Implementation of communication strategies during pandemics: The case of the 2009 H1N1 influenza

Background: International organizations appreciate the importance of using communication strategies during pandemics. Objectives: To review to what extent the WHO and CDC reports addressed the issue of health communication strategies in the case of the 2009 H1N1 influenza. We completed our analysis with an empirical case study of Israel, examining how the instructions and theories were implemented in the member states. Methods: First we compared the CDC and WHO reports from 2005 and 2009 to check what lessons were learned regarding the use of the health communication strategies of risk communication, social marketing and one-way versus two-way flow of communication. In the second stage we conducted 73 semi-structured interviews with stockholders from Israel; policy makers, journalists and healthcare workers. Findings: The instructions were mostly "top-down," with little attention to their implementation in the member states, feedback regarding lack of information or misunderstandings and local adaptations that were needed. Summary and recommendations: It is advisable to use the most up-to-date theoretical literature and theoretical dimensions in planning communication strategies. There is a gap between the instructions on the international level and their implementation in the member states. While many instructions and theoretical dimensions were successful on the international level, the Israeli case study showed that sometimes the diffusion to the member states was incomplete. Most of the communication process that was found in the reports flowed from the top down. A strategy of two-way communication would be advantageous.