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RESEARCH ON

MEDIA COVERAGE OF HEALTH


IN UGANDA
JULY 2015 – JUNE 2017
Copyright © ACME 2018

Published by
African Centre for Media Excellence
Plot 124 Nanjala Road, Bunga
P. O Box 11283 Kampala, Uganda
Telephone: +256393202351
Email: info@acme.org
Website: www.acme-ug.org
Facebook: ACME.UG
Twitter: @ACME_Uganda
ACKNOWLEDGEMENTS
This report is published with support from the United States
Mission in Uganda, which funded the African Centre for Media
Excellence’s project on Reporting Health and HIV/AIDS in Uganda
for two years. We are grateful for the support.

Several individuals contributed to the report and we single out a


few; ACME statistician Brian Ssenabulya; research report writer
Harriet Anena, data coder Godwin Okiror; Janet Napio for key
informant interviews, Director of Programmes Bernard Tabaire
and Executive Director Peter Mwesige for the oversight and
guidance.

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RESEARCH ON MEDIA COVERAGE OF HEALTH IN UGANDA
JULY 2015 – JUNE 2017

CONTENTS
Executive Summary vii

CHAPTER I: INTRODUCTION 1
Background to the Study 1
Context of the Print Media Environment in Uganda 1
Context of Health and Public Affairs Coverage in Uganda 4
Research Questions 6

CHAPTER II: METHODOLOGY 7


Scope of the Study 7
Study Population, Sample and Sampling Method 7
Methods of Data Collection 8

CHAPTER III: RESEARCH FINDINGS 10


1. Volume of Health Stories 10
2. Prominence of Health Stories on the Page 14
3. Front Page Coverage of Health vs. Other Public Affairs
Issues 15
4. Reporting Format 18
5. Story Trigger 28
6. Number of Sources 30
7. Occupation of Sources 34
8. Gender of Sources 36
9. Occupation of Sources by Gender 38
10. Institution that is the Focus of the Story 40
11. Health Topics Covered 41

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12. Context 49
13. Story Frame 54
14. Newsmaker 56
15. Location of Story 60

CHAPTER IV: CONCLUSIONS & RECOMMENDATIONS 62


Conclusions 62
Recommendations 63

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RESEARCH ON MEDIA COVERAGE OF HEALTH IN UGANDA
JULY 2015 – JUNE 2017

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EXECUTIVE SUMMARY
This report contains findings from research on newspaper
coverage of health in Uganda between July 2015 and June 2017
conducted by African Centre for Media Excellence (ACME) in the
last half of 2018. The study sought to provide systematic evidence
to support informed analysis and debate about health coverage
in Uganda. Five major Ugandan print publications were reviewed
under this study. They are:

1. Daily Monitor
2. New Vision
3. The Observer
4. The Independent
5. Bukedde
The research is one of the key outputs of ACME’s project,
“Entrenching Knowledge-Based Health Journalism in Uganda,”
which was funded by the United States Mission in Uganda
between 2016 and 2018.

The data that informs the key findings of this research is from
ACME’s on-going bigger research project on press coverage of
public affairs in Uganda, which has focused on 12 key issues.
These are:

1. Agriculture
2. Business and Economy
3. Defence and Security
4. Education
5. Energy and Extractives
6. Environment and Natural Resources

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RESEARCH ON MEDIA COVERAGE OF HEALTH IN UGANDA
JULY 2015 – JUNE 2017

7. Foreign Affairs
8. Health
9. Justice, Law and Order
10. Land, Housing & Settlements
11. People and Power
12. Public Works and Infrastructure
A summary of the findings about media coverage of health in
Uganda between July 2015 and June 2017 are as follows:

⿟⿟ Volume of stories: A total of 59,966 public affairs stories


were published by the print media monitored, with health
stories accounting for 7.4%.
⿟⿟ Front page coverage: Only 9.8% of health stories appeared
on the front page during the two-year study period.
⿟⿟ Prominence of coverage: At least 41.1% of health stories
were the first lead on newspaper pages. A breakdown by
publication shows that The Independent had more health
stories as first lead, while Bukedde had the least lead stories.
⿟⿟ Reporting format: Conventional hard news reporting was the
most dominant format (81.1%). A breakdown by publication
shows that Bukedde had the most number of health stories
reported conventionally, followed by its sister publication,
New Vision. However, the two publications also lead in
investigative health stories.
⿟⿟ Number of sources: A total of 27.3% health stories were
single sourced, while some 2.1% stories had no source.
⿟⿟ Occupation of sources: At least 18.6% health sources were
experts. Ordinary persons were the third most quoted in
heath stories at 17%.
⿟⿟ Gender of sources: Male sources (66.9%) were the most
quoted in health stories compared to female (33.1%). In
terms of occupation, more female sources were quoted in

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their capacity as ordinary persons and CSO representatives,
while male sources were mostly experts.
⿟⿟ Health topics covered: Stories about diseases were the
most covered compared to those on institutional or sector
management; drugs and equipment & supplies. A breakdown
of disease coverage shows that Non-Communicable Diseases
were the most covered. The top three diseases covered
included HIV, cancer and malaria.
⿟⿟ Context: Majority of health stories had “adequate context”
(56.4%).
⿟⿟ Story Frame: A total of 46.2% stories were packaged using
the service delivery frame, followed by those on livelihoods
and human development (39.2%).
⿟⿟ Location of stories: Although a majority of health stories
originated from parts of the country (57%) other than
the capital, Kampala took a disproportionate share of the
coverage.
The research findings offer a mixed picture. There appears to
be significant progress in areas such as provision of context,
multiplicity of sources, and a healthy focus on non-communicable
diseases -- which are a major global health challenge. However,
the predominance of the hard news storytelling format with
the accompanying lack of depth, enterprise and investigation,
limited diversity in sourcing, and over reliance on officialdom, still
undermine the contribution of media coverage toward improving
the health sector.

Key respondents who were interviewed blamed the shortfalls


registered in health coverage on the issues below:

⿟⿟ Persistent anchoring of newspaper content around politics,


with no effort made to link political actions and decisions
to health.

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⿟⿟ Inadequate knowledge and specialisation in health coverage


which makes it difficult for comprehensive and consistent
reporting to be done.
⿟⿟ Inadequate follow-up on stories that were reported as hard
news. This practice denies newsrooms the opportunity to
carry out exposés on health issues or in-depth reporting that
would enrich public understanding of issues.
Remedies for the above challenges can include more newsroom
investment in in-depth reporting; media literacy training on the
importance of source diversity in terms of gender and other
source dynamics; and self-improvement by journalists.

This report is divided into four chapters. Chapter One is


the introduction to the study, Chapter Two describes the
methodology of the study; Chapter Three contains the research
findings and discussion, while Chapter Four offers conclusions
and recommendations.

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CHAPTER I

INTRODUCTION
Background to the Study
This study sought to examine how the media covered health in
Uganda and to shed light on reporting health as a public affairs
issue. Specifically, the study provides evidence on the quantity,
quality and nature of health reporting, as well as trends and
patterns in press coverage from July 2015 to June 2017.

For the purpose of this study, health has been defined to include
issues, occurrences, and developments concerning, affecting, or
originating from activities, laws, regulations, policies, authorities,
as well as state and non-state actors and institutions involved
in the development, management and use of all forms of health
facilities, systems and services such as public and private
hospitals and health centres for the general physical and mental
wellbeing of the population.

Findings were derived from an examination of coverage of


health by five major print publications in Uganda, namely: Daily
Monitor, New Vision, The Observer, Bukedde and The Independent
magazine.

Context of the Print Media Environment in Uganda


Background
The print media environment in Uganda is generally vibrant but
continues to face a myriad of challenges, ranging from direct
and indirect government meddling, self-censorship, sometimes
unhelpful commercial interests by media owners, and “disruption”
from social media.

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While print media have embraced online and social media


platforms to bring their content closer to their audience, the
government continues to monitor and curtail these platforms that
have become a major source of news for many Ugandans. The
shutting down of social media during the 2016 general elections
still rings fresh in the minds of many.

For the health beat, the limited specialisation in coverage implies


that health issues are not dissected and covered in detail and
from a point of deep knowledge. Technical and scientific health
issues fail to receive the adequate breakdown necessary. Partly
as a result, reporting largely remains episodic and shallow.

The limited investment by newsrooms in investigative journalism


also implies that the health beat, just like others, suffers.
A reduction in newspaper copy sales globally has caused
media houses to keenly guard the business bottom line. It’s
not uncommon to hear journalists complain that newsroom
facilitation is not sufficient, a reason they give for a rise in
‘facilitation/transport allowance’ journalism.

A consequence of poor facilitation by media houses of their


journalists and journalism is the flight from the profession of senior
journalists, some of whom are health reporters. For instance, Daily
Monitor senior health reporter Emmanuel Ainebyoona underwent
ACME’s pioneer covering health training in 2017 only for him to
leave the media in 2018 for a more lucrative role in the Ministry
of Health’s communications department. While some media
development organisations invest in training journalists who
report health, it’s not a guarantee that they will remain in the
newsroom; and when they leave, a new crop of reporters have
to be trained, something that doesn’t happen easily.

Despite the challenges, different stakeholders - media


development organisations, journalism institutions, and media
houses themselves - continue to push for professionalism in the

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industry. Freedom House’s Freedom in the World report for 2018,
for instance, notes that Uganda’s status improved from “not free”
to partly free” “due to the resilience of the media sector and the
willingness of journalists, bloggers, and citizens to voice their
opinions”.

Standards and quality of reporting


The main print publications in Uganda show an above average
level of professionalism through the content they produce. They
are generally bold, comprehensive and independent in their
reporting.

Generally, the print media in Uganda still has a huge opportunity


to improve but concerns persist over professionalism and ethical
standards. Most stories still contain little enterprise, depth,
analysis and investigation. Elementary mistakes, single-sourced
stories, glaring inaccuracies, on-the-surface reporting, the
dearth of day-two journalism as well as ‘facilitation’ journalism,
undermine the credibility of the sector.

