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

Human Development Index rank: 162 out of a total of 175 countries.
Adult literacy rate: 61.0 percent (UNDP 2001)
GDP per capita: $570 (UNDP 2001)
Life expectancy at birth: 38.5 years (UNDP 2001)
Government expenditure on health as percentage of total general government expenditure: 12.3 percent
HIV/AIDS prevalence in the adult population (15-49 years): 14.2 percent (UNAIDS 2004)
Orphans due to AIDS: 500,000 (UNAIDS 2004)
Population size: 12 million
Print media surveyed:
Malawi News (weekly, privately owned)
The Nation (daily, privately owned)
The Weekly News (weekly, state-owned)

Malawi is one of the world’s poorest countries and has one of the world’s highest infant mortality rates – 620 deaths per 100,000 live births. Yet despite high levels of poverty and the prevalence of HIV, media coverage of public health issues in Malawi was rated extremely poor in this survey.

A total of three leading newspapers were included in the study: the Malawi News, a leading private weekly newspaper with a circulation over 20,000; The Nation, a leading privately owned daily with which sells more than 15,000 copies; and The Weekly News, which is state owned and has a circulation of 5,000. The survey analyzed a total of 109 issues of the newspapers during 2002. Of the 4,768 stories analyzed, fewer than 3 percent were health-related. Interestingly, the smallest newspaper carried the most health news and information. More than 52 percent of the health-related stories analyzed ran in The Weekly News, 28 percent were carried in the Malawi News and 19% appeared in The Nation.

Not surprisingly, the overwhelming amount of health coverage in all three newspapers (72 percent) was on HIV/AIDS, while malaria, the biggest killer of children under 5 and of pregnant women, accounted for only 5 percent of the health stories and TB accounted for only 4 percent of the health stories. The Nation put most of their health stories (60 percent) on the front page, while The Weekly News and the Malawi News put only 20 percent of their health stories on the front page. The Weekly News, a government publication, relied mainly on government sources for its news; the Malawi News used NGOs and foreign news agency reports for most of their stories, while The Nation used health professionals as well as their own journalists and other media associations as their sources.

There are several factors that explain the poor quality of public health journalism in Malawi, according to the editors, journalists and health specialists interviewed. One is the lack of training and specialization in public health issues among the Malawian media. Another is the resource constraints under which most journalists operate, forcing some journalists to pay their own way to travel to assignments. “Poverty is rampant and has a significant bearing on the output of journalists,” said Anderson Fumulani, a communications consultant who was the lead researcher for the project in Malawi. “The most popular radio station has no recording studio, and the reporters’ wage is as low as $47 per month.”

An impoverished environment leaves the media heavily dependent on sponsorships for radio programs as well as for training producers and reporters. It also leaves the media vulnerable to sell editorial space to the highest bidder or to run stories that are generated at a minimum cost, such as reporting on the moves and pronouncements of politicians and officials. Political bias in the print media was identified as a key problem in preventing the media from playing a public service role.

More women than men in Malawi are infected with HIV/AIDS, according to demographic projections developed by the Malawi National AIDS Commission. For that reason, participants in the study emphasized the need to target women with health information. They said women should get more information because they provide the care and are the last to seek help because of family priorities. Women also have difficulty exercising their own sexual and matrimonial rights because of Africa’s traditional and cultural practices.

Widespread poverty and limited resources allocated to the country’s healthcare combine to create a desperate situation. Mabvuto Banda, chief reporter at the Daily Times points to the 12 percent allocation for healthcare in the national budget as one explanation of the problem. “I think that is not enough to fight whatever we are trying to fight in terms of health,” he said. “I think we have been depending on donor support too much, but in issues like health and education, I think government needs to come out full throttle.”

A further pressure on the Malawian health system is the exodus of nursing staff for greener pastures. Respondents offered much anecdotal evidence of public health facilities relying on underqualified personnel to fill the gaps left by trained nurses who have been recruited to work in continental Europe and the United Kingdom. The principal of the Kamuzu College of Nursing, Christine Chihana, said that there was no scarcity of health information, but staff shortages meant that there were no trained health workers to deliver messages to communities at the grass roots.

Fumulani adds that both leadership and resources are needed in order to create a “best practice” example of quality journalism. “What is missing is a clear, issue-oriented approach, that takes more time in training and skills development,” he said. “Someone has to spend to make it happen, I’m afraid.”