially on behalf of our government clients.
But perhaps more importantly, this example shows that representing messages with simple graphics are more effective. Simple visuals are more memorable and salient, and crafting a graphic that directly relates to the topic at hand, instead of a graphic that misses the mark, is more likely to resonate.

What are your thoughts on the new food plate? Do you get excited when you can see that half of your plate really is filled with fruits and vegetables, or do you think that the new food plate will hardly make a difference in your diet?

Smart Listening Essential in Social Media – A Recap of the International Healthcare Social Media Summit

May 27

Last week, a couple of my colleagues and I had the chance to attend the International Healthcare Social Media Summit. We, along with over 150 people worldwide, joined the summit online via a livestream.

Hosted by GlobalHealthPR and convened at Spectrum Science in Washington, DC, the summit brought together social media and health communication experts and enthusiasts. The summit presented findings from social media research conducted around the topic of malaria  – what the current social media landscape on malaria looked like and how to get people online talking about malaria.

Before presenting the findings, GlobalHealthPR shared some interesting statistics on the growing use of social media and, shed some light on the growing importance of social media in developing countries. Most of us are already aware that at least one quarter of American adults use social media when seeking health information, but in Portugal, approximately 28% of people use the internet to search for health information. In India, about 45,000 people are joining social media networks daily, and in Mexico, the fasting growing sector of social media users are women over age 40!

GlobalHealthPR then introduced its social framework, which emphasizes the importance of “smart listening” to understand why people engage in social media and what value it adds, otherwise known as the “personal engagement proposition.” The framework also highlights that listening is part of an ongoing feedback loop to refine messages and engagement strategies. In addition, the social media principles (understand, add lots of value, leverage unique insights, and be open-minded) should be applied when considering and developing social media programs.

One unique insight that really hit me was the discussion of the fatalistic view of malaria and that this devastating disease is commonly seen as the common cold or flu, an illness that is inevitable. In fact, the study found that in high prevalent areas, malaria is seen as such and hence, social media interactions around the topic of malaria also reflect this view. In low malaria prevalent areas, the discussion on malaria is not social; the conversation revolves more around its science and disease epidemiology.   In order to establish a personal engaging proposition on the topic of malaria, the team suggested giving malaria personal relevance, encouraging experiences with malaria in the social space (creating personal stories is how I like to think about it), and establishing a sense of urgency (i.e. we need to take action now).

They were only able to arrive at these conclusions by engaging in smart listening. Sometimes, in order to be sure that you are engaging in smart listening, connecting with experts gives a sense of what keywords or “buzz” words to listen out for. So it’s important to be prepared to listen multiple times, even if that means listening in the physical space and then using what you’ve learned to better listen in the online space.

In the end, we realize that social media is just a tool to do what we’ve been doing for years, including advocating for a certain cause or getting people to change their behavior. We just need to ensure that we practice smart listening when considering social media conversations.

The video of the summit and the presentation slides are available for viewing online. Check them out here.

The Power and Influence of Emotion

May 06

Although humans are complex creatures, let’s face it – we are “cognitive misers.” We like to process information simply. And who can blame us, in this day and age of information bombardment, it is natural to place information in silos to help us better digest the content.  Sometimes we even ignore information, unless something pulls us in.

I personally am fascinated by the role that emotion can play in helping us become attracted to, and thus, better able to accept and use information to change our behavior. In fact, studies have found that emotional messages (those providing some appeal to our feelings) are more memorable than rational messages (those that ignore the emotional aspect and focus exclusively on providing technical information).

An interesting theory, popular in advertising, is Petty and Cacioppo’s elaboration likelihood model (ELM). When faced with information, the ELM asserts that individuals take one of two routes: the central route or the peripheral route. Those who take the central route have the motivation and ability to process the rational arguments presented, while those who take the peripheral route tend to not have the motivation and ability to process the information. So, those who travel the central route focus on the message content, such as the textual information, while those on the peripheral route pay more attention to heuristic cues such as colors and visuals.

Sounds a bit obvious, that when we really don’t care about an issue, we  may defer to other aspects of a message that may make us interested. But, taking a twist on the ELM,  if emotional appeals can serve as heuristic cues, then perhaps we will be more likely to process the technical aspects of the content.  Our emotional state will influence how we process the message and can even draw us in to become interested in the more technical, information-heavy message.

We have seen this in social marketing campaigns, and in my opinion, these campaigns have been very effective.  And I’m not just talking about using fear as an emotion. Even other emotions, such as pride, joy, gratitude, and even worry and anxiety can pull us in to absorbing a message. Check out this ad promoting seat belt use that Lauren Belisle includes in her post on traffic safety.

While social marketing has recognized the powerful role of emotion and have been open to letting their campaigns “wear their hearts on their sleeves”, I think in general, health communication can do more to ensure that when rational information is presented, for example, on a Web site, some emotional aspects are attached.

It seems like the role of emotion was discussed a fair deal in the recent World Social Marketing Conference. I’m still going through the materials; they’re finally posted online!, including Dr. Jose Mazzon’s presentation [PDF] on The Role of Emotions in Social Marketing. If you attended the conference, or even if you didn’t, what are your thoughts, or feelings (pun-intended), on emotions in social marketing and health communication?