Radio Soap for Health Education - Lessons Learnt by Health Unlimited Rwanda 1997-2003

Urunana – radio soap for health education

During the genocide in Rwanda in 1994, most of the country's trained health staff were killed or fled. Preventive health information to rural areas virtually stopped. The consequences affected the population's general and reproductive health and left the country traumatised by the conflict. In 1997, Health Unlimited set up the Well Women Media Project, which aimed to improve the feeling of wellbeing in Rwanda, and provided specific information on sexual and reproductive health in a country where over 70% of the population are under 24 years old. Sexual and reproductive health issues are vital to the health of the nation.

A Government of Rwanda survey of literacy rates (1996) showed that 47.3% of the population over six years old knew neither how to read nor write. 58% of this figure comprised women and girls. Using aural media is the main way to disseminate health information. In Rwanda, for every television, there are 101 radios, making it the dominant media in the country. Health Unlimited decided to use the power of radio to cross gender, generational, geographical and literacy barriers. In 1998, they set out to build the capacity of local producers to make high quality radio programmes to broadcast to the region on the BBC World Service's Africa Great Lakes Service and on Radio Rwanda.

Urunana (‘Hand in Hand') went on air in 1999 as a Kinyarwanda radio soap opera, fully researched, written and produced in Rwanda. It weaves sexual and reproductive health issues into compelling storylines and has stimulated discussion of sensitive subjects which are little discussed in Rwandan families, resulting in widespread ignorance. The content is audience-led with researchers visiting audience groups in Rwandan villages to chat to listeners about their health concerns. The more often a particular topic comes up, the more airtime it is given.

The Well Women Media Project also produces radio programmes in Cambodia, where the project has become a local NGO, and Somaliland, where programming is soon to launch on the BBC World Service's Somali Service.

Health Unlimited London has gathered lessons learnt by the team in Rwanda based on their experience of the innovative Urunana project. They have contributed a wealth of practical tips which have been collected as an illustration of good practice (*details later). Examples of their experience follow.

Adapting soap opera to the rural environment

During an external evaluation, a member of the Rwanda project team commented, "On my first day, I did not know what ‘soap opera' means. The words mean nothing to us. No one mentioned drama."

The term and concept of soap opera was unknown in Rwanda in 1997 so Health Unlimited began by explaining the planned soap opera as ‘an educational long running drama serial that holds a mirror up to society and examines the issues of the day'. Soap opera binds audience loyalty through its format. It allows educational content to be presented in real life situations observed by the audience. All the staff were briefed about the particular aims of Urunana as a health education tool and how the importance of breaking down taboos meant that they should be prepared to work on sensitive issues or dilemmas.

It is difficult to introduce totally new formats to teams that have never experienced creative radio for development. In Rwanda, only two members of staff had previous experience in radio. There was a need to empower all staff with the knowledge of how soap opera can improve health by encouraging the whole team to participate in the development of the programme. Additional activities, which led to this greater sense of ownership, included:

• team participation in the baseline needs assessment and in ongoing audience research
• joint discussion about characters, storylines, settings and messages
• analysing videos, cassettes and scripts of other soaps
• open discussion of the pros and cons of different ways of getting a message across
• team visits to the field with actors to get a real sense of the villages and of the characters being portrayed
• developing, pre-testing and post-testing storylines with rural communities
• using actors from rural areas
• visiting other soap opera producers to watch their techniques or watching filmed excerpts of others' production meetings and clips of the set-up of their studios

Keeping listeners' listening

"...it was common for regular listeners to complain that the programme always stopped just when it became interesting. This response is a clear indication of interest and a spur to listening." - comment made during an evaluation in 1999.

The key to soap opera is to ensure that a cliffhanger encourages people to tune in for the following episode. The following are examples of what the team in Rwanda have learnt:

• programmes no longer than 15 minutes are more marketable to broadcasters who have 15 minute transmission slots to fill
• the listener's ear tends to ‘tune out' after 15 minutes
• drama serials with longer episodes have a shorter life span
• varied storylines and characters over time add contrast and ensure that there is something for and about every type of listener
• plotting a story's development on a grid storyboard reduces the risk of inconsistency, repetition or missed educational opportunities
• ongoing storylines engage listeners over a long period, but occasional ‘hot stories' which begin and end across just two episodes give instant drama
• constantly incorporating listeners' feedback into the design of the soap and the time and frequency of transmission keeps it relevant to the audience
• broadcasting two episodes a week and an omnibus builds audience loyalty
• repeating simple messages reinforces information
• educational messages work at varied levels, eg. making first aid tips incidental to a main storyline
• characters with someone to confide in within the story enable the audience to hear what characters feel about events and work out how they would respond to the same dilemmas in real life
• storylines which involve action then consequence draw the audience along with the character's self-learning
• dialogue can be prescriptive while remaining realistic

These approaches are not mutually exclusive and it is good for the production team to discuss whether to take a particular approach and to look at how adults/youth learn and reflect on what is culturally and socially appropriate. Regular reviews of character development, including audience groups, inform this process. Scoring characters out of 10 for effectiveness and potential demonstrates their education and entertainment value and how useful they are for carrying the story forward and disseminating health messages.

Partnership for a range of viewpoints

Working in partnership is important for influencing the wider media environment as well as for validating the programme's content. Tips for making the most of such partnership working are:

• assign a liaison officer within the project for making visits and publishing project achievements in the partner agency's newsletter
• build a wide network of contacts who attend quarterly stakeholder meetings
• build relationships with ministries, other national bodies, women's associations and NGOs to:
  
  - discuss the health messages to be addressed in forthcoming storylines
  
  - co-design messages for partners' own use
  
  - assess opportunities for co-ordinating training and audience surveys
  
  - attend meetings, workshop and seminars to learn about current national strategies to fight disease and how these can be incorporated into the programme
• collaborate with the Ministry of Youth, Sports and Culture to introduce the project team to youth groups in different areas of the country in order to gather their input for the soap opera

With the project in Rwanda, the relationships have been successful because the organisations share a common goal and are based on mutual respect. Stakeholders value the popularity of Urunana and consider it an effective vehicle for disseminating health messages. As such, Urunana has been approached by non-health organisations for help in getting their message across. These include the National Electoral Commission, the National Poverty Reduction project and Kigali City Council. However, the team found it hard to insert their messages into the soap without deflecting from the health and wellbeing goals of the project.