2265536_2204524_Writing_for_Justice_final_report_feb2016

WRITING FOR JUSTICE:
A Qualitative Analysis of Ugandan Media Coverage of Women’s Reproductive Health
Rosanne Marrit Anholt

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Cover photo by African Centre for Media Excellence (ACME)
By
ROSANNE MARRIT ANHOLT
Student number 2516029
Under supervision and in collaboration with
ESTHER NAKKAZI, President of Health Journalist Network in Uganda (HEJNU)
EVELYN LIRRI, Vice President of Health Journalist Network in Uganda (HEJNU)
ELSBET LODENSTEIN, PhD Candidate, Athena Institute Vrije Universiteit Amsterdam
PROF. DR. JAQUELINE BROERSE, Athena Institute Vrije Universiteit Amsterdam
This work is submitted in partial fulfilment of the Master of Science degree Management, Policy
Analysis, and Entrepreneurship in Health and Life Sciences with specialisation International Public
Health at the Vrije Universiteit Amsterdam, the Netherlands.
February 2016

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“a healthy Ugandan society, capable of making good treatment
decisions, which is well informed on public health care issues through
excellence in health journalism”
Health Journalist Network Uganda

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INDEX
Acknowledgements 7
Abstract 9
Chapter 1 Introduction 11
Chapter 2 Theoretical background 15
2.1 Core concepts 15
2.2 Conceptual model 17
2.3 Research questions 17
Chapter 3 Methodology 19
3.1 Institutions involved in the study 19
3.2 Qualitative content analysis (framing analysis) 20
3.3 Semi-structured interviews 23
3.4 Colloquium (dissemination seminar) 24
3.5 Ethical considerations 25
Chapter 4 Media frames results 27
4.1 Article attributes 27
4.2 Media frames 29
4.3 Frames of men and women in relation to women’s reproductive health 38
4.4 Sources 42
4.5 Interim conclusion 42
Chapter 5 Frame-building results 43
5.1 Sample characteristics 43
5.2 Factors that influence frame-building 43
5.3 Interim conclusion 54
Chapter 6 Discussion & conclusion 57
6.1 Discussion 57
6.2 Strengths & limitations 59
6.3 Conclusion 60
6.4 Recommendations 60
References 63
Annex I Research framework 69
Annex II Codebook 71
Annex III Interview guide 75
Annex IV Research dissemination seminar invitation 77
Annex V Study information 79
Annex VI Informed consent 81

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ACKNOWLEDGEMENTS
First and foremost, I want to express my deepest gratitude to Esther Nakkazi and Evelyn Lirri for
hosting me for three months at their organisation. It is through your joy, positivity, and strength, that I
can count my final research internship is one of the most valuable experiences of my life. Thank you
for sharing the office with me and lobbying me into press meetings and conferences, and thank you
for the best lunches at Ntinda New Market. I could not have done the work without the two of you –
your contributions have been absolutely invaluable, and I am very much looking forward to keeping in
touch.
Many thanks also go to my interviewees and seminar participants. Without your enthusiasm to share
your stories, this project would not have been possible. I feel honoured and privileged to have been
able to listen to your personal and professional experiences, your knowledge and memories, and I was
deeply moved by your zeal and passion for health journalism and women’s rights. You have
demonstrated the crucial role of media in any development and human rights issue. I will carry this
with me in all my future endeavours.
My gratitude also goes to my supervisor from the Vrije Universiteit Amsterdam, Elsbet Lodenstein.
Thank you for your enthusiasm and continuous guidance throughout this project. I am hoping for
fruitful years of collaboration between the Athena Institute and HEJNU.

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ABSTRACT
Introduction: Women in Uganda encounter considerable challenges to the realisation of their
reproductive health rights. Mass media play a significant role in shaping a society’s understanding of
their health and perception on health rights. This study explored how women’s reproductive health is
framed in Ugandan media, and what factors contribute to the way these frames are built.
Methods: A qualitative content analysis of newspaper articles about women’s reproductive health was
conducted to identify and analyse media frames. Semi-structured interviews were conducted with 19
health journalists to identify factors contributing to framing.
Results: 210 articles from 4 national newspapers published between 1 and 31 May were selected, of
which 50% addressed pregnancy; 25% sexual violence; 13% STIs and HIV/AIDS; and 12% remaining
topics. Several factors play a role in framing, such as journalists’ role-perception; and understanding
and contextualisation of women’s reproductive health issues. Poor pay and working conditions in
journalism further influence the type of stories and their frames.
Discussion: Despite this study’s narrow focus on print media, findings contribute to understanding the
role media plays in women’s reproductive health. Recommendations are made as to how Ugandan
journalists and other key actors may facilitate reproductive justice through empowering media
messages and in this way contribute to an improved practice of health reporting.
(Number of words: 211)

