Interview with UNFPA

The Communication Initiative (CI): What are some of the main initiatives that UNFPA is involved in?

UNFPA: We should put this first into the context of UNFPA's mandate, which is to provide assistance to governments in population and development issues. After the 1994 International Conference on Population and Development in Cairo, UNFPA's focus shifted to reproductive health and rights, women's empowerment and gender equity issues. Hence, UNFPA's communication initiatives support these areas of population and development, reproductive health, reproductive rights and gender equity through three main communication approaches or types of interventions:

• Advocacy
• Behaviour Change Communication (BCC) and
• Education

In BCC and Education, we have long experience working with different institutions and countries at the workplace, in the planning, health and education sectors and agricultural extension. Now, we are focusing more and more on youth reproductive health issues.

Our social communication work is not always easy and nor does it include flashy interventions. It involves a long-term process and vision of what we can accomplish. I think that UNFPA, specifically in communication, is working to build the capacity of national counterparts, especially the public sector.

I think it is interesting to note that a lot of our pioneering activities have been taken over and amplified by other institutions. I could cite the work that we've done in the workplace establishing not only reproductive health services but also counselling for employees. We have also worked with union leaders in the area of population issues and providing support to consensus building. An interesting part of our work has been with institutions such as the army and uniformed services to establish population education programmes and also with the media, training journalists and establishing journalist networks on population issues, etc.

We have also been a pioneer in working with the education sector and developing curricula on RH issues such as HIV/AIDS prevention. A lot of people are now discovering that schools are an extremely important network to work with for reaching young people and shaping life attitudes and UNFPA should be credited with working through these very bureaucratic institutions to integrate content on youth issues and establish life-skills training. We have built capacity in reproductive health education in formal settings such as schools, and with different ministries - especially ministries of health - and we have also established communication-training programmes in several regional institutions. We have worked with ministries of education on curriculum development and the establishment of teacher training programmes in difficult themes such as population, reproduction and family life issues, and life-skills for young people.

In advocacy, we have worked very successfully with religious leaders in Africa and leading religious institutions such as Al Azhar University in Egypt. We have worked selectively and strategically with influential leading institutions, both government and non-governmental. In Africa for instance, UNFPA should be given credit for working collaboratively with partners to increase political support on these issues. In ministries of planning and finance etc, the communication component has worked to support the formulation of population policies and their approval. As a result in Cairo, African governments were extremely committed to the International Conference on Population and Development (ICDP) programme of action.

In the ministries of health, I think it's worth noting that we've done a great deal of establishing not only the procurement of condoms or contraceptives, but we've worked on establishing or increasing the capacity of service providers in counselling on family planning decisions, and in promoting a client perspective in quality of care.

But it's not just capacity building and providing technical assistance, it's also building institutions. In this area we have worked with universities and established Information, Education and Communication (IEC) strategies at all levels: national, district, provincial. This is something, which is very time consuming and doesn't get published but it establishes the groundwork for people to work together and have a common vision on what to do in communication. I would say that we have a strong coordination role in many countries.

UNFPA: Let me add to what my colleague has said… We operate at three levels. In terms of programmes we have global or inter-regional programmes, regional programmes and country programmes. At the global level, we are looking at how we can better share experiences, document best practices, develop partnerships, and do advocacy. At the regional level, our advisors are really key in providing technical assistance to countries in the areas mentioned earlier. To help our country programmes, UNFPA programme representatives formulate, implement and evaluate programmes in the area of communication.

UNFPA: It is also useful to mention that the terminology we use to capture our initiatives has changed quite a bit. Before Cairo we have used the terms like population education, population information and population communication. We changed it and adopted the term information, education and communication [IEC] to show the need for integration of approaches. In addition on the programming side, the pressure for results in limited timeframes with fewer resources is forcing us colleagues to plan by objectives and look at what we want to achieve from communication initiatives. This means not only looking at the process and the pathway to reach that result but also making a real commitment to change. This explains why we are changing our terminology from IEC to behaviour change communication [BCC].

