Performing arts as a social technology for community health promotion in northern Ghana

Objective: We present first-phase results of a performing arts public health intervention, ‘Singing and Dancing for Health,’ aiming to promote healthier behaviors in Ghana’s impoverished Northern Region. We hypothesize that live music and dance drama provide a powerful technology to overcome barriers such as illiteracy, lack of adequate media access, inadequate health resources, and entrenched sociocultural attitudes. Our research objective is to evaluate this claim. Methods: In this first phase, we evaluated the effectiveness of arts interventions in improving knowledge and behaviors associated with reduced incidence of malaria and cholera, focusing on basic information and simple practices, such as proper hand washing. Working with the Youth Home Cultural Group, we codeveloped two ‘dance dramas’ delivering health messages through dialog, lyrics, and drama, using music and dance to attract spectators, focus attention, infuse emotion, and socialize impact. We also designed knowledge, attitude, and behavior surveys as measurement instruments. Using purposive sampling, we selected three contrasting test villages in the vicinity, contrasting in size and demographics. With cooperation of chiefs, elders, elected officials, and Ghana Health Service officers, we conducted a baseline survey in each village. Next, we performed the interventions, and subsequently conducted follow-up surveys. Using a more qualitative approach, we also tracked a select subgroup, conducted focus group studies, and collected testimonials. Surveys were coded and data were analyzed by Epi Info. Results: Both quantitative and qualitative methods indicated that those who attended the dance drama performances were likelier than those who did not attend to list the causal, preventive, and transmission factors of malaria and cholera. Also, the same attendees were likelier than nonattendees to list some activities they do to prevent malaria, cholera, and other sanitation-related diseases, proving that dance dramas were highly effective both in raising awareness and in transforming behaviors. Conclusions: As a result of this study, we suggest that where improvements in community health depend primarily on behavioral change, music and associated performing arts – dancing, singing, and drama – presented by a professional troupe offer a powerful social technology for bringing them about. This article is a status report on the results of the project so far. Future research will indicate whether local community–based groups are able to provide equal or better outcomes at lower cost, without outside support, thus providing the capacity for sustainable, localized health promotion.