Framing of maternal health risk communication messages

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Tackling maternal deaths is a multi-dimensional, multi-perspective and multi-sectoral issue. The risk of maternal mortality is an important concept that requires comprehensive understanding from its stakeholders. This is because the methodologies for managing this risk are becoming more complex with the added complexity of stakeholders perspective and communication challenges.

A theoretical approach to constructing effective risk communication regarding behaviour change is “message framing” (Rothman et al., 1993). In this approach, health messages can be framed in terms of positive (gains) or negative (losses) associated with a particular behaviour, this framing then influences decision-making (Rothman & Peter, 1997). For example “presence of a skilled birth attendant during delivery, reduces the risk of mortality” (gain-framed), and absence of skilled birth attendants during delivery increases the risk of death” (loss-framed).

According to prospect theory, the way a message is framed determines the degree of acceptability and responses of different individuals. When the benefits are more salient, people are risk averse, on the other hand when presented with potential losses, individuals are more likely to tolerate risks (Kahneman & Tversky, 1979). As a result, this leads to two categories of behaviours. According to the theory, for detection behaviours perceived as risky (e.g. it may detect a health problem), a loss-framed health message is considered useful (Rothman and Salovey, 1997; Rothman et al., 2006). For perceived low-risk prevention behaviours (e.g. it prevents the onset of a health problem), a gain-framed health message is more compelling (Rothman & Salovey, 1997; Rothman et al., 2006).


The aforementioned concept has been utilised successfully in various interventions, from skin cancer prevention to smoking cessation. The relaying of messages effectively to stakeholders of maternal mortality depends on the output method of the message.

Proper manipulation of evidence-based messages can lead to changes in attitudes, intentions, perceptions and actions. However, as compelling as the results from message framing studies have been, they should be treated with caution, given the paucity of well-designed experimental studies. Further research has been advised to examine the potential mediating process to changing behaviours (Pavey & Churchill, 2014). Indeed, the efficiency of message framing can depend on the disposition of the audience, and therefore, to maximise persuasiveness of a message, people’s differences and perceptions should be accounted for when tailoring risk communication strategies (Covey, 2014).

Perhaps a combination of message framing and efficient message dissemination strategies may be vital routes to take when embarking on communication interventions for the African women of childbearing age.

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