In-depth reporting and investigation of public affairs remains


limited. For instance, ACME’s research on press coverage of public
affairs between July 2015 and June 2016, found contrast between
government funding priorities, citizens’ concerns as outlined in
the 2016-2021 Citizens’ Manifesto and press coverage. Only 3.3%
of the stories focused on public works and infrastructure, a sector
that consistently receives the largest proportion of government
budgetary allocations. Health and education, priority areas in the
Citizens’ Manifesto received 7.5% and 6.5% coverage respectively.
Agriculture, often touted as the backbone of Uganda’s economy,
was the fourth least reported public affairs issue during the study
period.

Ugandan journalists cite poor pay, lack of knowledge/skills,


limited or no facilitation for in-depth reporting, as the biggest

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RESEARCH ON MEDIA COVERAGE OF HEALTH IN UGANDA
JULY 2015 – JUNE 2017

obstacles to their work. Pressure not to publish comes from


government, major advertisers and media owners with political,
religious and business backgrounds.

The rate of job turnover in print media remains generally high.


Many experienced journalists have moved on to other fields such
as marketing and public relations for better pay and more flexible
working hours. Commentators note that such outflow of trained
and experienced journalists for new and inexperienced ones
weakens institutional memory and diminishes the intellectual
capital and credibility of news organisations. The dearth
of respected and experienced journalists who have earned
credibility over the years and who are capable of interrogating
claims with authority, undermines the media’s ability to effectively
set the agenda.

While this situation is made in reference to print media, it also


applies to other media forms – broadcast and online - which
calls for a cross-platform approach in addressing the challenges.

Context of Health and Public Affairs Coverage in


Uganda
For a long time, media coverage of public affairs has been largely
dominated by politics, or stories with a political slant1. This can be
explained by the ‘excitement’ that political stories attract and how
relatively easy it is to dramatise political issues. It is therefore not
uncommon to find a national daily leading with political stories
throughout the week.

While politics play a big role in determining the effectiveness (or


lack thereof) of health services, health infrastructure and health
policies, the media often treat health stories without paying close

1 ACME (2016), Monitoring Media Coverage of the 2016 Elections: Final Report

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attention to this nexus. A 2015 USAID report2, for instance, found
that the “emergence of “market-driven” or “market-oriented”
journalism and stiff competition were driving the media in Uganda
toward a trend of “news” that they believe audiences prefer.

The same study found that stories about health did not get as
much prominent coverage in our media, except in situations of
“outbreaks of deadly infections, or of mysterious diseases, and
during special health days”3.

ACME’s research on press coverage of public affairs4 shows that


while health as a public affairs issue is among the top six issues
covered by the media in Uganda (out of the 12 issues monitored),
when it comes to prominence of health stories, the picture
changes. For instance, while health was the third most covered
public affairs issue in the first year of our public affairs study in
terms of volume of stories, when it came to story prominence,
health was in the third last position.

Cooper et al (2016)5 also note that health reporting still does not
represent the changing burden of disease. The prevalence of non-
communicable diseases (NCDs), they argue, therefore requires a
change in mindset and approach to reporting so that audiences
are in tune with present-day health challenges and issues.

Previous studies on health (HIV) coverage in Uganda have


shown that most stories originated from the capital Kampala
and politicians were the dominant sources.

2 USAID (2015), Where are the human rights in human interest stories?
Analysing the coverage of health issues in the Ugandan mass media from a
human rights perspective.
3 Ibid
4 ACME (2017) Press Coverage of Public Affairs in Uganda: Research Report
(Round 1, Round 2, Round 3, Round 4).
5 Cooper, et al (2016) Does health-related content in a major Ugandan
newspaper reflect the changing burden of disease in East Africa?

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JULY 2015 – JUNE 2017

Poor coverage of health was blamed on, among other challenges,


the complexity of medical issues, low prioritisation by editors, as
well as inadequate facilitation by media houses.

How has the coverage changed, if at all, over time?

Research Questions
The study explores the following questions:

1. Who are the key voices and agenda-setters in health


stories?
2. What is the prominence of health stories in print
publications in Uganda?
3. What is the prominence of health stories on the page?
4. What is the nature of health reporting by Ugandan
media? What type of stories are reported?
5. How does gender play out in the sourcing of health
stories?
6. What health topics are covered most by Ugandan media?
7. What category of diseases do the media cover most?

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CHAPTER II

METHODOLOGY
This chapter presents the scope of study, the sample and
sampling methods, methods and tools of data collection.

Scope of the Study


Our study findings are derived from a purposive sample of English
and Luganda language print publications in Uganda and their
coverage of health from July 2015 to June 2017. The publications
under review are:

1. New Vision (daily -- English)


2. Daily Monitor (daily -- English)
3. The Observer (weekly -- English)
4. Bukedde (daily -- Luganda)
5. The Independent (weekly -- English)

Study Population, Sample and Sampling Method


Content analysis of data for the reporting health study was done
at two levels:

⿟⿟ Primary level: A census of coverage of health stories over


the 24-month period was carried out to generate the study
population.
⿟⿟ Secondary level: A sample equivalent to 10% of the articles in
the population was generated using probability, proportional
to size sampling based on each publication’s contribution to
the population of coverage. The sample was then distributed
proportionately among the five print publications through
simple random sampling.

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JULY 2015 – JUNE 2017

Therefore, the total number of public affairs stories published


between June 2015 and July 2017 was 59,966 (drawn from 12
public affairs issues). Of this total, 4,445 were health stories. For
the purpose of this study, a 10% (472) sample of health stories
was analysed for manageability purposes but, a 10% sample still
falls within the scientifically acceptable study portion.

The five publications selected for this study are mainstream


and widely circulated. This gives us sample that takes care of
audience reach and demography, and thus a fair representation
of he Uganda print media. The Daily Monitor and New Vision are
dailies with a national reach. As well as The Observer, they are
read by a cross-section of low and middle income audiences.
The Independent is a weekly magazine whose readership is
mostly elite and concentrated in the urban areas, particularly
central region. Bukedde is a Luganda-language daily with huge
readership in central Uganda.

Methods of Data Collection


The study relied on quantitative content analysis of data, and
key informant interviews to provide qualitative context for the
findings.

1. Content analysis
Content analysis of data detailed an all-round picture of the
nature of health coverage by the print media as assessed using
various dimensions of journalistic quality and quantity. Stories
were coded and analysed for the extent to which they reflected
various pre-determined features of coverage that were apparent
in nature, to more latent characteristics of reporting. They were
analysed using the following research variables:

1. Volume of health stories


2. Prominence of health stories on the page

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3. Front-page coverage of health vs. other public affairs issues
4. Reporting format
5. Story trigger
6. Number of sources
7. Occupation of sources
8. Gender of sources
9. Occupation of sources by gender
10. Institution that is the focus of the story
11. Health topics covered
12. Context
13. Story frame
14. Newsmaker
15. Location of story

2. Key informant interviews


Key informant interviews were conducted to make sense of the
nature of health reporting by print media in Uganda and what
informs it; the environment under which health reporting is done
and patterns of coverage. Media and journalism trainers, health
editors and senior reporters were interviewed to provide insight
into the findings and issues generated through content analysis.

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JULY 2015 – JUNE 2017

CHAPTER III

RESEARCH FINDINGS
1. Volume of Health Stories
a) Health vs. Other Public Affairs Issues
The media published 59,966 public affairs stories during the study
period — July 2015 and June 2017. Of the total, health stories were
4,445. This placed health in fourth position (percentage of 7.4%).

Our research on media coverage of public affairs issues shows


that in the third round of study (July 2015 – June 2016), health
was the fourth most covered issue, one place behind people and
power (i.e., politics). However, the gap increased in the fourth
round of study (July 2016 – June 2017) to sixth position, two
places behind people and power.

Uganda held general elections in February 2016. The active


electioneering period started in 2015 and faded out in May 2016
after the swearing in of President Yoweri Museveni. The coverage
of more health stories during this period (July 2015 – June 2016)
can be explained by the advocacy for better health and health
services by politicians seeking elective positions. An example
is the widely covered story about the visit to Abim Hospital in
Karamoja sub-region by presidential contender Kizza Besigye
in December 2015. Daily Monitor reported two months later, in
February 2016, that the hospital, which had not received a facelift
since its construction in the 1960s, had been renovated following
the politician’s visit and exposure of the rot at the government
facility.

While it’s noteworthy that health received prominent coverage


during a politically heavy period, it also shows that the media

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followed the story of the day as it happened (instead of setting
the agenda) and stopped doing so when electioneering ended,
as seen in a dip in health story volume. This episodic coverage
of news deprives the audience of in-depth reporting. It’s not
surprising that the conventional reporting format is dominant
as shown this and our public affairs studies.

Media analysts we spoke to emphasised that good health is


key in the execution of social, economic and political tasks and
recommended that regardless of the period, emphasis and
prominence should be accorded to health reporting.

Table 1: Volume of health stories vs. other public affairs issues

Issue July 2015 - July 2016 - Overall


June 2016 June 2017 (n=59,966)
(n=29,225) (n=30,741) %
% %

Justice, law and order 29.4 29.1 29.2


People and power 11.3 25.9 18.8
Business and economy 13.0 9.1 11.0
Health 7.3 7.5 7.4
Foreign affairs 9.3 5.6 7.4
Education 8.3 6.5 7.4
Land, housing & 5.5 3.2 4.3
settlements
Environment & natural 4.3 2.8 3.5
resources
Public works & 3.7 3.3 3.5
infrastructure
Agriculture 3.8 3.1 3.4
Defence 2.5 2.4 2.4
Energy and extractives 1.9 1.5 1.6

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JULY 2015 – JUNE 2017

b) Volume of Health Stories


Out of the 4,445 health stories published during the two-year
period, a sample of 472 (10%) was the subject of analysis for this
study. This was for manageability purposes, but also because 10%
provides an acceptable scientific sample. Compared with media
coverage of other public affairs issues, the volume of health
coverage is generally commendable.

Table 2: Volume of health stories by year

Period No. of stories (%)

July 2015-June 2016 2,315 52


July 2016-June 2017 2,130 48
Total 4,445 100

A breakdown of coverage by publication shows that Daily Monitor


(33.8%) and New Vision (30.7%) published the highest volume
of health stories. This can be explained by the fact that the two
newspapers are dailies, boasts of the widest circulation and have
weekly health pullouts. The Independent (4.3%) had the least
volume of health stories published (Table 3). The publication
is a weekly news magazine with very limited circulation across
the country.

