Print media coverage of primary healthcare and related research evidence in South Africa
TL;DR: Researchers in low- and middle-income countries need to be more proactive in making use of media analyses to help illuminate health related issues that require the attention of health policymakers, stakeholders and reporters, and to identify potential areas of research.
Abstract: The news media is located at the nexus of the public and policy agendas and provides a window into issues concerning the public. Therefore, it could be a powerful tool for advocating for citizens’ health and could help promote evidence-based primary health systems responsive to the needs of citizens. However, research on the coverage of primary healthcare and related research evidence in the South African print media is virtually non-existent. We examined 2,077 news stories that covered primary healthcare from 25 South African newspapers retrieved from the Lexis-Nexis online archive over a 16-year period (1997–2012). We analysed basic characteristics and conducted a content analysis of the news stories. Of the 2,077 news stories that mentioned primary healthcare, this was the main focus in 8.3% (n = 173). Of these, 45.7% discussed issues relating to clinics, whereas issues relating to community health workers and nurses were covered by 42.8% and 34.1% of news stories, respectively. The number of news stories discussing infectious diseases (55.5%) was more than twice the number discussing non-communicable diseases (21.4%). HIV/AIDS/TB illness- and service-related issues were covered by 54.3% of news stories and social determinants of health by 22%. Issues relating to how healthcare is organised to deliver services to the people received substantial coverage in the print media, with 72.8% discussing delivery arrangements, 72.3% governance arrangements, and 55% financial arrangements. A small fraction of news stories (7.5%) discussed research studies but none discussed a systematic review. Our study underscores the potential role of media analyses in illuminating patterns in print media coverage of health issues. It also shows that an understanding of coverage of health research evidence could help spur efforts to support the climate for evidence-informed health policymaking. Researchers in low- and middle-income countries need to be more proactive in making use of media analyses to help illuminate health related issues that require the attention of health policymakers, stakeholders and reporters, and to identify potential areas of research.
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01 Jun 2009TL;DR: The United Nations Children's Fund (UNICEF) as mentioned in this paper was originally created to provide relief for children in countries devastated by the destruction of World War II, and in 1965, it was awarded the Nobel Prize for Peace for its humanitarian efforts.
Abstract: The United Nations Children's Fund, or UNICEF, was originally created to provide relief for children in countries devastated by the destruction of World War II. After 1950, UNICEF turned to focus on general programs for the improvement of children's welfare worldwide, and in 1965, it was awarded the Nobel Prize for Peace for its humanitarian efforts. The organization concentrates on areas in which relatively small expenditures can have a significant impact on the lives of the most disadvantaged children in developing countries, such as the prevention and treatment of disease, child healthcare, malnutrition, illiteracy, and other welfare services.
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TL;DR: Findings suggest that narratives may have a positive influence when used as inspiration and empowerment tools to stimulate policy inquiries, as educational and awareness tools to initiate policy discussions and gain public support, and as advocacy and lobbying tools to formulate, adopt or implement policy.
Abstract: There is increased interest in using narratives or storytelling to influence health policies. We aimed to systematically review the evidence on the use of narratives to impact the health policy-making process. Eligible study designs included randomised studies, non-randomised studies, process evaluation studies, economic studies, qualitative studies, stakeholder analyses, policy analyses, and case studies. The MEDLINE, PsycINFO, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), WHO Global Health Library, Communication and Mass Media Complete, and Google Scholar databases were searched. We followed standard systematic review methodology for study selection, data abstraction and risk of bias assessment. We synthesised the findings narratively and presented the results stratified according to the following stages of the policy cycle: (1) agenda-setting, (2) policy formulation, (3) policy adoption, (4) policy implementation and (5) policy evaluation. Additionally, we presented the knowledge gaps relevant to using narrative to impact health policy-making. Eighteen studies met the eligibility criteria, and included case studies (n = 15), participatory action research (n = 1), documentary analysis (n = 1) and biographical method (n = 1). The majority were of very low methodological quality. In addition, none of the studies formally evaluated the effectiveness of the narrative-based interventions. Findings suggest that narratives may have a positive influence when used as inspiration and empowerment tools to stimulate policy inquiries, as educational and awareness tools to initiate policy discussions and gain public support, and as advocacy and lobbying tools to formulate, adopt or implement policy. There is also evidence of undesirable effects of using narratives. In one case study, narrative use led to widespread insurance reimbursement of a therapy for breast cancer that was later proven to be ineffective. Another case study described how the use of narrative inappropriately exaggerated the perceived risk of a procedure, which led to limiting its use and preventing a large number of patients from its benefits. A third case study described how optimistic ‘cure’ or ‘hope’ stories of children with cancer were selectively used to raise money for cancer research that ignored the negative realities. The majority of included studies did not provide information on the definition or content of narratives, the theoretical framework underlying the narrative intervention or the possible predictors of the success of narrative interventions. The existing evidence base precludes any robust inferences about the impact of narrative interventions on health policy-making. We discuss the implications of the findings for research and policy. The review protocol is registered in PROSPERO International prospective register of systematic reviews (ID =
CRD42018085011
).