Also now, we have elevated advocacy as a programme-related communication intervention at the country level. It is quite new for many UN and other external agencies such as bi-lateral donors to use country programmes to strengthen political will. But there are different levels of advocacy and using it at the country programme level -rather than just as a corporate public relations function- required a complete shift in the way we think about communication programming. A key feature of this initiative is to work with civil society organisations, governments and the media in partnership.

UNFPA: UNFPA works through the country offices with governments and sometimes NGO's to assist them in programming processes, but we use communication in a variety of innovative ways using, for instance, television or radio soap opera programmes . Of course local needs define which way to go and we also use folk media, print media and (an important area which I think UNFPA is really good at promoting) interpersonal communication and counselling. Using more than just mass media in this way is more effective in helping to bridge the knowledge-attitude-practice gap.

UNFPA: I would like to add two things on the modality of the intervention. For a very long time UNFPA has had it's place in the world of communicators solely as a funding agency, helping to mainstream population issues into other agencies' programmes. In doing so, we helped build their capacity for communication interventions. That's something to note, a really important aspect because our role was not quite visible.

The other thing I would like to mention is respect for national institutions. This can be a difficult role sometimes when we are not trying to impose pre-determined solutions or projects but instead, we negotiate with other counterparts; as a result, the approach or the strategies selected are very contextual and related to the vision of our counterparts. We see our work as a service agency rather than bringing our own brand. In that sense, we really are extremely flexible.

UNFPA: I have one more thing to add. I think UNFPA is probably the only UN agency that maintains an inter-disciplinary technical advisory programme. It's quite unique to the UN system because we have advisors that come from different disciplines such as communication, education, health, statistics, demography, and gender and bring a cross-disciplinary perspective on population, reproductive and sexual health. This has strengthened the way UNFPA does its planning.

CI: What do you see as the main opportunities for strengthening or improving communication for social change and what do you see as the obstacles?

UNFPA: Maybe it's just my personal opinion, but during the past 3 days of this meeting [International Roundtable on Communication for Development] I felt that people were talking about the big difference between knowledge and practice, particularly in the area of HIV/AIDS, and how in spite of the fact that a lot of people say that they are aware how AIDS is spread, many have not changed their practice. My feeling is that maybe there has been more use of communication approaches relying on mass media and the creation of awareness and less on approaches, which allow people to ask questions, clarify their feelings, get feedback, and clarify rumours. In other words, interpersonal communication approaches were not used enough. I think those are the areas where we need to spend a lot of time and energy. These are expensive approaches because they involve human elements.

UNFPA: Continuing on the same question or idea I see opportunities at 2 levels. At organisational level, UNFPA is currently undergoing the revision of its strategic direction through a number of working groups that are evaluating different aspects of the organisation including programme and policies, I see this as an opportunity for boosting the role of communication for social mobilisation for social development. The second level is the international scene where there are increasing numbers of initiatives like UN General Assembly Special Sessions but also from donor countries that together highlight issues that are major parts of the mandates of UNFPA and other UN Agencies. Increasingly there is a recognition that social and human development has to address human needs and behaviour, so this may further the cause for increasing the role of communication in programmes. There is a new environment, a new awareness in the international community and that's an opportunity to strengthen our message and our mandate.

UNFPA: I would like to add to what both my colleagues have said. In this process of rethinking our new strategic direction and also after the ICPD there has been an enormous renewed interest in tackling very sensitive but priority issues such as sexuality, HIV/AIDS prevention, gender equity, gender-based violence, migration, ageing and the relation between poverty, population and environment, which all call for looking at the human face of development. They also call for looking more carefully at the role of culture and politics and the role of civil society. They invite or require more skilled communication interventions because you need more research to do better work at the community level. The recognition of the necessity to implement the Cairo programme and the mandate of doing advocacy work has allowed the communication field in our organisation to touch upon the whole continuum of social change from individual to collective and that's really where we are now.

