Build on trust: Creating successful public health communication amid Covid-19

Covid-19 third wave
Dr Aruna Sharma’s inaugural address in the first episode of Delhi Dialogues emphasised the need for deliberations and wider consultations in tackling the third wave of Covid-19.

By Kaibalyapati Mishra

Public health communication amid Covid-19 crisis: As a resident of Odisha, known for its resilience against natural calamities, the Covid-19 pandemic was no reason for panic. Still my mother was concerned about any information on the deadly coronavirus, while I was hopeful that the efforts of scientific community and the government will lead us out of trouble. She will turn up every day with some new information about the infection, the chances of survival, and most importantly some home remedy which is obviously unscientific. But all this information without a strong scientific base create narratives that are circulated by individuals in the society facing crisis. Such narratives result in the failure of public health communication from the government.

A Time Use Survey conducted by the National Statistical Office in 2019 had disproved the notion that the rate of transmission of narratives among females is higher as they spend much time in leisure and social communication. The survey found that women spend 5 minutes less on an average every day in such activities compared with men.

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Narratives and Covid-19 crisis

It is normal for a citizen with no clinical knowledge to be unaware of terms like pandemic, outbreak, and vaccination. But the Covid-19 pandemic has made these esoteric terms known to a large number of people, injecting fear and pessimism that gives room for unscientific narratives. It is unfortunate that such narratives cannot be ignored because they influence individual and collective decision making. In other words, a person who heard that someone died after taking the vaccine may avoid vaccination and spread the narrative that vaccination is unhealthy. Such narratives render the public health communication on Covid-19 vaccination ineffective.

Low literacy rate is not the sole reason for the prevalence of such contagious narratives that are not confined to rural households. The principle of loss aversion widely used in behavioural economics can explain this phenomenon very well. It says individuals overvalue the value of losses over profits.

In this case, the death of a person after taking a vaccine (even though it is not established that the reason for death is vaccination) will be valued more by individuals than the immunity achieved by a large number of people. Even in high literacy countries like the US, a quarter of citizens hesitate to take vaccines, indicating the moral and emotional loss of a single person matters given the unpropitious chances of survival.

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Effective public health communication

At a time when the health situation is grim, it is imperative for the individual to look forward to the objective indicators. However, for the state and the leaders, this won’t suffice. To deal successfully with a pandemic, it is equally important to value public perceptions. Thus, the government and its public health communication should try to deal with the pandemic the way people want.

The attempts to change public perception won’t help people realise the risks on which their perceptions are based. For this, the government should not make policies based on formulae of teaching (following a top-down approach) rather make it a communication-based model. To establish good communication with the general public, governments should listen to the public, while continuously telling the truth. The prevalence of under-reporting of deaths and cases of Covid-19 is certainly not an act of truthfulness.

Proper channels need to be devised on which people can bring in elements, facts and experiences to promote effective health communication in the country. Pamphlets shared through social media platforms and other means hardly reach a significant section of the total population. News published in media is hardly taken seriously due to lack of trust among people.

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Building trust is vital to effective public health communication because people tend not to trust the government. The road to building trust is to avoid telling lies and also to anticipate questions that the public might have. The most important means to build trust is preparation. At times of crises, preparation builds trust among people.

The governments also must make people feel empowered in a way that makes them feel that they are in control of the issue, and not the government. Making people feel that they are the centre of the action fills them with trust and confidence. Situations of risk generate fear, which is a very strong emotion. Fear makes people emotional and emotional people tend to listen less to facts. Thus the medium of dealing with people should not only be scientific and fact-based, but also be empathetic enough to create and maintain rapport.

The government should realise that the situation is fluid. Dishonesty and overconfidence will result in losing the trust of the public, increasing the chances of public policy failure. Thus, maintaining an honest path in the moral and functional aspects of governance will yield greater support, build trust and promote better public participation.

(Kaibalyapati Mishra is a research student at the Centre for Economic Studies & Policy, Institute for Social & Economic Change, Bengaluru.)