A key point to ponder regards how many health stories covered


during this period were fresh/new, follow-ups or repeated
versions. An editor pointed to a practice where Media House B
covers a story that Media House A published — often without
enriching the story. If this practice is considered, perhaps it will
give a clear picture about how many health stories were “new”.

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Table 3: Volume of health stories by publication

Publication July 2015 -June 2016 July 2016 - June 2017 Overall

No. of (%) No. of (%) (%)


Stories Stories
Daily Monitor 864 37.3 640 30 33.8
New Vision 697 30.1 669 31.4 30.7
Bukedde 561 24.2 587 27.6 25.8
The Observer 106 4.6 132 6.2 5.4
The Independent 87 3.8 102 4.8 4.3
Total 2,315 100.0 2,130 100.0 100.0

A trend analysis of the volume of health stories shows a slight


drop in coverage from 52% in the first year of study to 48% in
the second year.

As highlighted earlier, while it’s commendable that health


received noticeable coverage during a period of general elections,
a decline in coverage in the subsequent year doesn’t help the
overall measly performance of health in terms of story volume;
but points to a lack of deliberate and consistent coverage of
health as a public affairs issue of note.

Figure 1: Trend of volume of health stories

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JULY 2015 – JUNE 2017

2. Prominence of Health Stories on the Page


Story hierarchy in newspapers can generally be divided into lead,
second lead, third lead and others (such as briefs). This ranking
shows the editorial importance, relevance or resonance that
editors attach to stories.

In this study, we measured prominence of health stories based


on what “rank” they were given on the page they appeared
on. Findings show that 41.1% health stories were the first lead,
followed by second lead stories (30.7%).

This finding shows that generally, the media provided prominence


to health stories. While this is a relief from the dismal coverage of
health stories on the front page (examined in the next variable),
it should be noted that three of the major newspapers monitored
— Daily Monitor, New Vision, as well as Bukedde — run a weekly
health magazine. As such, this prominence could be attributed to
the specialised coverage of health in the week, and not necessarily
on national or regional pages of the newspaper.

Figure 2: Prominence of health stories on the page

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3. Front Page Coverage of Health vs. Other
Public Affairs Issues
The front page (also known as the cover) is the “face” of a
newspaper and, as such, stories that are deemed absolutely
important (based on editorial parameters of different publications)
make it to the page. Front-page placement of a story is a measure
of prominence but only so many stories can make it there.

For this study, only 9.8% of health stories appeared on the front
page/cover; making it the fourth least prominent public affairs
issue out of the 12.

It’s worth noting that in this study, front-page coverage also


included flagged stories. This implies that the number of health
stories that actually started off the cover, or were the lead on the
front page, is much smaller. This outlook points to a possibility
that our media are either not producing health stories that are
front-page worthy, or; that the bias towards politics still remains
strong or that the media are yet to get a grasp of linking health
to other public affairs issues, particularly politics.

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JULY 2015 – JUNE 2017

Table 4: Front-page coverage of health vs. other public affairs


issues

Public affairs issue Front-page Inside page No. of stories


(%) (%) (n)

Defence 26.8 73.2 1,459


People and power 21.3 78.7 11,248
Energy and extractives 17.8 82.2 988
Education 14.0 86.0 4,413
Justice, law and order 13.8 86.2 17,533
Lands, housing and settlements 12.2 87.8 2,571
Public works and infrastructure 11.5 88.5 2,109
Business and economy 10.7 89.3 6,597
Health 9.8 90.2 4,445
Foreign affairs 8.7 91.3 4,439
Agriculture 7.8 92.2 2,047
Environment and natural 6.2 93.8 2,117
resources

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A breakdown by publication shows that New Vision (41.9%) and
Daily Monitor (39.2%) had the most health stories featured on
their front pages. Bukedde (3.5%) had the least number of health
stories featured on its front page. The Observer (7.1%) and The
Independent (8.3%) didn’t do any better either.

Table 5: Front-page coverage of health by publication

Publication July 2015 - July 2016 - Overall


June 2016 June 2017 (N=434)
(N=238) (N=196)

New Vision 38.2% 46.4% 41.9%


Daily Monitor 37.8% 40.8% 39.2%
The Independent 14.3% 1.0% 8.3%
The Observer 6.7% 7.7% 7.1%
Bukedde 2.9% 4.1% 3.5%

A trend analysis of front-page coverage of health shows a decline,


from 5.9% in the first year, to 4.5% in the second year.

Figure 3: Trend: Front-page coverage of health overall

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JULY 2015 – JUNE 2017

4. Reporting Format
The study analysed health stories on use of three reporting
formats; conventional hard news, enterprise, and investigative
reporting.

Under conventional reporting, fact-finding is the dominant


posture with common characteristics such spot or hard news that
tends to focus on events; generally one-dimensional; neutral and
often uncritical transmission of facts; tendency to assign equal
weight to all positions; faithful recording of the observed event
or issue; suppression of the journalist’s prior knowledge of the
subject; the journalist’s role is passive and often reactive; depends
largely or entirely on material provided by others; and tends to
be event-centred. Sophisticated forms of conventional reporting
combine factual observation with balanced presentation of
pertinent background and contextual information.

Under enterprise reporting – used generically for purposes


of this research to also include forms of journalism referred to
as interpretive and explanatory – the journalist undertakes to
explore issues and developments beyond routine news events
and occurrences. The coverage follows more leads than the
usual straight news story and depends on material gathered or
generated through the reporter’s independent efforts. Enterprise
stories generally use the creative style to explore issues in greater
depth usually with the aid of narrative or literary techniques.
These stories are traditionally presented as features or long-form
articles. Enterprise reporting focuses on the forces that shape
the events that may or may not be in the news. It emphasises
explaining, interpreting, and discovering patterns and trends that
may lie behind reported episodes or events. It adds meaning to
complex news situations, explains change and relates events
to each other resulting in multi-dimensional story-telling. The
reporting is largely process-centred because the journalist is

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usually proactive by initiating coverage rather than waiting for
events to happen.

Under investigative reporting, exposition is the dominant posture


with common characteristics such as the following: the story is
the journalist’s original initiative; depends on material gathered
or generated through the reporter’s own effort; reporting
uncovers information that an individual or entity may have tried
to conceal from public scrutiny, or information that an individual
or entity may have had an interest in keeping out of the public
domain; resources and evidence used by the journalist are clearly
discernible; evidence of strong documentation (the paper trail)
and sourcing.

Our findings show that 81.1% of health stories were reported using
the conventional hard news approach. This is also a dominant
trend of coverage for public affairs issues generally, according
to our research on press coverage of public affairs in Uganda.

Table 6: Trend of conventional reporting for public affairs


issues (July 2013 – June 2017)

Study period Conventional reporting range

Round 1: July 2013 – June 2014 60% - 80%


Round 2: July 2014 – June 2015 54% - 64%
Round 3: July 2015 – June 2016 72% - 92%
Round 4: July 2016 – June 2017 75% - 95%

Enterprise and explanatory reporting was the second most


dominant format of health reporting and investigation was last.

While it’s not journalistically criminal to report stories


conventionally, disproportionate reliance on this format denies
audiences the depth, context and background that come with
enterprise, explanatory and investigative stories.

19
RESEARCH ON MEDIA COVERAGE OF HEALTH IN UGANDA
JULY 2015 – JUNE 2017

Media practitioners blamed the policy of “story counts” by


newsrooms for the predominance of conventional hard news
stories. They said this practice of each reporter being required to
produce a certain number of stories a month was detrimental to
investigative and in-depth reporting as journalists end up settling
for hard news stories that don’t require as much investment in
time and money.

A finger was also pointed at the flight of experienced journalists


for better pay and work conditions outside the media, which often
undermines specialised reporting. Even when replacements are
got, they are often rookies who have to undergo training to attain
skills and knowledge required for in-depth reporting of different
areas of public affairs.

Figure 4: Reporting format of health stories

A disaggregation of findings by publication shows that Bukedde


had the most number of health stories reported conventionally
at 100% in the first year and 88.5% in the second year. However,
its sister publication, New Vision, had the most number of
investigative health stories (21% in the first year and 1.5% in the
second year). The Independent led in enterprise and interpretive
reporting (66.7% in year one and 54.5% in the second year of
study).

20
Table 7: Reporting format by publication

Format Bukedde Daily New Vision The The


(%) Monitor (%) Independent Observer
(%) (%) (%)

Y1 Y2 Y1 Y2 Y1 Y2 Y1 Y2 Y1 Y2
Conventional 100 88.5 77.9 77.9 74.3 91 33.3 45.5 81.3 66.7
Enterprise & 0.0 8.2 20.9 22.1 4.3 7.5 66.7 54.5 18.8 33.3
interpretive
Investigative 0.0 3.3 1.2 0.0 21.4 1.5 0.0 0.0 0.0 0.0

A trend analysis of reporting format, shows a slight rise in


conventional reporting and a decline in investigative format
during the study period. Enterprise and interpretive reporting
rose from 13.3% to 16.5%.

Figure 5: Trend: Reporting format

Media experts we interviewed blamed this trend of coverage that


tends towards hard news to lack of specialisation, the perception
that health is a ‘complex beat’ and that in-depth reporting is
taxing. The limited investment in investigative stories across all
journalism beats also makes the situation worse.

21
RESEARCH ON MEDIA COVERAGE OF HEALTH IN UGANDA
JULY 2015 – JUNE 2017

To get around this, the key informants recommended specialised


training on analytical, enterprise and investigative reporting
especially for upcountry journalists; more investment in
investigative projects by newsrooms; follow up of stories reported
as hard news in order to deliver depth and a look out for media
development organisations that provide funding for reporting to
ease pressure on newsroom budgets.

EXAMPLE OF A CONVENTIONAL STORY

Headline: NMS dismisses audit report on cancer drugs


Publication: Daily Monitor
Date: 21 September 2016
Website: https://www.monitor.co.ug/News/National/NMS--
-audit-report-cancer-drugs/688334-3388972-wjt5jh/index.
html

NOTES: The story relies solely on information by a National


Medical Stores official and the purported draft report. An
in-depth story would have verified the allegations being
traded; for instance, was the price of cancer drugs actually
inflated by NMS? What does the budget and expenditure of
both Uganda Cancer Institute and NMS show? Is the quality
of drugs actually poor as alleged (can an expert verify this?).
Was the wrangle between NMS and UCI actually “ironed out”?
How, when, by whom? Answering these questions, as well as
showing the implication of the alleged price inflation on the
cost of cancer treatment to the end user, would make for a
much richer story.

