Behaviour change in health communication: why socio-cultural factors matter?

2nd February 2023

Authors: Professor Sabihah Moola, University of South Africa (UNISA), Pretoria, South Africa. 

Health communication, health promotion: its effect on behaviour change 

Behaviour change is a core necessity in healthcare communication. Meaning that if we do not alter behaviour patterns our risk of illness increases. This was evident during the COVID-19 pandemic that affected us all, both locally, and globally. Raising awareness to the public was needed by all governments as a matter of urgency. Hence different countries made use of health communication tools, to help educate nations on the virus, its symptoms, and transmission, among other important information. Naturally, the media communicated health information daily to us all.

Health communication is the dispersion of information related to health and illness. It aims to increase health education, related to illnesses, by contributing to healthcare and wellness. This is duly affected by socio-cultural factors that influence individuals [1]. Health promotion is a tool that is used to promote health education and contribute to health behaviour change, as per this context, in the form of health campaigns [2].  Entertainment education, via health promotion, is aimed at cognitively altering individual mindsets. In aiming to alter behaviour change patterns, for the betterment of individuals [3].

Behaviour change constitutes lifestyle changes, depending on the type of illness. For example, with COVID-19 avoiding social contact, maintaining social distance etc. was hard to achieve since human interaction is almost unavoidable. While with diabetes for example, lifestyle changes need to occur such as diet, medication adherence, exercise etc. Hence some illnesses are easier to alter and maintain or manage positive behaviour change, as compared to others. The most important aspect is to maintain positive behaviour change, with respect to any illness and avoid defaulting. Since this can ensure a relapse occurs, which works against the individual’s progress.

African contexts: why socio-cultural factors matter?

The argument surfaces that in African or South African (SA) contexts socio-cultural factors such as culture, need to be adequately catered for, in order to positively contribute to health behaviour change. Cultural beliefs influence the treatment of various illnesses [4].  African traditional medicine is used to treat HIV/AIDS, diabetes, and COVID-19 amongst other illnesses.

Western biomedical medicine does not always sustain African contexts, which consider a more holistic, patient-centred care approach to the diagnosis, treatment and management of an illness [5].  Incorporating cultural consideration in the promotion of health information will cater for healthcare diversities in the African context.

Since cultural beliefs impact on illness diagnosis, medicine adherence and treatment options available [6].  Traditional herbal and plant-based medicines are a reality in SA. Hence religious diversities need to be integrated in health communication education, as well as actual health campaigns- be it for COVID-19, mental healthcare, or HIV/AIDS. 

Social barriers and their effects on health communication 

Social barriers such as stigma, misinformation and prejudices can negatively affect behaviour change implementation against COVID-19, or illnesses such as HIV/AIDS, cancer or even tuberculosis (TB). The barrier of stigma is noted in illnesses such as HIV/AIDS, TB and very recently with COVID-19, due to its type of infection [7] [8] [9].

Misinformation about COVID-19 causes prejudices towards the virus. Not accessing legitimate and authentic information about an illness, causes ignorance and thus affects behaviour change negatively. Since one is not empowered with adequate knowledge on how to alter behaviour accordingly. 

COVID-19 health promotional campaigns 

Many countries developed different forms of health promotional campaigns. Here, language and literacy preferences are needed to suit the representative audiences, in order to cater for patient diversities.

Literacy levels are associated with socio-cultural connotations [10]. Meaning that we interpret health messages according to our cultural beliefs. Hence, SA campaigns tried to cater for patient socio-cultural diversities in aiming to educate audiences on COVID-19 campaigns. 

Concluding thoughts 

The African context is culturally rich, with diversities that lead the management and care of health and illness.

Health information communicated through health campaigns needs to cater for cultural diversities, and literacy levels, as well as incorporate socio-cultural tolerance in the promotion of health education. These issues are vital in the shift towards effective behaviour change, for adequate healthcare and illness management.


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