Using Folk Media in HIV/AIDS Prevention in Rural Ghana

Sub-Saharan Africa, home to 70 percent of people with HIV, has the highest rate of the infection in the world. Ghana is taking steps to prevent the devastating impact of AIDS currently being experienced in other parts of Africa. To augment existing prevention programs, the CARE-CDC Health Initiative (CCHI) project in two districts in Ghana is exploring the use of traditional folk media to prevent HIV/AIDS.

The residents of the Wassa West and Adansi West districts of Ghana are predominantly illiterate or low-literate Akan-speaking people whose occupation is either mining or farming. These characteristics make most health communication strategies almost alien to the population. High-risk reproductive health behaviors are common in both districts because of the influx of migrant workers with disposable incomes. The indigenous culture is largely based on oral histories and traditions, much of which remains unwritten. Folk media are often used for personal as well as group information sharing, and they draw their popularity from their entertaining nature. Types of folk media include storytelling, puppetry, proverbs, visual art, drama, role-play, concerts, gong beating, dirges, songs, drumming and dancing. Folk media are used to communicate entertainment, news, announcements, persuasion, and social exchanges of all types. The power of folk media in changing behaviors in rural Africa results largely from the media's originality and the audience's belief and trust in the sources of the messages, which often come from people real to their audiences. Yet despite their power to capture people's imagination and subsequently to change behaviors, the use of folk media in health education campaigns has not been fully described in Western literature. Because folk media address local interests and concerns in the language and idioms that the audience understands, they are appropriate communication channels for rural populations.

Theatre for Communication Implementation and Development, a local group affiliated with the nongovernmental organization Center for the Development of People in Kumasi-Ghana, uses simulated live shows to educate crowds about health issues like family planning, breast-feeding and HIV/AIDS. Scenes, acted out publicly without onlookers' knowing they are being acted out, frequently provoke discussion and comment. African musical heritage is rich with songs that serve the dual purpose of entertaining and educating the audience. Funeral dirges are now being created with messages about health issues, especially HIV/AIDS.

The CCHI project will combine folk media with long-running serialized radio dramas portraying characters who will adopt positive reproductive health behaviors, such as condom use, family planning, breast-feeding, and early treatment of STDs. The Ghana project is currently at the formative research stage. Specific folk media that can be used as part of this strategy include audio-based methods for radio dramas and visual arts for selected community-based activities that will be undertaken to augment the radio broadcasts. In societies where the level of literacy is low, visual arts can be powerful HIV/AIDS education channels. Puppetry has considerable potential for health education because it is possible for puppets to "talk" about sensitive issues deemed unacceptable for an actor to discuss.

Affordable and accessible, radio is the most popular medium in Ghana. Available even in remotest Ghana, radio has the capacity of being heard by a large, diverse audience. Folk media such as story-telling, drama, poetry recitals, proverbs and music on the radio will appeal to rural audiences, potentially influencing them to adopt responsible, health behaviors. Radio also offers opportunities for interactive participation by local residents.

". . . Because folk media are an immediately recognizable vehicle for education, they are easily accepted by most Africans. . . . It is therefore imperative for projects whose goals aim at behavior change and sustainability in rural African settings to recognize and use the potential of folk media for the benefit of the rural folk as well as project implementers and funding agencies. Finally, there is a need for research into the myriad folk media forms that abound in rural Africa, both to explore ways to preserve these media and to document the effect they have on behavior changes in rural communities," the authors concluded.

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