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CHAPTER 1
INTRODUCTION
The media is a common source of health information in Sub-Saharan countries such as Uganda
(Bankole, Biddlecom, Guiella, Singh, & Zulu, 2007). Indeed, Seale (2003) explains that health behaviour
may be determined in large part by information drawn from various mass media, which may include
“depictions of what it is like to be sick, what causes illness, health and cure, how health care providers
behave (or ought to) and the nature of health policies and their impact” (p. 514). Media functions as a
mirror of society, providing an indication of how health is understood and constructed at national level
(MacKian, 2008). Media messages are not only shaped by society, however, they also have “a
significant effect on the shaping of that society” (Hope, 2010, para. 3). Previous research suggests that
media messages influence people’s health behaviour. Paek, et al. (2008), for example, found that
exposure to health-related radio programmes predicts family planning behaviour in Uganda. Likewise,
mass media may direct policy makers’ attention to important public health issues – and subsequently
influence the political agenda (McCombs & Shaw, 1972), especially when it regards concrete issues,
like high maternal mortality rates or poor health care services (Yagade & Dozier, 1990). Effects of
media messages, however, are likely to depend on the content of the message. If the content of such
media is positive, e.g. encouraging the use of family planning methods, it may be more likely that
health behaviours or policy actions reflect this acceptance of family planning. One study, for example,
showed that pregnant women are more willing to have an Influenza vaccination if messages are
framed positively, emphasising the benefits for the infant’s health (Marsh, Malik, Shapiro, Omar, &
Frew, 2014). As such, the way in which media represent or frame health issues may influence
audience beliefs, attitudes, behaviours, as well as to whom responsibility is attributed (Scheufele,
1999). A frame, in short, is “the process in which a ‘point of view’ on a given issue or event is used to
interpret and present ‘reality’” (Hardin & Whiteside, 2010, p. 313). Frames may highlight certain
aspects of reality and exclude others, which may then “lead individuals to interpret issues differently”
(Borah, 2011, p. 248). Frames, then, may “actually define our understanding of any given situation”
(Kuypers, 2002, p. 7). And indeed, it has been known for decades that health beliefs influence health
behaviour (Janz & Becker, 1984).
Although the content of media is significant, the process of making media is just as important (Hill,
2008). Watkins and Emerson (2000) argue that “[a]ny serious … analysis of the media industry must
devote considerable attention to the organisational milieu in which media products are created” (p.
153). Where a frame deals with the way in which an issue is presented, framing, according to de
Vreese (2005), “involves a communication source presenting and defining an issue” (p. 51). A media
frame is thus the product of journalists’ frame building – suggesting that journalists select aspects
from ‘reality’ (consciously or unconsciously) to produce frames (Brettschneider, 2003; Scheufele,
1999). Hope (2010) argues that “authors … discuss the (relatively neutral) concepts within the
boundaries of their own normative ideals and with reference to their selected empirical evidence thus
operationalising the frames which determine the various ‘meanings’ of” in this case, women’s
reproductive health (“II. A model of the framing process”, para. 6). In the process of frame-building,
journalists may be influenced by various factors, such as professional standards, organisational
constraints, and the political and economic environment (Hanitzsch et al., 2010; Vliegenthart & van
Zoonen, 2011). More specifically, a study of health journalists in New Zealand found that the way in
which health stories were framed depended on journalists’ understanding of health; their professional
norms; the nature of different sources they used; journalists’ understanding of audiences; and their
opportunities for so-called ‘civic journalism’ (Hodgetts, Chamberlain, Scammell, Karapu, Nikora, 2007).

