Deadline for Health: The Media’s Response to Covering HIV/AIDS, TB and Malaria in Africa
Country Report Summaries: Kenya

Human Development Index rank: 146 out of a total of 175 countries.
Adult literacy rate: 83.3 percent (UNDP 2001)
GDP per capita: $980 (UNDP 2001)
Life expectancy at birth: 46.4 years (UNDP 2001)
Government expenditure on health as percentage of total general government expenditure: 6.2 percent (WHO 2002)
HIV/AIDS prevalence in the adult population (15-49 years): 6.7 percent (UNAIDS 2004)
Orphans due to AIDS: 650,000 (UNAIDS 2004)
Population size: 31.9 million
Print Media Surveyed:
Daily Nation (privately owned daily)
Sunday Standard (privately owned weekly)

The advent of multiparty democracy in Kenya in 1992 opened the way for the growth of a robust independent media. Although media houses owned by political operatives make use of their position to support their chosen causes, the intimidation and self-censorship imposed during the presidency of Daniel arap Moi have passed, and professional journalists are enjoying a newfound media freedom. The Kenya Broadcasting Corporation, a national radio network, remains the dominant media outlet, covering some 98 percent of the country. Community radio stations were banned during the Moi era, but in the past decade there has been a proliferation of private FM stations in most urban centers. While newspapers cannot match the numbers reached by radio, they provide a longer lasting source for reference and analysis.

In this study, two newspapers were surveyed, the privately owned Daily Nation, circulation 180,000, which holds 74 percent of the market; and the privately owned weekly Sunday Standard, circulation 80,000, which enjoys 23 percent market share. Some 26 issues of the Sunday Standard were analyzed from 2002, while 72 issues of the Daily Nation were studied during the same year. In the Daily Nation, stories on HIV/AIDS amounted to 10 percent of the total coverage, malaria accounted for only 2.8 percent of total stories analyzed and TB was less than 1 percent. However, HIV/AIDS coverage was significantly boosted in the Daily Nation by articles carried in its weekly health, science and technology magazine, Horizon. In the Sunday Standard, HIV/AIDS coverage amounted to less than 2 percent of all stories printed, while coverage of malaria was less than 1 percent. The Sunday Standard did not cover TB by itself at all during 2002.

While malaria is the second most reported health issue in Kenya, it usually receives attention only after the sporadic outbreaks following the rainy season or when the surprisingly virulent forms appear in nontraditional malarial areas. Coverage of malaria is supplemented by advertising from pharmaceutical companies and the social marketing campaigns of organizations such as Population Services International.

Public health reporting in Kenya, as in most countries studied, suffers from the general propensity toward political content. The bulk of news reports are sourced from politicians who have little to offer in technical terms. The feature stories tend to quote experts, who often speak in terms that are incomprehensible to the average reader. While HIV/AIDS receives the greatest percentage of health coverage in the Kenyan media, in the absence of a framework for understanding public health issues, journalists tend to focus on statistics and funding issues rather than addressing human interest and service stories and the socioeconomic conditions that drive the epidemic. “I focus only on emerging issues around governance, politics and human rights abuses,” said a senior editor at the East African Standard. “But what influences my news beat is politics and policy.”

Survey respondents were divided in their assessment of the media’s performance in covering public health and especially HIV/AIDS. The media were praised for running special features on HIV/AIDS, malaria and waterborne diseases, demystifying HIV/AIDS and other taboo subjects, and acting as an interface between the public and government agencies and professionals. But respondents also drew a distinction between the quantity and quality of information, noting that there has been little behavior change with regard to HIV, despite information “overload” by the media.

The media was criticized for lacking reporters and editors with specialized knowledge and training who can knowledgeably report on public health issues. Some respondents said the media had actually worsened the situation in some cases through inaccurate or sensational coverage of HIV/AIDS.

Media houses argue that they are primarily profitmaking organizations, and unless public health stories are subsidized or sponsored, they say, it is not financially feasible for them to devote space to such issues. This has provoked criticism that media are focused on profit at the expense of the responsibility to inform and educate. “There is a perception that if a health issue cannot sell, then it is not worth spending time on,” said Lucy Oriang, managing editor for magazines at The Nation and lead researcher of the survey in Kenya. “In general the public ends up not being sensitized about the importance of public health and the media continue to disregard it. This attitude creates a vicious cycle, because media must first highlight the issues then gain public interest and not the other way round.” Oriang also says the lack of integrated reporting on health, poverty and development is essentially the result of a lack of analysis. Many of the young reporters who handle news do not have the knowledge or insight to add depth to their stories.

The most vulnerable groups – women and children – are also the most disadvantaged when it comes to accessing public health information in the mainstream media. All interviewed – media, health professionals and policy makers – agreed that women’s health needs were underserved in the media and yet were the most crucial. As for reaching children, says Oriang, the power of Western pop culture among urban youth poses a significant challenge for public health advocates and the media, who traditionally have relied on documentaries and educational programs to deliver their messages. New ways will need to be developed to produce material that engages the youth and provides relevant information especially regarding sexually transmitted infections such as HIV.

The study identified five obstacles that stood in the way of quality health reporting: the profit motive overriding social responsibilities, consumer preferences for good news or exciting information, inadequate funding and low investment in good in-depth media stories that require time and research, absence of in-house guidelines dictating minimum space for certain crucial content, lack of capacity among journalists to cover health and scientific information, and a preference for stories on the “easier stuff” such as politics.

“The problem with long-running things such as HIV/AIDS and war is that people soon become ‘immune’ to the crisis; it almost becomes the norm,” says Oriang. “You ‘do’ orphans, widows, vaccine tests, access to antiretrovirals, people stealing the intellectual property of others and then come round again to misappropriated funds … then back to infection and death rates. The burden of coverage should also be shared by those at the center of the action, who should keep in contact with journalists and explain regularly where we are at in such terms that journalists can actually understand what’s going on. My own experience of media work with development issues is that our advocacy can only be done within the context of news …. so let them give us the news pegs and we’ll get on with it.”

Oriang believes those who wish to influence the health agenda need to find ways to enter into the political debate and to approach health from a human rights point of view. “If straight news doesn’t work for anyone any more, then use it simply as an entry point and concentrate on analysis, commentary and features,” she said. “Kenyan journalism is at that stage where these are the only reasons why people bother to buy newspapers. They just love the opportunity to take part in the debates around points of view. I think anyone who wants to improve the way journalism is done must take the trouble to train journalists to become enough of specialists to work this way.”