UNFPA: While we see all the opportunities that my colleagues have outlined, there are also many demands on communications professionals because UNFPA has expanded it's mandate over the last 5-10 years to include the expanding global agenda of population, health and reproductive health. In a way, this could be seen as a constraint because we are not able to deal with them all. Knowing we have limited resources, we are beginning to define and refine our own understanding of communication strategies and concepts so we can use our own skills to support our different programmes. The challenge is that priorities are becoming very complex, demanding and too broad. This is forcing us to rethink what we can do with limited resources while still helping our country programmes improve their quality and content.

CI: What about the obstacles?

UNFPA: This is from personal experience working with UNFPA and previous work. Among the relatively wide range of the people we deal with at the field level and among national counterparts there is still a naive understanding of what communication is and what role it can and should play. They do not understand the evidence that few programmes will take off and achieve results without a communication component. People are still looking for the 'hardware', something that they can touch. They view communication as a second priority and we need to constantly demonstrate the strategic importance of having a sound social communication component. In a way we do more than provide technical support, we are engaging in an educational role to place communication where it belongs as a complex strategic scientific approach, not as some simple ad hoc product of a project. Sometimes this causes an obstacle to the work in the field with some national counterparts.

UNFPA: I would like to add a couple of obstacles. Although our aim is always capacity building and we train people all the time, what happens in a government system is you train people today but within a short time they disappear and then you are stuck again with untrained people. We are helping to build capacity in some fashion by providing training even if people move on to other jobs, but sometimes they quickly end up working in something totally unrelated. So it is a constant battle to build capacity in many of the countries where we work. But another obstacle, which is more serious to me, is the inadequacy of resources. I'll give you an example, in many countries where the literacy rate is high you would like to give information in a printed format but what happens is resources are so limited that you produce 1,000 copies when you actually need 100,000 copies. You never have the money to secure what you need. This is true even with radio because, in many countries now radio and television are totally commercialised. Commercial radio will say that you have to pay before a message can be aired and that has become a big cost. Previously when governments ran more radio stations, it was easier to have public health messages aired as a public service. So lack of resources is another obstacle.

UNFPA: An obstacle, which I think is a real challenge, is that UNFPA deals with a lot of sensitive issues. We are into sexuality, sex, harmful practices, as well as empowering and educating women in really traditional and conservative societies. We encounter a lot of obstacles to our programmes such as opposition from the religious community and traditional leaders. Family planning before it became acceptable had resistance from many different levels. I think we have to learn to creatively do our communication so that we become more acceptable and our programmes become more relevant.

UNFPA: I would like to take a crack at that. We talk about communication and we know that we have reached 90% -100% knowledge and awareness of family planning, but not in behaviour change. People have not adopted family planning in a big way. Behaviour change is really not taking place so in that sense we are loosing ground. I think, at least in my part of the world, we are not approaching it the right way. I'm very convinced now that to get to the individual behaviour change we want, we need to do community empowerment. But this is not what we are doing because we don't know how and it takes a long time. We think that we know how to change the behaviour of individuals but it is the community that has to change. For example, in parts of Nepal parents sell their daughters and this seems to be acceptable. Why is that? To change this we need to empower the community to say this is not right. These daughters, these girls have no rights and women are looked upon as commodities. A woman who has lost her husband and marries again cannot inherit the property, or if she goes for an abortion, she goes to jail and the community accepts that this is the right way. So I think that we should be changing individual behaviour through the community.

CI: Do you feel like you are gaining ground or not in terms of your mission and mandate?

UNFPA: I think that in addition to the themes, we face difficulties at the level of efficiency both within our organisation and with our counterparts. These constraints are more than just lack of resources but the fact that we are not specialised in communication like Johns Hopkins Center for Communication Programs and we are not working in an academic environment. We do not work only with peers who have a common understanding of what communication can do and know to start programming with good formative research, strategic planning, training etc. We work instead with peers and other colleagues that may not have the same understanding of what communication can do and how you plan for it.