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Civic journalism is the extension and re-politicisation of health coverage in order to “emphasise
collective responsibility for health and situational factors such as crime, deprivation, and life chances”
(Hodgetts et al. 2007, p. 49). In other words, the socio-political re-contextualisation of health through
media coverage with the aim of transforming “the underlying conditions that drive distributions of
disease, and deprivations of rights” (Yamin, 2011, p. 1).
African media systems are still young (Goretti Nassanga, 2008). A British colony from 1894 to 1962,
Uganda’s independence was followed by Idi Amin’s violent dictatorship from 1971 to 1979. Yoweri
Museveni has been Uganda’s political leader since 1986, under whose rule in 1993 a period of media
liberalisation allowed the (broadcast) media to expand from one radio station (Radio Uganda) and one
TV station (Uganda Television) to over 150 FM radio stations and 11 TV stations (Goretti Nassanga,
2008). Even though “Uganda is often cited as an ‘exciting’ example of a vibrant free press in East Africa
… the country’s journalists and media continue to battle against the government’s entrenched hostility
to free expression and criticism” (Mwesige, 2004, p. 75). Ten years later, Uganda’s press status ranks
as ‘partly free’, scoring 58 point out of 100 where o is best and 100 is worst (Freedom House, 2014).
Uganda’s media environment nevertheless seems to become increasingly challenging. Several laws
were recently been signed that threaten to limit press freedom, and media houses are routinely
subjected to government interference, including temporary shutdowns (Freedom House, 2014). In
addition, violence against journalists – from state and non-state actors – is fairly common (CPJ, n.d.;
Kaiji, 2013). Mwesige, (2004) nevertheless asserts that Ugandan journalists have “a modest amount of
professional autonomy and freedom” (p. 79).
Hanitzsch et al. (2011) found that Ugandan journalists are relatively young in terms of their
professional experience. On average, they have eight years of professional experience, similar to
countries such as Russia and China (ibid, 2011). Despite national laws requiring them to have
university degrees, only about 54% graduated from college (ibid, 2011; Mwesige, 2004). Although
about a third of Ugandan journalists are female, the profession is not very likely to retain female
journalists, due to journalism being demanding and stressful (Hanitzsch et al., 2011; Mwesige, 2004).
Kaiji (2013) explains that many Ugandan women are leaving the newsroom because of long working
hours that some feel is not reconcilable with wanting to spend time with family and children; a lack of
career opportunities, and sexual harassment in the newsroom. Ugandan journalists – male and female
– are in general not very satisfied in their profession. Low pay subsequently promotes taking bribes
from sources (Freedom House, 2014). Similar practices were found neighbouring countries, such as
the Democratic Republic of Congo (Koch, 2014).
Reproductive health indicators imply that Uganda has a lot of ground still to cover. For example,
Uganda is one of the ten countries that together comprise 58% of maternal deaths globally (WHO,
2014). National maternal mortality rates for 2011 amount up to 438 deaths per 100,000 live births,
and 18% of all deaths of women between the ages of 15 and 49 are pregnancy-related (UBOS, 2012).
The estimated risk of dying during delivery in the sub-Saharan African region is as high as 1 in 38 –
compared to only 1 in 3700 in developed countries (WHO, 2014). Some media gloomily suggest that
giving birth might just be ‘the most dangerous thing an African woman can do’ (“Giving birth”, 2012).
Nevertheless, it is being a mother or nothing: women who experience (secondary) infertility may
suffer stigma and social ostracism (WHO, 2010). Only about 26% of married women are using a family
planning method (UBOS, 2012). Uganda has one of the highest unmet needs for family planning in the
world (UN, 2013), which is likely to be related to the high number of (unsafe) abortions in the country.
Although abortion is prohibited by law, 54 abortions are carried out per 1,000 women, much higher
than the regional average (Guttmacher Institute, 2013). Abortion-related causes account for 26% of all
maternal mortality (ibid, 2013). In addition, HIV prevalence rates are currently at 7.3% – which

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translates to 1.5 million people living with HIV/AIDS (UNAIDS, 2014). More than half of these are
women (ibid, 2014). Finally, 28% of women have ever experienced sexual violence, and 16% have
experienced sexual violence in the last 12 months (UBOS, 2012). Moreover, since 2010, there is a
national law against female genital mutilation/cutting (FGM/C). Less than 2% of women are
circumcised, and the majority of women (83%) want the practice to stop (UBOS, 2012).
For the media in Uganda there may be ample opportunities for civic journalism: to produce media
messages with the intention of realising women's access to their reproductive health rights. The ways
in which media has framed women in relation to their reproductive health – and its likely effect on
empowerment – has been studied before. In the United States for example, a case study found that
representations of sexuality and reproduction in hip-hop lyrics and prime-time television de facto
limited reproductive justice, as “[w]omen who actively choose to use birth control are portrayed
negatively, misinformation about condoms and access to reproductive healthcare is perpetuated, and
[negative] stereotypes about women and reproduction are reinforced” (Jaworski, 2009, p. 105). In
Uganda, MacKian (2008) found that in health stories, women were often represented as having the
primary responsibility of caring for others. This reinforces and leaves unchallenged any social
pressures and expectations that women are subjected to (ibid, 2008). Hill (2008) found that Ugandan
women found it difficult to relate to dominant media discourses about women. The way in which
reproductive health itself is portrayed in the media however, has hardly been studied. In order to
understand the role that media plays in women’s (reproductive) health, it is important to not only look
at how women are portrayed in relation to their reproductive health, but also reproductive health
issues themselves.
Therefore, the primary objective of this study is to provide insight into the way in which Ugandan
media frame women’s reproductive health, by analysing media frames and the factors that influence
frame-building, in order to identify opportunities for an improved health reporting practice. The study
aims to answer the following primary research question: What is the role of the media in women’s
reproductive health in Uganda?