National Medical Stores (NMS) has refuted findings of a draft


audit report leaked to the media claiming that the government

22
body supplied anti-cancer drugs to Uganda Cancer Institute (UCI)
at inflated prices.

Mr Moses Kamabare, the NMS general manager, while addressing


a press conference at the Uganda Media Centre yesterday said the
findings of a leaked internal audit report are “a mere fabrications
of some unpatriotic people”. “NMS has not received from, or been
advised by the internal auditor of the existence of an alleged draft
report,” Mr Kamabare said.

The internal audit report in question alleges that NMS supplied


cancer medicines at inflated prices to UCI and caused a financial
loss of Shs2 billion in the Financial Year 2015/16.

It also indicated that the NMS has kept the UCI budget at Shs7
billion and that it also supplies poor quality medicines to the
cancer institute.

However, in his response, Mr Kamabare said UCI has been rejecting


all medicines which are not approved by the United States Food
and Drugs Agency (USFDA). “The unit cost for USFDA approved
medicines is much higher than the cost of medicines of other
quality standards,” he said.

For example, Mr Kamabare said out of the alleged Shs2 billion,


Xeloda 500mg alone contributed Shs545 million.

“No such loss was occasioned because the cost of the said item
was the actual cost for the USFDA-approved medicines,” he
added.

Citing an example of the cost of Erlotinib 150mg, which is USFDA-


approved on Uganda market, Mr Kamabare said the current unit
cost of the drug is Shs10 million as opposed to Shs1m quoted by
the draft report.

23
RESEARCH ON MEDIA COVERAGE OF HEALTH IN UGANDA
JULY 2015 – JUNE 2017

On the allegation of poor quality medicines, Mr Kamabare said the


mandate of checking the quality of medicines that enter Uganda
is charged with the National Drug Authority (NDA). “NMS only
maintains the said quality once the medicines are in its warehouse,
till they reach the customer,” he said.

Mr Kamabare added that the wrangles between NMS and UCI had
been ironed out under the auspices of the Office of the Prime
Minister and the Health minister.

He also clarified on all allegations raised by the report and asked


the public to ignore it with the contempt it deserves.

Meanwhile, Mr Keith Muhakanizi, the Permanent Secretary


and Secretary to the Treasury in the Ministry of Finance, who
commissioned the investigation, said that he had not yet received
any draft audit report regarding investigations.

24
EXAMPLE OF AN ENTERPRISE STORY
Headline: Hepatitis: Ignored killer
Publication: The Independent
Date: 5 August 2016
Website: https://www.independent.co.ug/hepatitis-ignored-
killer/

NOTES: The story is an elaborate report about hepatitis - how


it’s acquired, how it can be prevented, treatment options and
the budgetary challenges that the country faces, all of which
lead to it being a “killer”. There are many takeaways from the
story owing to the information provided and explanations that
accompany each. However, clarity would have been necessary
in emphasizing that there are many types of hepatitis, and
this particular story is specific to hepatitis B. Further, stating
that people with hepatitis B are taking ARVs due to “lack
of money” to buy hepatitis drugs wasn’t adequate. Are the
ARVs approved (other than by NMS) to treat hepatitis? What
is the implication of taking ARVs to a hepatitis B patient?
The information would help allay fears or make concerned
stakeholders offer explanations.

World Hepatitis Day was marked on July 28 under the theme,


`Know hepatitis Act now’. It was designed to focus this year’s
activities on increasing global awareness and strengthening
prevention, diagnosis, and treatment services around the world.
The increased focus could not have come at a worse time for
Uganda where those infected with hepatitis are suffering without
drugs and have resorted to using HIV/AIDS drugs.

“Many hospitals have vaccines only. If you need drugs, you are
told to go to the referral hospitals where most times you are
given ARVs (Anti-Retroviral Drugs),” says Kenneth Kabagambe
who is infected.

25
RESEARCH ON MEDIA COVERAGE OF HEALTH IN UGANDA
JULY 2015 – JUNE 2017

The Commissioner Clinical Services at the Ministry of Health, Dr.


Jacinto Amandua, confirmed he was aware that patients living
with hepatitis are given HIV drugs because of lack of money.

“The money available was planned to initially extend vaccination


to cover all parts of the country,” he told The Independent.

This financial year, hepatitis has been allocated Shs10 billion.


Amundua said the same Shs10 billion was allocated for procuring
hepatitis drugs and vaccines and it was not adequate and the
ministry had to request for additional Shs3 billion.

Additionally, he said money is released by Ministry of Finance on a


quarterly basis and given to the National Medical Stores to do the
procurements. The money released in the first three quarters of
the 2015/16 financial year which ended in June was for vaccination
and that of the Fourth Quarter was for Anti-retroviral drugs.

He added that the National Drug Authority has approved a single


drug – Tenofivir which is manufactured locally to be used by
hepatitis patients. He says it is not yet available on the market.

While 1.4 million Ugandans live with HIV, about 3.5 million
are infected with hepatitis and 30% (more than a million) are
chronically ill and require treatment.

The 2005 HIV sero survey which included screening for hepatitis B
showed the disease to be more prevalent in the Karamoja region
with 23.9%, Northern Uganda (20.7%), West Nile (18.5%), and
Western Region (10.0%); and the lowest infection rates were in
Central Region (6%) and South­-Western (3.8%).

Areas with highest prevalence were considered first in the four


phased vaccination exercise. First, they considered 30 districts
of West Nile, Acholi, Lango and Karamoja sub regions. Also, last
year, the government made it compulsory for children and health
workers to be vaccinated. The vaccine is given in three intervals.

26
The second is given a month after the initial one and then the
final one after six months.

Hepatitis which is treated by antiviral medication spreads through


blood and other body fluids and attacks the liver. Experts say it
kills faster than HIV. In fact, Amandua said, the disease is 10 times
more deadly than HIV and Uganda is one of the countries with
the highest prevalence in the world.

In 2010 the World Health Assembly (WHA) recognised viral


hepatitis as a global public health problem and urged governments
to take actions to prevent, diagnose, and treat it. Five years later,
the World Health Organisation (WHO) came up with a first ever
set of guidelines for treatment.

Statistics from WHO indicate 240 million people suffer from the
disease and an estimated 780,000 succumb every year. Most
of these deaths are registered in developing countries where
awareness is still lacking. Some people only get to know a thing
about the disease when they test positive for it. Many do not show
any symptoms until when they are diagnosed with liver cancer
which is the most advanced stage of the disease. At this point,
it is too late for them.

Amandua says, however, some get symptoms like yellowing of


the skin, discomfort on the right side of the belly, dark urine, and
fatigue.

Amandua says just as HIV, the risk of acquiring the disease


increases when one has unprotected sex with a person with
the disease or with multiple partners. Residents and staff of
correctional facilities and group homes, those with multiple sex
partners, health workers, and emergency personnel, those who
share sharp instruments and men who have sex with men are at
a higher risk.

27
RESEARCH ON MEDIA COVERAGE OF HEALTH IN UGANDA
JULY 2015 – JUNE 2017

He encourages people to use condoms and also conduct routine


testing because people with chronic infections may feel fine for
a long time, even as the virus is causing damage and by the time
symptoms appear the liver damage may be advanced. Amandua
says everyone needs to be tested.

Hepatitis B becomes chronic when it lasts more than six months


without treatment. Although infections can persist in adults, most
chronic cases occur in children.

Amandua said they have programmes focused on prevention of


mother to child transmission of the disease since many contract
the disease at birth. Those newly infected are referred to as acute
cases.

Blood tests can tell doctors whether the infection is acute or


chronic and whether the virus is actively multiplying. Additional
important tests to consider after testing positive, according to
Amandua, include the liver function which is meant to determine
whether it’s functioning normally, the hepatitis antigen; which
shows whether one has a dormant or active virus, and the viral
load which determines the amount of virus in the blood.

He however clarified that the disease does not spread through


sneezing, coughing, hugging or eating food prepared by someone
who is infected with hepatitis B.

5. Story Trigger
This refers to what sparked off or motivated the coverage.

Findings reveal that 25.2% stories were derived from independent


reporting. While this, on the surface appears encouraging, a look
at Table 8 shows that all story triggers, excluding independent
reporting, material source, data and “other”; are event-based/
episodic activities (66.1%). This also conforms to our finding on the

28
dominance of conventional reporting format which often result
from events. Further, a look at the story triggers also suggests a
dominance of “officialdom”. For instance, stories that originate
from the government and arms of the government (central
government activity, local government activity, parliament and
judicial activity) are 20.8%.

Our research on press coverage of public affairs shows that


independent reporting and events/activities by central/local
governments remain the key triggers of stories. While stories from
news conferences have been declining, spontaneous newsworthy
events have been on a steady rise for all public affairs issues.

Table 8: Story trigger

STORY TRIGGER July 2015 - July 2016 - Overall


June 2016 June 2017 (N=644)
(N=298) (N=346) %
% %

Independent reporting, research or 23.5 26.6 25.2


investigation
Spontaneous newsworthy occurrence 12.8 22.5 18
NGO or CSO activity 14.1 11.3 12.6
Central government activity 11.1 12.7 12
News conference 14.4 6.1 9.9
Local government activity 5 6.1 5.6
Material source 7 2.9 4.8
Company or business activity 3.4 2.3 2.8
Parliamentary activity 1.7 3.5 2.6
News release 2.7 1.4 2
Other 2.7 1.4 2
Data 1.3 2.3 1.9
Judicial activity 0.3 0.9 0.6

29
RESEARCH ON MEDIA COVERAGE OF HEALTH IN UGANDA
JULY 2015 – JUNE 2017

6. Number of Sources
Sources are voices in a story. For this study, focus was on human
sources – people who comment on stories either in their official
capacities or as victims, interested parties to events, perpetrators,
etc. Sources, whether human or documentary, help enrich stories
through diversity of views and depth of issues raised.