There is also the issue of professional dominance. In population issues we deal with people who come from totally different backgrounds and mindsets, such as demographers and medical doctors. These people make the Fund's management decisions. At country level, there is the same issue of gatekeepers and having to negotiate with different government agencies and managers of programmes who have the same professional profile. This means in reality that a lot of things that we would like to do such as formative and socio-cultural research, end up getting lost as we are forced to take shortcuts and go immediately into an intervention mode when we would prefer to be in an analysis mode. So we don't always have enough control to implement the communication programming in its entirety with all the stages of a good communication programme intervention. I see this as a big obstacle. In the end, we are criticised for not producing results or not demonstrating visible results, when in fact, we all know that if we have had the luxury of conducting a baseline or having the time frame to involve communities, we would be able to show the results.

Other difficulties are that we deal with other donors who perhaps have more resources and not the same policies. Some of them may pay for instance for airtime or research but not for training. This obstacle relates to the lack of donor coordination.

UNFPA: I think we've won in many ways because if you look at the countries where UNFPA has programmes, we have done many things whether introducing family planning programmes, or communication support to family planning or helping programmes shift to reproductive and sexual health. But I think the losing side is where we have not really dealt with the sustainability of these programmes. There is one good example: population education where we had a long tradition of working with ministries of education to introduce population education into schools. After 25 years or so, we don't know what has happened. We have not followed up. Some of our programmes are very successful but on a pilot scale. We have no resources to upscale them and maybe that is where the challenge is, we need to work with other donors to help us to bring them to scale in some contexts.

UNFPA: I would take an optimistic view if we look at the overall picture. If we look at the record for family planning 10,15, or 20 years ago and what we have now, we've made quite a bit of progress. Of course we cannot claim that we did it alone, we're not the sole players. However we should not underestimate the weight of our presence in a country and the UNFPA's credibility as a neutral advocate for population programming. We were credible because as a UN agency, we were perceived as neutral. Now we are talking about women's liberation, women's equality, women's empowerment, things no one talked about 10 years ago. We are opening up new grounds as we begin talking about adolescent rights to reproductive health, services, and information. Overall, within communities, we are gaining. Where we might be loosing and need to focus more on is in reaching the hard to reach, the marginalised, the deprived segments of the society. With these people, we are not winning at the pace we should but there is now recognition that this will be a priority.

UNFPA: I think that our work needs to be seen in light of the experiences from several countries in the world where UNFPA was the main player, funder and population agency, bringing in the family planning message. In these countries we find tremendous success in terms of popularising reproductive health matters. I remember a very interesting experience we had in the Maldives. It's a small country. UNFPA funded a TV soap opera and the drama became very successful. Initially they thought they would do only 13 episodes but it turned into 75 and the people still wanted it to continue. They did some survey's and found that the contraceptive prevalence rate (CPR) had gone up from 13-16% to 32% in a short period of 3 or 4 years. It is not only the television drama that was responsible for it yet it was a significant jump in the CPR of that country. Very recently I was in Turkmenistan, Central Asia, where they are doing a very good job of producing and distributing IEC materials, in counselling training and other types of communication activities; the latest demographic health survey showed that in 1997 the CPR was 15% and now at the end of 2000 it has gone up to more than 27%; again, I think it is a very significant jump.

UNFPA: Yes, we were brainstorming yesterday and trying to figure out that we can actually attribute to UNFPA funded-communication programmes and it's quite clear in countries where no one else has intervened. We mentioned Maldives; there are extremely fascinating examples in Iran in population education and girls education and here in Nicaragua in the work with the army and communal movement; in Vietnam, we worked with youth and women's organisations; not to mention female genital mutilation and population censuses in Africa.

In general, we are winning thanks to the adoption of a programme approach, away from small projects. There is a tendency to go to a larger scale and to integrate these different approaches and it was very clear during this Roundtable that there is an emerging consensus among agencies that we need a multiplicity of complementary approaches, including consciousness raising, social marketing, and community empowerment.