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CHAPTER 2
THEORETICAL BACKGROUND
This chapter describes this study’s research perspective, which consists of “a set of core concepts,
each connected to one another in causal relationships” (Verschuren & Doorewaard, 2010). These core
concepts include ‘media’; ‘media frame’; ‘frame-building’; ‘reproductive health’; and ‘reproductive
justice’. The way in which these concepts relate to one another will be visualised in the conceptual
model. The research sub-questions that flow logically from this model together provide an answer to
the primary research question: What is the role of the media in women’s reproductive health in
Uganda?
2.1 Core concepts
The following paragraphs will discuss the core concepts and define them in the context of this study:
print media; media frame; frame-building; and reproductive health.
Print media
The first core concept is ‘print media’, which is a form of ‘mass media’. Wimmer and Dominick (2014)
define mass communication as “any form or communication transmitted through a medium (channel)
that simultaneously reaches a large number of people. Mass media are the channels that carry mass
communication” (p. 2). In this study, ‘media’ refers to institutionalised channels carrying information
to the public, specifically print media in the form of newspapers. Kline (2006) notes in her review of
research on health context in the media, that “[t]he majority of content-analytic research attends to
journalism, especially magazines and newspapers” (p.45). Most Ugandans however, receive their news
through radio. The African Media Barometer of 2012 notes that countrywide, 68% of the population
tune into the radio for news (77% urban, 66% rural), whereas only 9% gets their daily news from
newspapers (28% urban, 6% rural). However, despite the relative high cost of print media, it seems to
retain its influence: “‘[m]ost radio and television stations review the print media. Therefore
newspapers become the main source of news for the whole country’” (Friedrich Ebert Stiftung, 2012).
Torwel and Rodney (2010) also found that print media often inform the broadcast media. Moreover,
MacKian (2008) notes that although newspaper “readership is patchy and limited, national media
messages do nonetheless filter through to local distribution channels” (p.109). In addition, community
networks, such as family and friends, may often be a trusted source for health information (Marsh,
Malik, Shapiro, Omer, & Frew, 2014). As audiences spread information through their personal and
community networks, they provide (print) media with a much broader audience than their direct
readership (Paek et al., 2008).
Media frame
The second core concept is a ‘media frame’. For the purpose of this study, media frames are
understood in terms of Entman’s (1993) definition: frames “define problems – determine what a
causal agent is doing with what costs and benefits, usually measured in terms of common cultural
values; diagnose causes – identify the forces creating the problem; make moral judgements – evaluate
causal agents and their effects; and suggest remedies – offer and justify treatments for the problems
and predict their likely effects” (p. 52). As such, frames consist, initially, of four frame elements: (1)
problem definition; (2) causal agent; (3) moral evaluation; and (4) treatment recommendations –
which can easily be operationalised (Matthes & Kohring, 2008). In addition, the way women are
described in relation to their reproductive health may be important in the way media messages come

