Wednesday, July 16, 2008

What journalism can learn from a handwashing campaign in Ghana

Last Sunday's New York Times had a really interesting article about how public health workers in Ghana solved the problem of getting more people to wash their hands (and therefore reduce the incidence of child-killing diseases caused by dirt). Tellingly, the article wasn't in the international section. It was in Business. Even more interesting, the article held important insights for those of us in the news business who understand that the average American's lack of interest in the news is largely what is killing newspapers.

First the background.

The problem: Illnesses due to dirty hands, like diarrhea, kill a child somewhere in the world every 15 seconds. The solution is simple: Get people to wash their hands more frequently. The difficulty in that: Public health workers could not for the life of them get people in countries like Ghana to take up the habit. "We could talk about germs until we were blue in the face, and it didn't change behaviors," Val Curtis of the London School of Hygiene & Tropical Medicine told the Times.

Then a lightbulb went off: Companies like Proctor & Gamble and Unilever have mastered the art of creating habits in American consumers (exhibit A: Febreze fabric cleaner: Who knew fabric freshner was a critical part of everyday life? Apparently no one, until P&G decided they needed to sell it.) If anyone could figure out how to sell the habit of hand-washing to Ghanaians, the public health folks decided, these guys could.

And they did.

First, they conducted a series of surveys to understand how and when Ghanaians perceived the need to wash hands. Talking about diarrhea and other diseases apparently had no effect, since, in the minds of Ghanaian mothers, those were just normal part of childhood, not dramatic calamities they were desperate to avoid. Next, they discovered that, when people did wash hands, their decision to do so was prompted by a feeling of disgust. They felt their hands were dirty--after cooking with oil, for example, or traveling through the city. Feeling their hands were dirty, they soaped them up and washed them clean. Now here's the interesting part: many Ghanaians didn't feel disgust after using the toilet. Hunh? You might say. That makes no sense to us. Exactly. But here's the thing: beautiful porcelain toilets had replaced latrine pits. In the minds of Ghanaians, then, toilets were actually associated with cleanliness.

With the marketers' help, the public health advocates figured out a new strategy. Forget about preaching about germs. Instead, cultivate a sense of disgust about using the toilet. "The commercials, which began running in 2003, didn't really sell soap use," the Times wrote. "Rather, they sold disgust. [emphasis mine]"

And apparently the campaign is working: Soap use after using the toilet has gone up 13 percent. And soap use before eating has gone up 41 percent!

So what do this have to do with journalism, you might ask. Very simple. Just about every single conversation among journalists about the demise of newspapers focuses on how bad this is for the country. News is important, the argument goes. Newspapers should be saved because of the "critical democratic function" they perform. (For the latest culprit, see Eric Alterman's piece in the upcoming issue of The Nation.)

What the Ghana handwashing story tells us, however, is you can't make people pick up a habit if they don't see the value in it, even if the value is objectively there. To us, avoiding germs is a perfectly valuable thing to do. To the Ghanaians, it wasn't. And no matter how much the public health workers tried to bang it over the Ghanians head that they needed to avoid germs, it didn't have any impact on their habits. It wasn't until the public health folks took the time to understand how the Ghanians saw the world, what was important to them, and what was effective in triggering certain behaviors, that they were able to craft messages that generated the behaviors the public health folks were gunning for.

The same goes for journalism in the States. We journalists can talk until we're blue in our faces about the importance of journalism. But if the average reader doesn't perceive that importance,* that argument isn't going to move any mountains. We will be more likely to succeed if we can appeal to something that does matter to the average American reader. I don't know what that is. But I ask you: What value can you think of that would be effective in "selling" the news-reading habit to the average American? What does the average American care about, that would get them in the habit of reading the news?

Tip: Think outside your journalism mindset box. Really. Think beyond everything you were taught in newsrooms and j-school. That's our mindset, our germs-should-be-avoided belief system, as it were, that the average American doesn't share. Instead, what is their mindset?

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* And after the lead-up to the Iraq War, who can really blame them? We subscribe to our mythology, that we provide a valuable public service. But there are many non-journalists out there who have every reason to be skeptical of that claim. But that's a whole different topic.

Photo courtesy of asplosh. Creative Commons license.

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