Reviewed BookFalade, B. and Murire, M., eds. (2021).
Health communication and disease in Africa.
Singapore: Palgrave Macmillan, Springer Nature Singapore Pte Ltd.
What do you do if you are cooped up at home for months on end, as the editors were during the height of the COVID-19 lockdown in South Africa? Bankole Falade and Mercy Murire used the time constructively to conceptualize a body of work featuring African authors with novel ideas and perspectives on health communication. With their experience in public health communication and academia, the result is this book of African scholarship which fills a much-needed gap in health communication in Africa.
This arrangement of four hundred pages highlights broad themes of tackling stigma (5 chapters), beliefs and traditions (5 chapters) and rethinking approaches to health communication (3 chapters). Chapters are arranged in nine sections: Introduction, Conceptual approaches, Stigma and health, Risk perception and health, Reproductive health, Traditions and beliefs, Mental health, Communities, Western and indigenous communication, Religion and health communication, Conclusion.
The introductory section on health communication theories and communication development approaches in health provide a useful framework for the chapters that follow. Most chapters are bite-sized and easy to digest with clear references to the communication theories underpinning the research. Many of the essays are compiled as academic articles which is useful for students hoping to publish their own work. Authors are drawn from disciplines of physiology, anthropology, psychiatry, reproductive health, sociology, and communication from African countries including Kenya, Malawi, Morocco, Nigeria, South Africa, Uganda, and Zimbabwe.
The content is diverse and captivating, tackling topics such as fat acceptance in Africa (contrary to studies in developed countries where people with obesity may be perceived as ugly, lazy or lacking in self-control), prostitution as a survival tactic, belief systems of traditional birth attendants around pre-eclampsia, combating HIV stigma through gospel songs, radio as a medium for collective social change, the phenomenon of ‘selfitis’, COVID-19 and religion, and using indigenous knowledge and elder mentors to reduce teenage pregnancies.
Indeed, one of the highlights of this book is the weight it gives to indigenous knowledge systems and the need to consider cultural contexts. In Africa, alternative channels for health communication include dance, song, story-telling, masquerades, festivals, elder and townhall meetings which are particularly appropriate for rural communities or those who do not trust mainstream media sources. (See chapter 14, “Combating malaria in Nigeria’s rural communities through indigenous communication strategies”.)
While science communication has made great strides in moving beyond the minds and ‘ivory towers’ of scientists into the public domain, the book reveals the challenges facing health communicators: communication alone will not move individuals, communities, or societies into health-promoting behaviour. Humans are too complex for that! Differences in health behaviour are often a result of culture. As Airhihenbuwa and Obregon [ 2000 ] argue, “The differences in health behaviours are often the function of culture. Culture should be viewed as a strength and not always as a barrier. The metaphorical coupling of ‘culture’ and ‘barrier’ needs to be exposed, deconstructed, and reconstructed so that new, positive, cultural linkages can be forged.”
Approaches which recognise the social, cultural, and political contexts of the targeted population, and which overcome the barriers which constrain behaviour change, such as stigma and indigenous beliefs about health and illness, are more likely to succeed. For instance, chapter 6, “ Sinikithemba Gospel Group and the grassroots struggle against HIV/AIDS stigma in South Africa”, is a cogent, stirring account of the way in which music and documentary film can broaden the ways in which HIV/AIDS is regarded, helping to destigmatise it and provide dignity to those living with disease.
Actions across multiple levels of determinants are required for interventions to be effective. Participatory research and involving community voices (see chapter 13, “Collective change through mass media: engaging adolescent girls through interactive radio to promote AIDS-free communities in Kenya”) yields fascinating insights which strengthen the evidence-base for collective change. Many chapters reveal the need for further research on health behaviour and communication in the sphere of public health in Africa.
It is most unfortunate that this book was not proofread. Frequent grammatical, spelling and editorial errors could seriously detract from what is essentially a fascinating volume. Readers should also not be put off by the inclusion of very technical information on Alzheimer’s Disease in chapter 4, curiously the first chapter as one digs in past the Introduction and Conceptual approaches.
The book targets health practitioners, policy-makers, researchers, and students. Lecturers could also find this a valuable teaching tool for students of both public health and health communication. It is available as an e-book (€93.08) or hard cover (€109.99), and individual chapters are available to download for €24.95. Notably, though, the cost may be prohibitive for audiences in Africa.
Airhihenbuwa, C. O., & Obregon, R. (2000). A critical assessment of theories/models used in health communication for HIV/AIDS. Journal of Health Communication 5 (sup1), 5–15. doi: 10.1080/10810730050019528
Greer van Zyl has a Master of Public Health degree from the University of the Witwatersrand, specialising in Social and Behavioural Change Communication. She has worked as a health communications consultant for 12 years, most recently in the field of health systems and policy for WHO’s Centre for Health Development in Kobe, Japan. Prior to that, she was the senior writer for the Regional Director of WHO in the African Region in Brazzaville, Congo. She is passionate about public health, communicating research for lay audiences, and Africa. E-mail: firstname.lastname@example.org .