Kabul, Afghanistan: Despite high illiteracy rates in most of rural Afghanistan, Afghan families are keeping abreast of the news through the country's most popular medium: radio. Surveys show that in some rural provinces, 75% to 90% of all households are listening, spurring Afghan public health officials to take a creative approach to communicating messages about health care.

Over the past two years, the Rural Expansion of Afghanistan's Community-based Health Care (REACH) program has been holding script-writing and broadcasting workshops in Kabul for staff from Afghanistan's Ministry of Public Health (MOPH) and from Radio/TV Afghanistan to develop dramas and radio spots about health issues. The most recent session has produced 24 spots, 15 focusing on immunization and nine on birth spacing.

Once the new spots are on the air, expected this October, REACH will have delivered 73 health care messages for broadcast to homes throughout Afghanistan. Recorded in both Dari and Pushto, complete with music and sound effects, the health-focused dramas are designed to entertain as well as inform.

The REACH program is funded by USAID and implemented by Management Sciences for Health (MSH).

Topics for the radio spots and plays run the gamut from immunization and child spacing to the treatment of diarrhea, the importance of hand-washing, and the prevention of malaria.

"I believe we've developed spots that are really effective because people in Afghanistan like a drama much better than just getting information from a narrator," said Nazila Ghafori, an experienced Afghan broadcaster who is part of the REACH workshop to develop the scripts. "I think people will listen to these messages and follow up on them."

The participants in the current workshop spent an afternoon last week in a studio recording four scripts to be tested on a live audience.

This week, the recorded messages are being taken to health clinics located in outlying areas of Kabul, where patients typically have educational levels similar to those who live in the country's more rural areas. The pilots will be turned into 24 final scripts over the next two months.

One storyline to be tested this week focuses on a woman named Maryam and the birth of her child. The spot is sprinkled with critical health messages about immunizations and vaccinations.

In the drama, Maryam learns that women should be immunized against tetanus at least twice before delivery and five times between the ages of 15 and 45. During Maryam's visits to the clinic, nurses tell her that children should be vaccinated for polio and tuberculosis starting six weeks after birth and that if they experience redness and swelling after the injection, they should return to the clinic immediately.

At one point in the drama, Maryam forgets the date of her newborn's next vaccination, but neither she nor her husband can read what is on the vaccination card that the nurses gave her. "Her husband remembers the nurse saying, 'If you are not able to find out the exact date of the next vaccination, go so someone who can read,'" the script advises, so he seeks out a teacher who is literate. The drama ends with Maryam telling her neighbors about the vaccination process after a nurse encourages her to spread the word.

Currently, 47 radio stations are broadcasting on AM and FM within Afghanistan, 28 of them opened and operated by InterNews. Once completed and taped, the 24 radio spots will be broadcast by InterNews on Radio Kaleed, its Kabul-based station, and on its other stations around the country.

"Radio stories and dramas engage listeners' imaginations," says Nancy Newbrander, a REACH consultant working with MOPH staff on the project. "People identify with the characters and care about the story's outcome. Healthy behaviors make for a happy ending, and that's a good way to promote behavioral change."

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