Single sourcing remains a big problem for print media in Uganda


generally. From our findings, 27.3% of health stories were
single-sourced, followed by those that had two sources (26.1%).
Stories with three sources, the recommended minimum number
of sources, were third in hierarchy. Multiple sourcing provides
more opportunity for fulfilment of key journalistic tenets such
as balance, fairness, right of reply as well as provision of context,
and use of data in stories.

Our research on public affairs coverage in Uganda between


July 2013 and June 2017, shows that public affairs stories have
an average of 2.8 sources while health stories have an average
of 2.5 sources. A trend analysis over the years, show that the
number of stories with the recommended minimum number of
three sources, have remained below 12%. The good news is that
the proportion of stories with four, five or more sources have
risen since the second round of the study.

Figure 6: Number of sources in a health story

30
A further breakdown of sourcing by publication shows that New
Vision had more stories with five or more sources, while 27.3%
stories by The Independent had no source.

Table 9: Number of source by publication

No. of Bukedde Daily New Vision The The


source (%) Monitor (%) Independent Observer
per story (%) (%) (%)

Y1 Y2 Y1 Y2 Y1 Y2 Y1 Y2 Y1 Y2
No source 1.8 0.0 0.0 2.6 2.9 0.0 0.0 27.3 12.5 0.0
1 source 45.6 54.1 26.7 23.4 11.4 3.0 25.0 45.5 43.8 26.7
2 sources 29.8 26.2 36.0 33.8 30.0 7.5 8.3 27.3 6.3 13.3
3 sources 10.5 3.3 23.3 20.8 21.4 26.9 25.0 0.0 12.5 33.3
4 sources 5.3 1.6 7.0 14.3 17.1 20.9 8.3 0.0 6.3 13.3
5 or more 7.0 14.8 7.0 5.2 17.1 41.8 33.3 0.0 18.8 13.3
sources

Laziness featured prominently among the reasons our key


respondents gave for single-sourced stories, blaming the
allure of desktop journalism and “social media reporting”. The
respondents also downplayed the explanation that some health
sources are unwilling to go on the record and that health experts
shun being quoted for reasons that complex issues may not be
accurately reported. However, health reporters interviewed also
blame editors for giving them too little time to work on stories,
in addition to limited funding for in-depth health reporting. They
argued against journalism of convenience and noted that stories
from NGO activities, workshops and events, should be treated
as tips for further investigation.

31
RESEARCH ON MEDIA COVERAGE OF HEALTH IN UGANDA
JULY 2015 – JUNE 2017

EXAMPLE OF A STORY WITHOUT A SOURCE


Headline: Uganda under no threat of Zika virus
Publication: The Observer
Date: 3 February 2016
Website: https://observer.ug/news-headlines/42394-uganda-
under-no-threat-of-zika-virus

NOTES: The story is basically lifted off a press statement from


the Ministry of Health. Since no human source is quoted in
the story, the reporter comes off as the source of information.
This raises queries about attribution and credibility, since this
is a scientific issue that would have required an ‘expert’ to
offer explanations.

Surveillance reports from the Ministry of Health have found that


Uganda, the original host of the Zika virus, is under no threat from
the mosquito-borne virus now ravaging South America.

In a recent statement, the ministry said the virus battering South


America is a different species from the one once discovered in
Uganda.

The virus was first isolated in Uganda in April 1947, from a rhesus
macaque monkey. The monkey had been placed in a cage in the
Zika forest located near Entebbe by scientists of the Yellow Fever
Research Institute, now the Uganda Virus Research Institute
(UVRI). Human infections were later reported in African countries
such as the Central African Republic, and parts of Asia.

“Although Uganda has the mosquito species capable of


transmitting Zika virus, the mosquitoes are arboreal (forest
mosquitoes) and bite at night or at dusk and dawn, mostly in the
canopy. People have moved out of the forests by the time they
bite,” the statement said.

32
Additionally, the Ae. aegypti mosquito found in many parts of
Uganda, which bites during the day, does not prefer to bite
humans, but animals. Owing to this, there is reduced risk of
transmission.

The ministry says UVRI has testing facilities for the Zika virus
and that the public should remain calm as no cases have been
recorded.

Zika virus causes a mild illness in humans known as Zika fever, or


Zika disease. Common symptoms include mild headaches, rash,
fever, malaise, conjunctivitis and joint pains.

By last Thursday, cases of Zika had been reported in 23 countries,


including Brazil, El Salvador, Venezuela, Mexico, Panama and
Haiti. The virus is being linked to poor pregnancy outcomes, with
pregnant women having babies with birth defects.

33
RESEARCH ON MEDIA COVERAGE OF HEALTH IN UGANDA
JULY 2015 – JUNE 2017

7. Occupation of Sources
In what capacity do sources in health story speak? Are they
ordinary persons, experts, or lawmakers? This variable helps
explain which category of sources dominates health news
coverage and what that means for news consumers.

Findings show that 18.6% of health sources were experts, followed


by central government representatives (17.5%), and ordinary
persons (17%).

Comparatively, findings from our research on press coverage


of public affairs issues in Uganda show a trend of central
government representatives and ordinary persons consistently
dominating coverage. The findings also show that expert sources
were in positions eighth and eleventh for our third and fourth
rounds of studies respectively, out of 21 source categories.

From Table 10, government officials from all branches and organs
(i.e., representatives of central, local government, minister, MP,
law enforcement, military, president, judicial official and vice
president), make up 42.5% of all sources in terms of occupation.
This is against voices of people whose occupations fall under
“private sector” (20.3%) - excluding experts (since this can be
either government or private experts), “other”, anonymous/
unknown sources and ordinary persons quoted in their individual
capacity.

Like the variable on story trigger, this finding shows a dominance


of sources in their “official” government capacities, pointing to
“officialdom”, a lack of diversity in voices, and the possibility that
stories focused on ordinary persons are lacking.

34
Table 10: Occupation of sources

Occupation of sources July 2015 - July 2016 - Overall


June 2016 June 2017 (n=1201)
(n=614) (n=587) %
% %

Expert 20.4 16.7 18.6


Central government 15.8 19.3 17.5
representative
Ordinary persons quoted in their 15.5 18.6 17.0
individual capacity
Local government personnel 13.2 10.7 12.0
Minister 5.7 7.0 6.3
International NGO 6.2 2.9 4.6
representative
Business representative 4.7 3.4 4.1
Local NGO representative 4.9 2.7 3.8
Civil society representative 2.8 3.6 3.2
Member of Parliament 1.5 4.4 2.9
Religious representative 2.8 1.7 2.2
Other 1.0 2.0 1.5
Cultural representative 0.8 1.5 1.2
Law enforcement 1.5 0.9 1.2
representative
Military/security representative 1.6 0.7 1.2
President 0.3 1.4 0.8
Diplomatic representative 0.3 0.9 0.6
Politician or political operative 0.8 0.3 0.6
Judicial personnel 0.3 0.7 0.5
Anonymous or unknown 0.0 0.5 0.2
Vice President 0.0 0.2 0.1

35
RESEARCH ON MEDIA COVERAGE OF HEALTH IN UGANDA
JULY 2015 – JUNE 2017

8. Gender of Sources
Data shows that male sources were the most quoted in health
stories at 66.9% compared to 33.1% female. A look at the overall
coverage of public affairs issues during the study period, shows
that less than 25% female sources were cited in stories, with many
quoted as victims or witnesses to events.

Balancing gender in story sourcing is a long running issue that


was also recorded in our previous research, notably on media
coverage of the 2016 general elections and media coverage of
public affairs issues. The reasons for the trend were that female
sources are less willing to be quoted, and that they worry about
what to wear, the perfect words to use before they can go on
air. This doesn’t augur well with the perishable nature of news.

Key respondents noted that men still control and occupy most
leadership and work positions (including in the media) and make
key decisions, which explains the slanted nature of sourcing
against women. However, many acknowledged that more female
journalists report the health beat; that women have more health
seeking behaviour and are key caretakers in health situations.

The fact that these dynamics are not reflected in media


coverage of health points to a need for the media to continue
cultivating relationship with female sources, some of who are
not comfortable talking to the media; and to emphasise the
importance of diversity of voices in stories to their audiences.

36
Figure 7: Gender of sources

The Independent had the most number of female sources in its


health stories at 78.8% in the first year and 89% in the second
year, while Bukedde had the least (49.7% in the first year and
38.6% in year two).

Table 11: Gender of sources by publication by year

Gender Bukedde Daily New Vision The The


(%) Monitor (%) Independent Observer
(%) (%) (%)

Y1 Y2 Y1 Y2 Y1 Y2 Y1 Y2 Y1 Y2
Male 50.3 61.4 44.7 57.8 49.2 64.7 21.2 20.0 46.2 64.0
Female 49.7 38.6 55.3 42.2 50.8 35.3 78.8 80.0 53.8 36.0

37
RESEARCH ON MEDIA COVERAGE OF HEALTH IN UGANDA
JULY 2015 – JUNE 2017

A trend analysis shows a slight rise in the number of female


sources during the two-year period, from 30.1% to 36.1%.

Figure 8: Trend: Gender of sources

9. Occupation of Sources by Gender


More female sources were quoted in their capacity as CSO
representatives and ordinary persons. Male sources on the other
hand were quoted in their capacity as president, vice president,
religious representative, security representative, law enforcement
representative or politician.

It’s interesting to note that under the category of “anonymous or


unknown” sources, all who could be identifiable by gender were
female. This lends credence to the argument by our respondents
that female sources are generally unwilling to speak to the media,
and those who do so sometimes request for anonymity. This
leaves room for an inquiry into why some female sources prefer
to remain unnamed/unidentified in stories.

This outlook of coverage where men are the dominant category


of sources by occupation is similar to findings from our research
on press coverage of public affairs issues generally by the media.

