Gender, health communications and reproductive health in international development -Book Review

Sexual and reproductive health and rights (SRHR) are essential for the advancement of gender equality and in the last decades these have become more pressing for developed and developing countries alike. In many parts of the world women are still subject to multiple forms of oppression and control over their bodies and sexualities as well as further encountering difficulties in accessing healthcare services. Reproductive health rights, and women’s rights, have been currently under attack across various regions of the world by various political and religious groups, with misinformation, ‘fake news’ and stigmatization on the topic being a constant and widely spread on social media and online platforms. Thus information on reproductive health, and on women’s health, that circulates in the mediated public sphere is often ideologically manipulated, having an impact on women’s rights to have access to accurate information to make choices on their health, which then leads to anxieties, fears, misapprehensions and even self-censorship practices. Moreover, the COVID-19 global pandemic of 2020 has added greater pressure on tackling structural gender and health inequalities, including efforts to combat poverty, having further the capacity to set back the clock on women’s rights, particularly in areas such as reproductive health.

The four year project Gender, communications and reproductive health in international development, which has been published as a full manuscript by McGill Queen’s University Press, has examined 52 NGOs from across the world, both in the North and South, and how these have used communication tools and practices to advocate for sexual and reproductive health and rights (SRHR).  It is an original and multidisciplinary research project which aims to fill the gap in knowledge on how health and feminist NGOs use communication tools and messages for advocacy around gender equality and reproductive health. The partners of this research included IESP UERJ, Rio Brazil, US’s Global Fund for Women and the Centre for Internet and Society in India, and during the course of the four year project early career researchers and PhD students from the UK, Brazil and Latin America as well as India participated in the data collection of the project.

    Questions asked here included how members of lower income groups, who are inserted within specific local contexts, are subject to misinformation on issues of sexuality and reproductive health, and how these make sense of media messages and communications on sexuality and reproductive health. 1) How does misinformation and “fake news” about women’s rights affect people’s perceptions of reproductive health? 2) How do people make sense of health messages on reproductive health?; 3) Would they like to see better debate in the public sphere on this, and improvements in the construction of messages?; 4) How does ideological manipulation and misinformation online on reproductive health affect the stagnation of rights, translating into impediments to the advancement of policies in the field?

      This research has the aim to further strengthen in depth public debate in the public sphere on women’s rights in the global South, as well as in the rest of the world, thus contributing to the advancement of gender equality in developing countries as well as to the capacity-building of communications and advocacy activities of NGOs working in the fields of women’s rights and health.

A mixed methods research approach was adopted, combining in-depth interviews with more than 50 gender experts with the application of questionnaires to the communication professionals of the health and feminist organizations and networks. These were further juxtaposed with content and media analysis, including critical discourse analysis (CDA) of the institutional websites of the organizations. A codebook which contained specific categories aimed at describing different types of communication practices, from fundraising, mobilization to advocacy, was also developed.

       The core results of the research revealed that many NGOs are facing innumerous challenges with engaging members of the community on complex issues such as sexuality and reproductive health. Despite the lack of resources for projects as well as for communications activities, quite a few however showed that they make use of creative approaches in their messaging and advocacy communication engagement with communities at a local, regional and international case. It is often the case though that they find themselves “preaching to the converted”, to other public health professionals and to those “in the know”, encountering difficulties moving away from one-way flows of communications, with the need to intensify dialogue, communications and participation around reproductive health matters. This is particularly at a moment when these have come under intensified attack by populist right wing groups from across the world, from Trumpian politics in the US to Bolsonaro in Brazil, as well as throughout Eastern Europe. Discourses, language and rhetoric around reproductive health matters and women’s bodies are being constantly subject to manipulation and misinformation, having an impact on the access of communities to accurate, informative and correct health communication messages on reproductive health and in their ability to access these services.

     Some of the organizations who participated in the research recognized that public health arguments and the mere adherence to advocating on reproductive health based on facts, reports and statistics is not enough and is not ‘winning hearts”, at a particularly crucial time where emotions and cultural values around sexuality and reproductive health are being on purposely targeted and manipulated by conservative groups for their own vested interests. They have advocated a wider use of advocacy on facts (‘reason”) combined with the use of entertainment-education formats, digital storytelling and other human interest approaches (“emotion’), which can be more capable of reaching out to people, connecting health communication narratives with wider personal stories of hardship as well as enabling more spaces for the participation of communities in the co-construction of their own health communication messages and campaigns.  

     Drawing from the fields of Communications, Development and Feminist Studies, as well as Sociology and Health Communication, this research contributes to theoretical and empirical research in the fields of gender development, media and sexuality (Correa and Petchesky, 1994; Cornwall et al, 2008; Harcourt, 2009; Butler, 2019; Gill, 2017), health communications and NGOs use of media for advocacy communications for social change (Obregon and Waisbord, 2012; Wilkins, 2016). The anticipated value of the research is that it aims to inform the communication practices and strategies of NGOs, practioners and other organizations who work in the field from across the world under challenging circumstances, from socio-political constraints to wider economic pressures, such as cuts to spending on public health systems. The wider findings on the communication strategies of the NGOs, and the proposals on improvements to messages, will be developed separately in a practioner directed toolkit sheet. A communications advocacy plan is also being developed, and the results of the wider research project which have included, among others, the need for more sophisticated messages on SRHR which combine ‘emotion’ with facts, are sensitive to specific cultural and social contexts, and which are more participatory-led and capable of engaging more with the reasons for the resistance and fear around the topic of reproductive health among less privileged groups.

To buy the book, you can access it here: https://www.mqup.ca/gender–communications–and-reproductive-health-in-international-development-products-9780228017547.php