Johns Hopkins Gazette: March 4, 1996

Pop Planning--The Center for Communication Programs

Mike Field
Staff Writer

     In Peru, women tap their forefinger against their forehead
and say �tromes!, meaning they are savvy to family planning. In
the Philippines, a national tour featuring singer Lea Salonga
promotes sexual responsibility among teenagers with the hit song
"I Still Believe." As Salonga sings of love, commitment and
abstinence, the audience joins in singing lyrics familiar to them
all. In Egypt, a TV spot dramatizes the dangers of early marriage
and pregnancy when a teenage bride nearly dies during childbirth.

     Each of these images conveys information meant to help women
plan their families and the number of children they wish to have.
Each uses one or more forms of popular mass communication--
including television, radio, print and display advertising--to
deliver its message of improved health for women and children
through family planning. And each was developed with the
assistance and expertise of the School of Public Health's Center
for Communication Programs, a pioneer in the field of using
today's communication technologies to improve child and maternal

     "We believe in the communication revolution," says Phyllis
Tilson Piotrow, director of the center and senior associate in
Population Dynamics at the School of Public Health. Piotrow has
good reason to believe. In 30 years of population and family
planning work, she has witnessed--and helped direct--a growing
public education movement based on the accessibility, portability
and near-universality of the new forms of communication. With the
help of CCP, 45 nations around the world have discovered that
daunting public health problems such as the spread of AIDS,
infant mortality and uncontrolled population growth are most
effectively addressed through a joint effort linking accessible
and high-quality health services to widespread public education.

     Yet the direction and momentum of that effort faces severe
disruption, the victim of the ongoing budget battles in
Washington. Much of the CCP's annual $25 million budget is funded
through the U.S. Agency for International Development. Recently,
in an effort led by House conservatives, Congress voted to cut
the agency's family-planning assistance by 35 percent and to
further hamper USAID's efforts by imposing a nine-month
moratorium on funding. 

     The move is an effort on the part of some in Congress to
prevent spending for abortion, even though USAID has been
specifically prohibited from this practice since 1973. Critics
charge the spending reductions could have just the opposite
effect, as studies have shown that women will turn to illegal--
and oftentimes self-induced--abortion when other methods of birth
control are unavailable. 

     In the West African nation of Cameroon, for instance, public
health officials must cope with women who ingest large quantities
of chloroquine--a readily available and relatively inexpensive
anti-malarial drug--to induce spontaneous abortion. Often, the
uncontrolled dosages are enough to harm and even kill both fetus
and mother. In Bolivia, which has the Western Hemisphere's
highest infant and maternal mortality rates, illegal abortions
account for a substantial portion of the unnecessary deaths. 

     Nor is abortion the only threat to maternal and child

     "Childbearing itself is an inherently risky procedure,
especially when a mother is very young, or has been weakened by
illness or disease," notes CCP deputy director Alice Payne
Merritt. Even in developed nations, until relatively recently,
childbirth was the No. 1 cause of death among women of
reproductive age. Yet, according to Merritt, many of the risks
and dangers of childbirth and early infancy can be addressed. The
answer, she says, lies in the dissemination of vital information-
-such as how to treat an infant's diarrhea through oral
rehydration therapy or the need for immunization--by means of
mass communication.

     From increased literacy coupled with the copier and
inexpensive offset printing, to radios, TV, cassette players,
cellular phones, CD-ROMs and computer networks, new technologies
offering new means of reaching even the remotest village have
swept the world. Today, it hardly seems surprising when
schoolchildren in Nepal know of Michael Jackson, or villagers on
a Pacific atoll want to drink Coca-Cola. Such is the power of
global mass marketing.

     The Center for Communication Programs taps into this highly
developed expertise in devising images that sell products and
uses its potential to transmit information and ideas that promote
health and save lives.

     "If you think of 20 years ago, and how much time people
spent in contact with other individuals, and then you compare it
to our reality today, you begin to get some idea of how tied we
are to the mass communication culture," says CCP project director
Jos� Rimon. "Today, you may get up and watch Good Morning
America, drive to work listening to National Public Radio, work
all day on a computer connected to a network, drive home
listening to NPR again, and then end the day watching the evening

     How much more of your central nervous system is plugged into
communication technology than just two decades ago? For better or
for worse, the communication revolution that is taking place
today affects how we live and work and learn."

     In less developed nations, the reach of modern technologies
is still impressive. Recent survey data shows that 99 percent of
the population of Egypt has access to television, says Rimon, and
even in nearby Yemen, one of the world's poorest nations as
measured by the World Bank, access to television is estimated at
70 percent. 

     Throughout the world, the battery-powered radio and the
inexpensive cassette player have brought songs, drama and
programming of all types into homes often lacking the
rudimentaries of electricity and running water. In the eyes of
CCP workers, this growing web of international communication
represents one of the most potent tools in the public health
worker's bag of community medicines.

     "Our goal is to make family planning a household word, a
community norm and an informed individual choice," Piotrow says.
"Mass communication allows us to promote the idea of individual
consent and informed choice. When coupled with community
mobilization, meetings and group activities, and better
counseling by health providers, it has proven highly effective at
saving lives and improving women's health." 

     In November, prior to the budget cuts, the center was
awarded a competitive $109 million cooperative agreement by USAID
to continue its work in family planning and reproductive health
communication through the year 2000. It is the fourth consecutive
cooperative agreement CCP has won since the communication program
was begun at Hopkins in 1978.

     Yet the planned cuts currently approved by Congress could
derail and possibly even disband some of the center's most
effective international programming. 

     "No one knows how this is going to work out," Piotrow says
of the current uncertainty surrounding the government's plans. In
February, Maryland second district Congressman Bob Ehrlich (R)
toured the downtown Baltimore facilities and listened attentively
as staff members described the center's work. 

     "We hope a lot of congressmen and senators will hear from
their constituents about these horrendous cuts. Sens. Sarbanes
and Mikulski have been very supportive," says Piotrow. In the
meantime, there is much to do. On Feb. 29 the center premiered
"Hits for Hope," a video about a campaign in Uganda that invited
local singing groups to compose and perform their own AIDS
education theme song. 

     The winning song was professionally produced, and is now
being distributed to radio stations, record stores and
discotheques throughout the country. The idea is to get young
people talking about the behavioral changes necessary to stop the
spread of the disease. Wherever the virus can travel, the song--
titled "A Ray of Hope"--will travel too.

     "There has been a tremendous extension of communication
worldwide in the last 20 years," says Piotrow. "Our goal is to
harness that technology and use it as a tool for public good."

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