From Mexico to India, using development TV for social education.

Latin America’s soap operas (telenovelas) have long captivated TV audiences with their overwrought stories of love and betrayal, sin and punishment, and triumph over adversity. But for public health advocates, they also are an ideal medium for transmitting positive messages about healthier living. The soap opera has evolved as "an interesting tool for evoking the curiosity of people, stimulating them to look for further information which could lead to positive social acceptability of the subject(s)”.

The protagonists are all fictional characters, their stories, however, mirror the lives of real men and women and thus provide a powerful medium for transmitting positive messages on important issues of public health. At first, the messages were basic, almost intuitive, such as "smoking is bad" or "you need an education to make something of yourself." Over time they have evolved toward deeper social themes, providing a subtle but effective guide for public opinion on sometimes controversial matters of public health while promoting a healthier and more ethical society.

The power of fiction:

• An early indication of soap operas / programs' enormous potential came in 1986, when a character on Venezuela’s Crystal was diagnosed with breast cancer. The episode led to an avalanche of female patients getting check-ups in Venezuela and in Spain, where the series also aired.

• Observing these successes, Miguel Sabido, former vice president of the Mexican network Televisa and a pioneer in "edutainment," produced a series of seven programs between 1975 and 1978, called "soap operas / programs for development," that combined education and entertainment - one, promoted sexual responsibility among adolescents, another promoted the notion of gender equality in Mexican society and a third encouraged adult education.

• The Mexican experience was adapted for use first by Population Communications International (PCI) and later by the Population Media Center (PMC), - organizations that work at the global level to promote education in family planning, prevention of sexually transmitted diseases, reproductive health and gender equity.

• PMC has used "soap operas / programs for development" in India, Ethiopia, Kenya, Côte d’Ivoire, Malawi, Burkina Faso, Nigeria, Rwanda, Sudan and Swaziland. During preproduction, experts analyze the cultural norms of each country and then adapt the stories to local cultures, increasing the messages’ chances for success.

• In 1994, Colombia’s Ministry of Health coproduced a soap opera / program about social and health issues aimed at a female audience.

• Last year, officials from Brazil's Ministry of Health acknowledged that the theme of drug addiction in TV.

• Brazil's TV Globo network has been incorporating social themes into its soap operas / programs since 1990. According to the most recent edition of its annual report Social Marketing: Entertainment Serving Social Good, in 2002 more than a thousand episodes of soap operas / programs included social themes, ranging from condom use and organ donation to caring for the environment. Globo's El Clon (The Clone) in 2001 had done more for the prevention and treatment of drug dependency than many government campaigns.

• Pan American Health Organization (PAHO) helped Suriname import the South African soap Soul City, whose plots cover such issues as AIDS, teenage pregnancy and drug addiction.

• In Kenya, a 1987 television series that promoted family planning "became the most popular TV show in the country’s history."

• Responding to such success, producers, writers and public health advocates have been working together to reinforce health themes through week-long public awareness campaigns aired in conjunction with the soap operas / programs.
  

Measurement of impact:

Just as ratings confirm the success of soap operas / programs story lines, the impact of social messages in soap operas / programs can be demonstrated quantitatively.

• To demonstrate soap operas / programs ’ potential for promoting social change, TV Globo producers carried out a study in which they tracked changes in health services during the airing of Lazos de Sangre (Blood Ties), whose protagonist, Camila, was diagnosed with leukemia. The study, titled "The Camila Effect," found that in November 2000, during the show’s early episodes, Brazil’s National Registry of Bone Marrow Donors reported an average of 20 new registrations per month.

• One study, headed by PMC president Ryerson and funded by the Rockefeller Foundation, looked at Humraahi (Come Along With Me), an Indian soap opera that aired in 1992. The study found that people who watched the show regularly changed their attitudes about the ideal marrying age and the acceptability of women in the work force, two central themes of the story.

• In Kenya in 1987, the soap operas / programs Tushauriane (Let’s Talk About It) and the radio program Ushikwapo Shikamana (If Assisted, Assist Yourself) were aired with the aim of getting men to be more open minded about their wives’ practicing family planning. They became two of the most popular shows on Voice of Kenya. By their conclusions, contraceptive use had increased some 58 percent in the country, and the average family size considered as ideal among Kenyans had declined from six children to four.

• In addition, a study of rural health centres by the University of Nairobi’s School of Journalism found that women were more likely to seek birth control after hearing and seeing the programs.