[The street: a scenario for health] La calle: un escenario para la salud.
The UN Children's Fund (UNICEF) has substituted the infant mortality rate for per capita income in determining its plans for cooperation with poor countries. More than 15 million infants under 1 year die each year from such causes as dehydration during diarrhea, malnutrition, illnesses preventable by immunization, and immunological deficiencies caused by early weaning. In 1984 a 4-pronged approach to control of infant mortality was announced by UNICEF. It called for treatment of dehydration by oral rehydration therapy, immunization against 6 killing diseases, use of growth charts by mothers, and promotion of breast feeding. UNICEF based the strategy on a number of elements not directly related to public investment, including a high level political commitment, consensus of the most dynamic social forces, intense social mobilization of the priority sectors for application of the strategy, and full support of the mass media. Most of the interventions in which UNICEF has cooperated have been of the campaign type, raising questions about the permanence of the actions. Compromises were believed to be needed to ensure that activities go on in circumstances that would otherwise overwhelm the public health services. The job of communication in such circumstances is to find ways of guaranteeing that the new health behaviors become routinized and incorporated into the everyday life of the target population. The communication program for the vaccination campaign in Peru in 1985 faced specific challenges: understanding the relationship between mass communication and social mobilization, and providing mass media for a single campaign that would be valid for the entire country in its geographic and social diversity. Although no formal pretesting was done of the mass communication materials, the impact of the messages, music, slogans, and images was informally measured in the early phase of diffusion. Messages for the 1st vaccination day were created for radio, television, and the press that tried to maintain a festival atmosphere while attracting parents of infants and children under 5, dispelling their resistence, furnishing information on the location of vaccination posts, and emphasizing the date. Themes stressed for the 2nd vaccination day were the need to attend all 3 days to be fully protected, changes in location of posts, and continuing need to overcome fear of side effects. It became clear that more stress was also needed on the risks and consequences of not being vaccinated. The festival atmosphere was maintained in the numerous social mobilization activities held at the local level to publicize the vaccination days.