38
Table 12: Occupation of sources by gender

Occupation July 2015- July 2016- Overall


June 2016 June 2017

Female Male Female Male Female Male


(%) (%) (%) (%) (%) (%)
Anonymous or unknown 0.0 0.0 100.0 0.0 100 0
Business representative 34.5 65.5 20.0 80.0 28.6 71.4
Central government 29.9 70.1 28.3 71.7 29 71
representative
Civil society representative 41.2 58.8 61.9 38.1 52.6 47.4
Cultural representative 20.0 80.0 33.3 66.7 28.6 71.4
Diplomatic representative 0.0 100.0 60.0 40.0 42.9 57.1
Expert 31.2 68.8 26.5 73.5 29.1 70.9
International NGO 39.5 60.5 35.3 64.7 38.2 61.8
representative
Judicial personnel 0.0 100.0 25.0 75.0 16.7 83.3
Law enforcement 22.2 77.8 0.0 100.0 14.3 85.7
representative
Local government personnel 13.6 86.4 19.0 81.0 16 84
Local NGO representative 23.3 76.7 43.8 56.3 30.4 69.6
Member of Parliament 22.2 77.8 46.2 53.8 40 60
Military/security 10.0 90.0 0.0 100.0 7.1 92.9
representative
Minister 17.1 82.9 73.2 26.8 47.4 52.6
Other 66.7 33.3 41.7 58.3 50 50
Ordinary person quoted in 52.6 47.4 50.5 49.5 51.5 48.5
their individual capacity
Politician or political 20.0 80.0 0.0 100.0 14.3 85.7
operative
President 0.0 100.0 0.0 100.0 0 100
Religious representative 0.0 100.0 0.0 100.0 0 100
Vice President 0.0 0.0 0.0 100.0 0 100

39
RESEARCH ON MEDIA COVERAGE OF HEALTH IN UGANDA
JULY 2015 – JUNE 2017

10. Institution that is the Focus of the Story


This variable sought to assess media coverage of government
as an institution, and the private sector – and all their associated
branches.

For this period of study, the central government was the focus
of most health stories (33.6%). When divided into central
government organs and private sector, our findings from
coverage of public affairs issues show that the former (including
central government, local government, state-owned enterprises,
parliament & judiciary – a total of 62.5%), dominate coverage
over private sector/business/organisations (32.3%). The central
government and private sector grouping both exclude the
category “other” (5.2%).

While one may explain the lion share by government on its policy
control and resource allocation role, it’s noteworthy that even with
decentralisation the private sector still lags far behind in health
coverage. However, because most health stories are reported
conventionally with a focus on disease outbreaks (as we’ll see
in the variable on health topics covered), central government’s
dominance could also be tagged to ‘official’ communications
that Ministry of Health representatives give in cases of outbreak,
shortage of medical supplies, etc.

40
Table 13: Institution that is the focus of the story

Institution July 2015 - July 2016 - Overall


June 2016 June 2017 (n=592)
(n=286) (n=306) %
% %

Central government organisation 30.1 36.9 33.6


State-owned enterprise or 14.3 11.1 12.7
parastatal
Local government organ 14.0 10.8 12.3
Private sector or business 7.3 12.7 10.1
Indigenous NGO or private 9.8 7.5 8.6
organisation
International NGO or private 9.8 5.2 7.4
organisation
International public organisation 5.9 4.6 5.2
Other 5.2 5.2 5.2
Parliament 2.1 4.2 3.2
Political party/organisation 1.4 0.3 1.0
Judiciary 0.0 1.3 0.7

11. Health Topics Covered


The health topics under this study included:

(i) Diseases
(ii) Institutional or sector management of health
(iii) Drugs
(iv) Equipment and supplies.
From the analysis, stories about diseases were the most covered
(41.1%), while those on equipment and supplies (8.9%) were the
least covered.

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RESEARCH ON MEDIA COVERAGE OF HEALTH IN UGANDA
JULY 2015 – JUNE 2017

Figure 9: Health topics covered

A breakdown of disease coverage by category shows that non-


communicable diseases (51.9%) were the most covered. This
coverage corresponds with global trends in health where NCDs
are increasing and therefore more reporting towards the same is
expected. The World Health Organisation has reported that out
of 56.9 million deaths globally in 2016, 71% were due to NCDs.
Of that, 31.5 million deaths occurred in low to middle income
countries such as Uganda.6

Figure 10: Health topics by disease category

6 WHO, NCD mortality and morbidity https://www.who.int/gho/ncd/


mortality_morbidity/en//

42
Further disaggregation of findings reveals the top three covered
diseases by the media were HIV/AIDS (28.7%), cancers (15.9%)
and malaria (8.2%).

Surprisingly, tuberculosis which is a leading cause of death


among persons living with HIV in Uganda; stands at seventh
position (2.1%), out of the top 14 diseases. According to data
from the Centers for Disease Control and Prevention, TB and
HIV co-infection is the second most common cause of death in
Uganda, only after diarrhoeal diseases.7

Additionally, sickle cell, which is among the major health issues in


Uganda today, didn’t get prominent coverage either. The Uganda
Demographic and Health Survey report, 20168, puts the sickle cell
prevalence at 0.73%. The figure goes up to 13.3% for people with
the sickle cell trait (i.e., if a sickle cell trait married another sickle
cell trait, they will produce a sickler). Respondents felt that the
disease should be given more coverage by the media. An editor
noted that the government should provide treatment for sickle
cell the way it does for persons living with HIV.

Other diseases covered by the media included; spina bifida,


bilharzia, dementia, epilepsy, fistula, rabies, river blindness,
trachoma, kidney disease, measles, asthma, sleeping sickness,
bird flu, hydrocephalus, tungiasis, urinary tract infections, obesity,
dandruff, dental complications, cough, diseases related to
malnutrition, swine fever, blood clots, tonsillitis, kala-azar, stunted
growth, visual impairment and sinusitis.

7 CDC Factsheet, Uganda, 2016 https://www.cdc.gov/globalhealth/countries/


uganda/pdf/Uganda_Factsheet.pdf
8 Uganda Demographic and Health Survey, 2016 https://www.ubos.org/
onlinefiles/uploads/ubos/pdf%20documents/Uganda_DHS_2016_KIR.pdf

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JULY 2015 – JUNE 2017

Table 14: Health topics by diseases name

Break down of July 2015 - July 2016 - Overall


diseases June 2016 June 2017 (%)
(%) (%)

HIV 27.8 29.9 28.7


Cancers 16.7 14.9 15.9
Malaria 7.4 9.2 8.2
Cholera 2.8 5.7 4.1
Mental health 2.8 3.4 3.1
Hepatitis 1.9 3.4 2.6
Heart diseases 1.9 3.4 2.6
TB 2.8 1.1 2.1
Nodding disease 2.8 1.1 2.1
Ebola 2.8 0.0 1.5
Sickle cell 0.0 3.4 1.5
Yellow fever 2.8 0.0 1.5
Typhoid 1.9 0.0 1.0
Zika virus 1.9 0.0 1.0
Other 24.1 24.1 24.1

Key respondents argue that the focus on disease coverage is due


to the fact that diseases directly affect people and this makes
it easy to write a human-interest story. Secondly, coverage of
diseases, in whichever format it is packaged, is considered
appealing compared to a story about lack of medical equipment,
unless the lack is directly linked to patients’ conditions.

While focus on disease coverage is in tune with the surveillance


role of journalists, framing the story to touch on aspects of
oversight and accountability, governance as well as rights and
rule of law are key for holding officials accountable, according
to respondents.

44
EXAMPLE OF A TYPICAL STORY ABOUT DISEASES
Headline: A child’s story recovery from cancer
Publication: Daily Monitor
Date: 20 October 2016
Website: N/A

NOTES: From this story, several related issues arise. For


instance, the patient fails to get a scan at Mulago Cancer
Institute due to the breakdown of the cancer machine; it
takes a long time to diagnose the child with cancer, with
earlier diagnosis cited as Brucellosis; after the first round of
treatment at Mulago, the patient was discharged but had no
place in Kampala from where to commute for treatment ans
so he ended up at a shelter for patients like him. From the
above, three things are clear: equipment and supplies failure;
institutional and sector management failure (due to wrong
diagnosis, delayed diagnosis), as well as the impact of poverty
on cancer treatment. Unfortunately, these key issues are not
overtly explored and linked to the disease at hand for a reader
to appreciate the gravity of the problem.

His uncle carries him into the reception room and sits him down
on the sofa, where he had earlier placed large sheets of black
polythene.

At first contact, Vincent Otita, 10, is shy just like any other child
when near strangers.

But then, he laughs at something, a little girl seated next to him,


says in Ngakarimojong.

He opens up immediately and begins to talk alternating between


his mother tongue and English.

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JULY 2015 – JUNE 2017

Otita is slowly recovering from paraphlegia paralysis brought


about by Burkitt lymphoma.

He spends most of the day in a chair playing Ludo with other


children as he recovers from the cancer at Akiba House.

‘Do you want to go to school today?” his uncle asks nodding in


the affirmative. The House, under Bless a Child Foundation, runs
a school for the children and their caregivers.

On February 12, 2016, while living in Changaroi village in Amudat


District, as he prepared to begin his Primary Three, Otita began
to feel pain in his back.

“I was taken to a clinic and the nurse suspected it was Brucella


(Brucellosis). They have me Ibuprofen and Gentamicin. My leg
started becoming weak and then one day, I lost control of my body
functions. I became paralysed from the waist down,” he narrates.

Brucellosis is an infection caused by a bacteria called Brucella.


The infection is transmitted by ingestion of undercooked meat
or unpasteurized milk. Gentamicin is an antibiotic used to treat
bacterial infections while Ibuprofen is used to treat pain and
inflammation.

Double jeopardy

Since Otita’s mother was also sick at the time, his uncle, 16-year-
old William Lochoro, then in Senior Two at Pokot Secondary
School, became his caretaker in hospital.

“The feeling was completely gone from his legs and feet,”
Lochoro says adding, “he had terrible pain in the back and when
his condition worsened, we took him to Matany Hospital. He was
admitted in the children’s ward and given pain killers. There was
no further treatment. He had diarrhea and he could not control
his body functions.”

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It was in their third week at the hospital that the doctor decided
to do an ultrasound scan. The results showed there was a mass
in Otita’s kidney and two masses in his liver.

After the diagnosis, the doctor suspected it was cancer and wrote
a referral letter to Mulago hospital, where Otita was transferred
and admitted to the Uganda Cancer Institute (UCI).

At UCI, doctors recommended another scan but unfortunately


the machine broke down before he could be scanned.

Otita spent three weeks at UCI without treatment despite the


fact that his diarrhea was worsening.

Later he was moved to International Hospital Kampala, where a


feeding tube was inserted into him.