90 citations
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TL;DR: Media research is crucial to understanding the complex ways in which attitudes towards policy interventions shape, and are shaped by, public discourses and can provide public health advocates with insights into strategies to successfully position policy arguments, and highlights key insights and gaps.
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TL;DR: The need for primary health care reform to develop the competencies of CHWs in HCWM is suggested and PHC and HCWM policies should address the infrastructure deficit in low resource communities.
Abstract: In South Africa, community health workers (CHWs) working in community-based care (CBC) programmes provide care to patients most of whom are living with HIV/AIDS and tuberculosis (TB) Although studies have shown that the caregiving activities provided by the CHWs generate health care waste (HCW), there is limited information about the experiences of CHWs on health care waste management (HCWM) in CBC This study explored HCWM in CBC in Durban, South Africa from the perspectives CHWs We used three ethnographic approaches to collect data: focus group discussions, participant observations and informal discussions Data was collected from 85 CHWs working in 29 communities in the Durban metropolis, South Africa Data collection took place from July 2013 to August 2014 CHWs provided nursing care activities to patients many of whom were incontinent or bedridden Some the patients were living with HIV/AIDS/TB, stroke, diabetes, asthma, arthritis and high blood pressure These caregiving activities generate sharps and infectious waste but CHWs and family members did not segregate HCW according to the risk posed as stipulated by the HCWM policy In addition, HCW was left with domestic waste Major barriers to proper HCWM identified by CHWs include, lack of assistance from family members in assisting patients to use the toilet or change diapers and removing HCW from homes, irregular waste collection by waste collectors, inadequate water for practicing hygiene and sanitation, long distance between the house and the toilets and poor conditions of communal toilets and pit latrines As a result of these barriers, HCW was illegally dumped along roads or in the bush, burnt openly and buried within the yards Liquid HCW such as vomit, urine and sputum were disposed in open spaces near the homes Current policies on primary health care (PHC) and HCWM in South Africa have not paid attention to HCWM Findings suggest the need for primary health care reform to develop the competencies of CHWs in HCWM In addition, PHC and HCWM policies should address the infrastructure deficit in low resource communities In order for low-and-middle-income-countries (LMICs) to develop effective community health worker programmes, there is a need for synergies in PHC and HCWM policies
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TL;DR: The Spanish written media reflects the socio-political interest aroused by PC, but messages circulating about PC do not describe professional practice, or the contribution of the same for patients.
Abstract: Introduction
The goal of palliative care (PC) is to improve the quality of life of terminal stage patients and their families. The subject frequently appears in the mass-media and this helps create a socially accepted identity. The aim of this study is to describe and analyse PC related news items appeared in the Spanish written media.
Methodology
A descriptive cross-sectional study was designed. Considering diffusion, scope and the range in editorial policy criteria, four printed newspapers (PN) were selected, together with four exclusively digital media sources (DM). Through Mynews, a newspaper content depository, and the search tool for each DM website, articles published between 2009 and 2014 which included the terms "palliative care" and "palliative medicine" were sought. A questionnaire was created to characterise each article identified and a descriptive analysis was undertaken.
Results
A total of 627 articles were identified, of which 359 (57%) were published in PN (42% in the printed editions -PE- 16% in their online editions -OE-) and 268 (43%) in DM. In general, they appeared mainly in sections concerning Health (23%), Culture and Society (18%) and General/Home News (15%). In PE, just 2% were found in the Health section and nearly 70% in Culture and Society and General/Home News. Most of the articles were informative in nature and contained socio-political messages (90%). Statements by PC professionals were found in 35% of the articles and by politicians in 32%. The most frequent content was related to facing end of life (74%) and patient quality of life (70%).
Conclusions
The Spanish written media reflects the socio-political interest aroused by PC. Nevertheless, messages circulating about PC do not describe professional practice, or the contribution of the same for patients. Content more in line with the clinical practice might help contribute to the development of this new area of medicine.
15 citations
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TL;DR: It is argued that the strategic reconceptualisation of the programme to include learnerships for community caregivers that impart more mid-level to higher-level skills to meet current and future labour market demands particularly in primary health care will address the scarcity of skills in the health sector of the economy.
Abstract: This paper examines employment and skills training for community caregivers within the expanded public works programme in South Africa. The paper argues that, as currently conceptualised, the skills and learnership programmes for community caregivers fail to take full advantage of the prevailing labour market realities. Therefore, the paper argues for strategic reconceptualisation of the programme to include learnerships for community caregivers that impart more mid-level to higher-level skills to meet current and future labour market demands particularly in primary health care. This, it is argued, will address the scarcity of skills in the health sector of the economy. Furthermore, the proposed programme will simultaneously have positive impacts on unemployment, the primary health care system and the socio-economic well-being of community caregivers.
7 citations