Abstract
Background: Many lower and middle income countries (LMICs) have high levels of linguistic diversity, meaning that health information and care is not available in the languages spoken by the majority of the population. This research investigates the extent to which language needs are taken into account in planning for HIV/AIDS-related health communication in development contexts. Methods: We analysed all HIV/AIDS-related policy documents and reports available via the websites of the Department for International Development UK, The Global Fund, and the Ministries of Health and National AIDS commissions of Burkina Faso, Ghana and Senegal. We used quantitative and qualitative analysis to assess the level of prominence given to language issues, ascertain the level at which mentions occur (donor/funder/national government or commission), and identify the concrete plans for interlingual communication cited in the documents. Results: Of the 314 documents analysed, 35 mention language or translation, but the majority of the mentions are made in passing or in the context of providing background socio-cultural information, the implications of which are not explored. At donor level (DFID), no mentions of language issues were found. Only eight of the documents (2.5%) outline concrete actions for addressing multilingualism in HIV/AIDS-related health communication. These are limited to staff training for sign language, and the production of multilingual resources for large-scale sensitization campaigns. Conclusions: The visibility of language needs in formal planning and reporting in the context of HIV/AIDS-related health care is extremely low. Whilst this low visibility should not be equated to a complete absence of translation or interpreting activity on the ground, it is likely to result in insufficient resources being dedicated to addressing language barriers. Further research is needed to fully understand the ramifications of the low prominence given to questions of language, not least in relation to its impact on gender equality.
Highlights
Effective communication has long been recognised as a crucial factor in health care
The bulk of research in this latter area has been on migrant communities accessing health care in Western settings, notably people with limited English proficiency (LEP) accessing health care in the United States (see, for example, Brach et al (2005); Elderkin-Thompson et al (2001); Flores, 2005; Jacobs et al (2004))
This research has found that language barriers can have a major adverse impact on health and health care (Flores, 2005) and that people with LEP ‘have worse access to care, receive poorer quality of care, are less likely to understand and adhere to care plans and are less satisfied with their physicians’ (Gregg & Saha, 2007, p. 368)
Summary
Effective communication has long been recognised as a crucial factor in health care. Much of the focus of both academic scholarship and training for practitioners has been on intralingual communication, i.e. communication between individuals using the same actual language (English, French, etc.). This research investigates the extent to which language needs are taken into account in planning for HIV/AIDS-related health communication in development contexts. Eight of the documents (2.5%) outline concrete actions for addressing multilingualism in HIV/AIDS-related health communication These are limited to staff training for sign language, and the production of multilingual resources for large-scale sensitization campaigns. Conclusions: The visibility of language needs in formal planning and reporting in the context of HIV/AIDS-related health care is extremely low. Whilst this low visibility should not be equated to a complete absence of translation or interpreting activity on the ground, it is likely to result in insufficient resources being dedicated to addressing language barriers. Further research is needed to fully understand the ramifications of the low prominence given to questions of language, not least in relation to its impact on gender equality
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