However, he was again returned to Mulago hospital after a CT scan


taken from Mengo Hospital that showed he had Burkitt lymphoma.

At UCI doctors took another sample from his bone marrow to


confirm whether he had Burkitt Lymphoma, a type of cancer that
is common among children. The results confirmed the diagnosis.

“They put him on chemotherapy immediately and we began


seeing some changes in him. After the first cycle, we were
discharged but we had nowhere to go. A nurse directed us to
Akiba House. We, together with my sister (Otita’s mother) left
the hospital on a bodaboda. Unfortunately, his leg was burnt
badly by the exhaust pipe but he could not feel it,” says Lochoro.

So far, Otita has been at Akiba House for three months and is
responding well to treatment.

He can now lift his legs although he cannot walk but once in a
while, he holds onto surfaces to support his movements.

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RESEARCH ON MEDIA COVERAGE OF HEALTH IN UGANDA
JULY 2015 – JUNE 2017

“I now feel okay and there is no pain. I can control by body now
and the doctors removed the catheters. My parents visit me and
then go back to Amudat where they both work, but we keep in
contact,” he says.

Otita, who loves Mathematics and dreams of becoming an


accountant, is his parent’s firstborn and he says he misses his
siblings.

For Lochoro, his dreams of studying Senior Two were dashed by


his nephew’s illness.

“I understand why I am not at school. It is a good thing to take


care of him (Otita) and I willingly do it. When he gets better, I
will return but I have missed so much,” he says.

ABOUT BURKITT LYMPHOMA

What it is. Burkitt lymphoma is named at British surgeon Denis


Burkitt, who first identified this unusual disease in 1956 among
children in Africa. In Africa, Burkitt lymphoma is common among
young children who also have malaria and Epstein-Barr, the virus
that causes infectious mononucleosis.

Symptoms. The symptoms of Burkitt lymphoma depend on the


type. The endemic (African) variant usually starts as tumours of
the jaw or other facial bones. It can also affect the gastrointestinal
tract, ovaries and breasts and can spread to the central nervous
system, cusing nerve damage, weakness, and paralysis.

Treatment. Intensive intravenous chemotherapy – which usually


involves hospital stay – is the preferred treatment for Burkitt
lymphoma. Because it can spread to the fluid surrounding the
brain and the spinal cord, chemotherapy drugs also may be
injected directly into the cerebrospinal fluid, a treatment known
as intrathecal chemotherapy.

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TIT BITS ABOUT BURKITT LYMPHOMA

It is a cancer of the lymphatic system that affects both children


and adults. It is more common in makes.

Possible symptoms of the disease include night sweating, weight


loss, and tiredness. One may also notice a painless swelling in the
glands in the neck, groin, or under the arms.

These swellings can grow rapidly. The disease can start in the
spinal fluid, abdomen, ovaries or testes. Burkitt lymphoma
presents with enlarging tumour masses in the chest or abdomen
but can spread to the nervous system and involve the liver, spleen,
and bone marrow. It is a fast-growing lymphoma that needs to
be quickly treated with intensive chemotherapy.

Outside of Africa, Burkitt lymphoma is rate with 1,200 people in


the US diagnosed with the cancer each year.

12. Context
Context in stories, provided through meaningful perspective and
relevant background information, helps the reader understand
better the topic/issue covered. Findings show that majority of
health stories had “adequate context” (56.4%).

While our findings show that the media generally reports health
conventionally, it’s commendable that context is still provided.

Comparatively, findings from our research on press coverage


of public affairs issues show that about half of the stories are
consistently given adequate context, which is the ideal threshold
for professional reporting standards. Further, the proportion
of stories with no context at all declined as did stories with
“significant context”.

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JULY 2015 – JUNE 2017

Figure 11: Context in the health stories

A disaggregation of coverage by publication shows that health


stories by The Independent had the most “significant context”,
while Daily Monitor had the most number of stories with no
context. However, generally, all publications provided “adequate
context” to health stories.

Table 15: Context in health stories by publication

Context Bukedde Daily New Vision The The Observer


(%) Monitor (%) Independent (%)
(%) (%)

Y1 Y2 Y1 Y2 Y1 Y2 Y1 Y2 Y1 Y2
Significant 1.8 1.6 7.0 1.3 7.1 1.5 33.3 18.2 12.5 6.7
context
Adequate 36.8 65.6 64.0 79.2 71.4 26.9 50.0 36.4 37.5 33.3
context
Some 45.6 1.6 12.8 14.3 17.1 37.3 16.7 45.5 50.0 60.0
Limited 14.0 31.1 7.0 5.2 4.3 25.4 0.0 0.0 0.0 0.0
context
No 1.8 0.0 9.3 0.0 0.0 9.0 0.0 0.0 0.0 0.0
context

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EXAMPLE OF A STORY WITHOUT CONTEXT
Headline: CIRCUMCISION NOT SOLUTION TO HIV/AIDS
Publication: New Vision
Date: 2 May 2017
Website: N/A

NOTES: According to the World Health Organisation, there’s


compelling evidence that circumcision reduces chances of
HIV infection among heterosexual men by 60%. This context
would have been more useful than the mere mention that
“circumcision is a preventive measure”. The story also doesn’t
contextualise the minister’s reference to men “jostling” for
circumcision. What do the circumcision numbers say (before
and after introduction of SMC)?

The state minister for health, Sarah Opendi has blasted the way
men are jostling to undergo nationwide Safe Male Circumcision
(SMC), which she said is not the permanent, lasting solution to
HIV-AIDS.

She said despite the fact that circumcision is a preventive


measure, men should not take it for granted because they risk
catching the virus.

“Men are jostling for circumcision. This is not a permanent


solution. Men need to take care of their lives, if they are to live
and look after their families,” Opendi said.

She said although the Government and organisations have


intervened, the scourge is still prevalent, for example in Bugisu,
where the biggest percentage do not have “foreskins”.

She made the comments on Sunday at Bugaya sub-county


headquarters in Buyende District during the women’s Day
celebrations where she was the chief guest.

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JULY 2015 – JUNE 2017

Flanked by Buyende Woman MP Veronica Babirye Kadogo, the


minister said the HIV/AIDS prevalence in Buyende district at 5.8%
and the national rate at 8%, calls for the communities to refrain
from reckless living and exposing their bodies to deadly risks.

Opendi said although ARVs are now available, the challenge of


taking them daily is why many abandon them and die.

Babirye said unlike women who crave for routine blood checkups,
the men are adamant to do so under the guise of having busy
work schedules.

She, however, noted that the women are overstretched by their


daily chores.

Earlier, Babirye and Budiope East MP Geoffrey Dhamuzungu told


the minister that Buyende, with a population of 320, 468, people,
does not have a referral hospital.

Babirye said Buyende, Kidera and Bugaya Health Center IIIs can no
longer handle the patients from the six sub-counties and 348 LCs.

The function was attended by MPs Hajati Rehema Watongola


(Kamuli Municipality), Molly Lanyero (Moyo), Geoffrey
Dhamuzungu (Budiope East), the LC5 Chairman, Robert
Ziribasanga, among other dignitaries.

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EXAMPLE OF A STORY WITH CONTEXT
Headline: TB patients share wards with other patients
Publication: Daily Monitor
Date: 21 September 2016
Website: https://www.monitor.co.ug/News/National/TB-
patients--wards--patients/688334-3389048-9m5ybjz/index.
html

NOTES: The story scores in explaining why TB patients


need an isolation ward (its infectious nature) and adds
information on the TB burden in Uganda plus TB funding.
Further information regards the overwhelming number of
patients that Kaabong Hospital is grappling with, as well as
other challenges such as bed bug infestation. These details
place the TB problem in perspective and helps the reader
appreciate the gravity of the problem.

Patients suffering from tuberculosis (TB) in Kaabong District


Hospital are sharing wards with those admitted with other
ailments, making it difficult to control the spread of the
contagious bacteria.

Potentially infectious TB patients are usually kept in hospital


isolation centres as a way of preventing the disease’s spread. But
patients seeking services in the hospital are worried that if the
government does not check the situation, several people’s lives
could be endangered.

Kaabong Hospital in Karamoja sub-region in the north eastern


Uganda, serves nearly 22,000 people. The hospital management
confirmed there are no isolation wards and this has forced them
to accommodate both TB and malaria patients in one ward.

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JULY 2015 – JUNE 2017

Dr John Bosco Lopoi, the acting medical superintendent, Kaabong


hospital, told Daily Monitor in an interview that TB patients are
sharing a ward with malaria patients due to lack of space.

He said the hospital also had no running water and asked


government to intervene quickly.

Ms Grace Angolere, one of the mothers with malaria, described


the situation as “unacceptable”. “TB patients often cough at night
and they spit saliva on the floor that is shared by children and
adults. The government should not take this lightly. They should
intervene to prevent the disease’s transmission,” she said.

The hospital is also infested with bedbugs that are chasing away
patients. Mr Sharif Nalibe, the district health director, said he has
consulted the authorities in Kampala over the issues.

Uganda is among the 22 high burden countries of the world. These


are countries with the highest number of TB cases.

Currently, TB mortality remains high in Uganda, with about 4,000


people dying of the disease every year.

A programme review report conducted in 2013 indicates that less


than $30,000 (about Shs85m) was allocated by the government
to NTLP and about $2m (Shs5b) to the National Medical Stores
for TB drugs.

13. Story Frame


In this study, a ‘frame’ is the underlying narrative through which
a story is told. Frames cut across different issues. A typical story
could bear more than one frame, so up to three could be recorded
for each story analysed in the study. Their relative dominance in
a story was ranked from first to third in descending order of the
weight they carried in the story.

54
Majority of health stories were packaged using a service delivery
frame (47.2%), followed by those on livelihoods and human
development (39.2%).

It’s telling that stories about accountability in the health sector is


the third least covered. Rights and rule of law is also a rare frame.
This corresponds to a 2015 USAID study which found that health
doesn’t get as much prominent coverage in our media, except
in situations of “outbreaks of deadly infections, or of mysterious
diseases, and during special health days”9.

The findings from this variable also alludes to the surface level
coverage of health (evidenced through findings on overwhelming
hard news reporting, a focus on diseases, etc.), without a look at
the big picture of what the issues mean in terms of governance,
rights and rule of law, and what they portend for oversight and
accountability of the sector.