But we are also victims of our success. After all these 25-30 years of working on communication for development, communication for development is becoming everybody's business and we find medical doctors saying things like, "Oh yes, for behaviour change, we just need a few community education sessions here and there". This way of looking at community empowerment makes it sound so easy, like you can come with a van, show a video and go. The whole process of social change is being overlooked. So I think that's one challenge.

UNFPA: Well actually we're losing because many of our colleagues do not perceive communication as something efficient in terms of bringing about rapid change. On the other hand, if you look backward at the investments in capacity development, you'll see that the long-term investments have produced some valuable results. For example, if you go to countries where we have invested in staff short or long-term communication training, people in the media have been able to take over population concerns in their day-to-day work. This is something that we think is a positive result, where we no longer need to be physically involved - what we call internalisation or appropriation- and I think that's a plus of UNFPA.

UNFPA: In the development context again, the trend towards decentralisation and work at the local level will, I think, allow communities to be more involved with communication. For instance, our staff are increasingly working with youth and women's organisations and with community media. We are responding to requests for support and are no longer the one orchestrating the show. Now we are really seeing locally-owned initiatives - people coming up with local theatre troupes and wanting to do something - we are becoming a coach rather than an initiator and I think that is success too.

CI: CI would love to profile any evaluations you have from these experiences through our website and The Drum Beat. Being able to share successful and not so successful initiatives is an important way for all of us in the field to learn and there is not enough of this kind of information available.

UNFPA: We should learn from things that don't work.

UNFPA: That's a good point. Because we don't control access to resources we are not always able to document our processes. This leads to the question of what if we had more money? The answer for me is more research, monitoring, evaluation and the documentation of experiences. Not only reporting what you started with and where you got, but what happened in the process? This is really where you learn what happened, what didn't work and how you readjusted the course of events to make it work in the end.

UNFPA: One other aspect is the sharing of good materials in different countries and languages. At the global level we are seeing good examples from Africa that we know that could be adapted and translated to other cultures. So, if we had more resources we could look into reproduction, adaptation, and translation of IEC materials that can be used by our friends in different programme countries without having to reinvent the wheel. There are many good examples.

UNFPA: For example, of the manual that is prepared by Puntos de Encuentro to involve young men as allies in gender-based violence and health would be very useful in other countries. Such community-based manuals act as models and ideas for how community discussions should be shaped and it could be translated from the Spanish. Many Latin American countries have well established sexuality education programmes in-and-out of schools and some of these are extremely innovative. If we had the funds to translate them we would be able to read them and identify really good materials for translation to other countries.

UNFPA: The Media/Materials Clearinghouse at Johns Hopkins Center for Communication Programmes is fantastic and it's doing just that in terms of the audiovisual part but not the training tools. It's doing that for posters, videos, and brochures, but not for the methodological tools for communication planning and evaluation. It's very, very important to have a central place where we can access and share this kind of knowledge. We also need a space for peer review and exchange of experiences. Our field in general has limited forums of international stature and there is the artificial compartmentalisation between health education and health communication and the two sectors do not speak very much to each other. There is also a predominant experience in health communication, which stops us from learning what is happening in gender and environment issues for instance which could be adapted for our work. If we had the resources we could do a lot more long-term communication training for UNFPA and for the community of communicators. We really need to multiply the number of training institutions that offer masters degree of communication all over the world as well as developing centers of excellence in communication.

UNFPA: I think that one of the major problems countries are facing in regard to RH and population-related education, for example, are the need to have generalised access to materials at all level of the school system. If we had more resources we could invest in the production of more teaching and learning materials that would enable countries to go to a larger scale with the introduction of population, RH and HIV/AIDS content. I think some countries have attempted to take soft loans from banks but that's not something that is done in many countries.