Figure 12: Framing of health stories

9 Ibid

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JULY 2015 – JUNE 2017

14. Newsmaker
Newsmakers are people who, individually or collectively, are the
reason for coverage. The study identified individuals or groups
who performed actions important to the story or were the subject
of a substantial amount of the coverage. We recorded the identity
of the given newsmaker or capacity in which he/she appeared in
the story. It was anticipated that a typical story could cover more
than one newsmaker, so we recorded up to 20 by indicating their
respective identities.

Findings show that 21.5% of newsmakers were ordinary persons


quoted in their individual capacities, followed by experts 18.8%.
However, when you combine all the other newsmakers other than
ordinary persons, they have one similarity of being “authority
figures” or “officials”, implying that our reporting is still heavy
on ‘officialdom’.

Findings from our research on press coverage of public affairs


show that authority figures covered in their different occupational
or official capacities were dominant compared to newsmakers
who were ordinary persons. And in cases where ordinary persons
made news, it was primarily as affected persons or “victims”, or
“perpetrators”.

56
Table 16: Newsmakers of health stories

Newsmaker July 2015 – July 2016 – Overall


June 2016 June 2017 (n=452)
(n=241) (n=211) %
% %

Ordinary person quoted in their 16.6 27.0 21.5


individual capacity
Expert 20.3 17.1 18.8
Central government 15.8 13.7 14.8
representative
Local government personnel 12.0 14.7 13.3
Minister 6.2 2.8 4.6
International NGO 5.4 2.8 4.2
representative
Business representative 3.7 1.9 2.9
Cultural representative 1.2 4.3 2.7
Religious representative 1.7 3.3 2.4
Civil society representative 1.2 3.3 2.2
Local NGO representative 3.3 0.9 2.2
Other 3.7 0.5 2.2
Member of Parliament 1.7 2.4 2.0
President 1.2 1.9 1.5
Law enforcement representative 2.1 0.5 1.3
Politician or political operative 1.2 0.9 1.1
Military/security representative 1.2 0.5 0.9
Diplomatic representative 0.8 0.5 0.7
Anonymous or unknown 0.0 0.9 0.4
Vice President 0.4 0.0 0.2

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JULY 2015 – JUNE 2017

EXAMPLE OF A STORY WITH ORDINARY PERSON


AS NEWSMAKER
Headline: Expectant mothers fight for space at Kagadi Hospital
Author: URN
Publication: The Observer
Date: June 12, 2017
Website: https://observer.ug/news/headlines/53308-
expectant-mothers-fight-for-space-at-kagadi-hospital

NOTES: This story ticks all boxes in terms of presentation of


ordinary persons as “victims” and “affected persons”. The
article shows how mothers sleep on the floor due to lack of
space; the overwhelming numbers the hospital deals with and
the voice of a caretaker explaining the difficulty in getting
treatment (especially IV treatment) when one is lying on the
floor.

At Kagadi general hospital in western Uganda, expectant mothers


struggle to find space and beds.

The hospital receives about 20 expectant mothers daily, according


to Principal Senior Nursing Officer Specioza Nabukeera. She said,
however, that the available space and beds in the facility are not
enough for the expectant mothers, newborn babies and patients
with pregnancy-related complications.

Located along Kyenjojo-Kabwoya road in Kagadi town, the


hospital receives more than 200 patients from the western
districts of Kagadi, Kibaale and Kakumiro.

It also receives patients from the nearby sub-counties in Kyenjojo


and Hoima districts and a few, who, cross from eastern Democratic
Republic of Congo.

58
Several women sleep on mats and mattresses spread on the floor
as they wait for midwives and nurses. Some share the little spaces
with newborn babies.

Barbara Agaba, 25, one of the expectant mothers found at the


facility, said sleeping on the floor exposes both mothers and their
newborn babies to multiple infections.

Nabukeera said it is difficult for nurses to treat mothers and


children who are lying on the floor especially if they have to be
put on drip medication. Nabukeera appealed to government
to construct a bigger and well-equipped maternity ward at the
facility.

The medical superintendent Dr James Olowo, said Kagadi


general hospital was built to handle 100 in-patients in 1968. But
the number has since doubled, mainly as a result of population
growth.

Dr Olowo appealed to the ministry of Health to think of expanding


the hospital.

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JULY 2015 – JUNE 2017

15. Location of Story


The location of the story refers to the place/district where the
subject of the story took place. It’s key in determining issues that
affect the livelihoods of communities where the subject of the
story happens; or the issues that are of concern to a particular
area.

For this study, Kampala district was compared against the rest
of the country. Findings show that majority of the health stories
were located in Kampala (43%), compared to the rest of the
country combined.

Other than the fact that major print publications are headquartered
in Kampala, respondents noted that experienced and well-trained
reporters are also based in their main offices. Additionally, the
presence of Ministry of Health and other government officials
in Kampala makes most stories take a Kampala focus. In fact, a
respondent noted that cholera may break out in western region
but the reporter will quote a ministry official based in Kampala.
Another key explanation was that health sources willing to talk
are based in Kampala, while upcountry reporters lack contacts
in the capital city and vice versa.

Figure 13: Location of stories

60
A breakdown of location of health stories shows that The
Independent had the most number of health stories from Kampala
(53%). This can be explained by the fact that the magazine is
largely circulated and audience-focused in Kampala. The Observer
(65.5%) and Daily Monitor (60%) had most of their health stories
generated from parts of the country other than Kampala.

Table 17: Location of stories

Publication Kampala The Rest Of The Country Total (N)


(%) (%)

The Independent 53.3 46.7 15


Bukedde 46.2 53.8 117
New Vision 44.4 55.6 126
Daily Monitor 40.0 60.0 155
The Observer 34.5 65.5 29

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JULY 2015 – JUNE 2017

CHAPTER IV

CONCLUSIONS AND
RECOMMENDATIONS
Conclusions
The research findings offer a mixed picture. On the positive front,
there appears to be some progress in key reporting areas such as
provision of context, use of multiple sources and a healthy focus
on non-communicable diseases, which are a major global health
challenge. On the negative side, however, the predominance
of the hard news storytelling format with the accompanying
lack of depth, enterprise and investigation, limited diversity
in sourcing, and over reliance on officialdom, emasculate the
contribution of the media to more responsiveness, transparency
and accountability in the health sector.

Predominance of the conventional hard news format


Health stories are still largely reported using the conventional
hard news format. We could go as far as saying that most
reporting is on the surface level. There is little depth, enterprise,
analysis and investigation.

Concentration of coverage on diseases and outbreaks


Findings show that stories about diseases were dominant,
compared to those about institutional or sector management of
health, drugs, and equipment and supplies. While this is not bad
in itself, it points to the fact that the media is not treating health
as a sector with various interlinked branches; or one that deserves
proactive coverage, even when there are no disease outbreaks.

62
It’s commendable, however, that in the coverage of diseases, the
media are giving more attention to non-communicable diseases,
which is a current global health concern.

Central government focus and officialdom


The central government is the focus of most health stories,
according to our findings, while newsmakers are also mainly
‘officials’. This is true for Ugandan media coverage of public
affairs generally. The focus on officialdom in reporting comes
at the expense of highlighting voices of “ordinary” persons
and private sector players. It also begs the question as to the
effectiveness of the government’s decentralisation of delivery
of services such as health.

Limited diversity of voices in the media


Our findings show that gender parity in health coverage and in
general public affairs coverage is still generally skewed towards
men. Additionally, government and its officials also dominate
media when assessed through newsmakers and occupation
of sources that make it into the news. In cases where ordinary
persons feature, they are portrayed primarily as victims, affected
persons or perpetrators.

Recommendations
Newsroom investment in in-depth reporting
The persistent dominance of the conventional reporting format,
not just in this study, but in our public affairs research, point to a
need for the media to invest time and money in training journalists
to effectively report in-depth about health. This problem is further
illustrated by our finding on story trigger which reveals that most
stories emanate from events and spontaneous activities.

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JULY 2015 – JUNE 2017

The absence of in-depth reporting denies the media the


opportunity for multiple sourcing that would ensure diversity of
views, provision of adequate background and context, as well
explanatory and interpretive rendering of issues in a story.

While newsrooms argue that in-depth and investigative stories


require time and money which they don’t have, exploring funding
options from media development organisations can be a step in
the right direction.

Media literacy and ensuring diversity of voices


The media should invest in educating its publics that their
voices matter. The dominance of voices of central government
officials, should be a concern that prompts action. While most
communiqués on health comes from the Ministry of Health
headquarters, journalists can reach out to local governments
and health practitioners in the grassroots to ensure a localisation
and ownership of health issues. Further, the portrayal of
ordinary persons and women need to go beyond the victim and
perpetrator lens that has dominated coverage.

Additionally, while a narrative exists that women are not often


willing to talk to the media, stressing to them that it doesn’t
help to remain anonymous even on issues that pose no obvious
threat to them, will go a long way in breaking the ice. The op-ed
columns of newspapers, or the public editor’s column (like the
one Daily Monitor recently introduced), are good platforms to
make a case for more women inclusion.

The lopsided coverage of women by the media world over has


existed for a long time. While it’s generally true that “men run
the world” and the newsroom, which then gets reflected in the
content produced, deliberate efforts should continually be made
to include women’s voices that matter in stories, after all, diversity
is a key tenet of journalism.

64
While several newsrooms, notably the New Vision and Daily
Monitor, have reporting guidelines that require reporters to have a
mix of male and female sources, care should be taken not to only
tick the gender box; or to reinforce the stereotype that women
can be sources only when they are victims, or perpetrators.

Investing in self-improvement
From our study, the impression that some journalists are lazy
and prefer armchair journalism, especially in this age of social
media, came out quiet prominently. This calls for self-reflection
and self-improvement by individual journalists.

A lot of newsrooms world over are constrained budget-wise as


newspaper sales and advertising revenue dip; this means that
journalism training may not be a priority for some newsrooms
as it should be. However, technology, which has disrupted
mainstream media performance to some extent, also provides a
great opportunity for self-training and improvement, at little to
no cost without one having to take leave of absence to study.

Being a specialist in any journalism field is key, and even more


crucial for the health beat. Breaking down the complex healthcare
issues, their implications, costs, etc., can only be done by a
journalist who is on top of his or her game.

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