UNFPA: In the area of in-school life-skills and sexuality education the issue is two pronged. One is the issue that each child deserves to have access to reading materials associated with the core topics that we can invest in. Also, these are sensitive topics that require training in methodology as well as in content for the teachers, and lots of advocacy at the grass roots levels in every community. This is an enormous investment; if you want to do it successfully, you should go to scale in 200 schools at a time. We don't have the money for the replication of the materials or for the training of that many people. And we used an inadequate training of the trainer system that works "so so". By the time you get down to the actual implementers in the classroom they are far removed from the original people who were trained by the highest quality people. If we had more money we would have more high quality trainers closer to the implementers.

CI: Which are the voices out there that you think are important but that we're not listening to in the way we should?

UNFPA: I think clearly we agree that the voices of beneficiaries or clients of services and the most vulnerable groups and people at the grass roots level are not heard enough. But also, interestingly, because we deal with sensitive issues and because we need to be strategic, we also need to know our opponents or adversaries better. Since we are dealing with sensitive issues in our work area, we also need to know what the opposing positions are on certain issues such as new gender roles or standards related to sexuality of young people. We need to understand issues like what prevents parents from speaking with their children. We may know what parents think but young people are very much unheard.

UNFPA: We haven't really developed capacities for listening to young people and getting them in our programmes. We say we should involve them but how to do it? When to do it? What do we get out of it? Who else should we get involved to get young people involved? Working with the youth segments of the population is relatively new in UNFPA in the sense that we no longer want to see them as beneficiaries but as partners in our programming and that's a skill we need to develop. It's getting better as we improve certain communication channels such as hotlines. I think these are a marvellous way of listening to people if you really analyse what people are asking for.

UNFPA: Also, I think the voices of women who are subjected to violence need to be heard too. And young girls who are not getting the opportunity to go to school, I think their voices should be heard.

UNFPA: I think the point mentioned earlier about reaching the hard to reach is a real challenge. I think many, if not most, of our programmes are still based in urban areas and less in remote areas and I think reaching these remote areas is still a big issue for UNFPA in communication. We've used effective media like radio, but we could be doing much more.

CI: We are inundated with stories of the growth and promise of the Internet and new communication technologies. We all know that they are not the whole answer but how important are they in carrying out your work?

UNFPA: Initially, it was not a happy marriage or an easy one. Personally, I discovered an extremely interesting debate going on. It was not just about high-tech; you could actually change the course of development through the strategic use of new information and communication technologies (ICTs). We organised a conference in Ankara called "ICPD Advocacy in the context of the global information and knowledge management age" [LINK TO THE REPORT]. We invited various partners that were using this technology to understand what it could mean for our communication work on the ICPD.

Traditionally UNFPA has used this technology for sharing knowledge and creating networks of communities among demographers, such as POPIN. We used software technologies to do things like map out population trends, etc. But we discovered that with new ICTs, there is a whole communication movement going on and whether you are sceptical or not, communities are organising themselves to have access to the technology and the information to bridge the digital divide. It's opening new avenues to promote issues of concern; in fact; we are getting closer to the community through technology such as community radio and hotlines. We have a project in Uganda where villagers are using walkie-talkies to call for transportation in emergency obstetrics cases, we have call-in shows for young people, young people creating their own websites, etc. So there is a tremendous opportunity for us if we create bridges with the private sector.

UNFPA: In the area of capacity building, UNFPA has started using distance learning quite recently and we have developed with the help of our own technical people 6 courses in our area of work, which include advocacy and adolescent sexual reproductive health. The distance learning course is initially only to be offered to UNFPA staff to update their skills and knowledge but will eventually be open to our counterparts in countries as well.

UNFPA:The Condoms CD-ROM is another successful initiative, packaging in one single CD-ROM, information on how to actually ORGANISE communication campaigns for condom promotion. In terms of possibilities, we are thinking of using more interactive tools for communication programming. For instance, we can share experiences in communication through an online service on our intranet where we can now insert stories online.

CI: Thank you very much. This has been a very interesting discussion.