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across on the reader. Moreover, assessing the way in which women appear in media has been studied
before (see for example Hill, 2008; MacKian, 2008). Therefore, ‘descriptions of women’ is added as a
fifth element in the media frame. Gill (2007) argues that in order to understand descriptions of
women, one must also look at descriptions of men, in relation to women’s reproductive health, for
example in their role as partner. ‘Descriptions of men’ is therefore added as the sixth media frame
element. Finally, the media frame also includes the sources used in a reproductive health story. When
studying sources, we study the interactions between journalists and their sources, but also journalists’
role as gatekeepers for which information enters news discourse (Carlson & Franklin, 2011). Schwartz
(2011) for example, showed that male voices as sources not only outnumbered female voices, but
were also more likely to express a view different from those expressed by female sources. As sources
are likely to interpret particular topics differently themselves, it is likely that ‘sourcing’ has an effect on
how the topic is presented in a media message. Therefore, it is added as the seventh element.
It is possible that not all of these frame elements are present within a particular reproductive health
story. Media frames, then, relate to media in the way that media employs frames in order to get
messages across in a certain way. As mentioned before, frames are likely to highlight certain aspects
of a story and exclude others, leading individuals (i.e. the reader, the public, policymakers) to interpret
the issues in a certain way, whether this was intended by the journalist or not (Borah, 2011). This also
highlights that frames are built by journalists, which leads us to the third core concept, ‘frame-
building’.
Frame-building
Frame-building is the process that links the media to media frames. As mentioned in the introduction,
“authors … discuss the (relatively neutral) concepts within the boundaries of their own normative
ideals and with reference to their selected empirical evidence” (Hope, 2010, “II. A model of the
framing process”, para. 6). This is not to say, however, that journalists have full agency per se over
what they write. Indeed, not only personal but also organisational and source-related factors have an
impact on the building of media frames. For the purpose of this study, frame-building is understood as
a process of selection, which is influenced by different factors on five different levels. These levels are
(1) personal factors, which include for example one’s understanding of women’s reproductive health;
(2) professional factors, such as professional norms and values, and standards of ‘good practice’; (3)
organisational factors, such as organisational policies, and rules of conduct; (4) source-related factors,
such as the nature of news source, or what he/she demands in exchange for information; and (5)
wider contextual factors, such as the political climate, and national laws (Hanitzsch et al., 2010;
Hodgetts et al., 2007; Vliegenthart & van Zoonen, 2011).
Reproductive health
In the context of the current study, reproductive health concerns the overall content of the media
frames. Reproductive health is defined as “a state of complete physical, mental and social well-being
and not merely the absence of disease or infirmity, in all matters relating to the reproductive system
and its functions and processes” (UN A/CONF.171/13, chap. 7.A). Reproductive healthcare, then, is the
“the constellation of methods, techniques and services that contribute to reproductive health and
well-being by preventing and solving reproductive health problems” (ibid). Elements of reproductive
health include, but are not limited to, family planning (including emergency contraception); pregnancy
(including antenatal, delivery, and post-natal care, and emergency obstetrics); infertility; abortion;
reproductive tract infections (RTIs), sexually transmitted infections (STIs), and HIV/AIDS; and sexual
violence (including harmful traditional practices such as female genital mutilation/cutting (FGM/C))
(UNFPA, 2008). It needs to be cleared that the concept of reproductive health used for this study

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excludes elements of sexual health and rights. Including these would open up an entire range of
additional topics, such as sexual identity and sexual preferences. Uganda’s current legal environment
with regards to sexuality is increasingly restrictive (for example with regards to the LGBTIQ1
community), and local media have been involved in naming and shaming games (“Ugandan
‘homosexuals’”, 2014). To analyse sexuality in Ugandan news media, an entire separate study would
be necessary.
2.2 Conceptual model
The schematic representation of the research perspective can be found below (Fig. 1).
Figure 1. A schematic representation of the research perspective (i.e. conceptual model).
On the left, the figure shows the factors that are considered to influence the frame-building process,
which then lead to the frame – consisting of the four elements discussed; the problem definition,
causal agent(s), a moral evaluation, and treatment recommendations. ‘Descriptions of women’ and
‘descriptions of men’ in relation to women’s reproductive health are added as the fifth and sixth
elements. Also, the sources used in the story are added as a (seventh) frame element.
2.3 Research questions
This study aims to address the following main research question: What is the role of the media in
women’s reproductive health in Uganda? Following from the conceptual model displayed above, this
study aims to address the following sub-questions – in line with the available time and resources:
(1) How is women’s reproductive health framed in Ugandan media?
a. How are women’s reproductive health topics understood in Ugandan media?
b. Who are what is considered responsible for women’s reproductive health issues?
c. How are these issues evaluated against a background of norms and values?
d. What solutions are proposed for women’s reproductive health issues in Uganda?
e. How are women described in relation to their own reproductive health?
1
Lesbian, gay, bisexual, transgender, intersex, and queer.

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f. How are men described in relation to women’s reproductive health?
g. What sources are used in women’s reproductive health stories?
(2) What factors influence Ugandan journalists’ framing of women’s reproductive health?
a. What personal factors influence frame-building?
b. What professional factors influence frame-building?
c. What organisational factors influence frame-building?
d. What source-related factors influence frame-building?
e. What external factors influence frame-building?

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CHAPTER 3
METHODOLOGY
The primary objective of this study is to provide insight into the way in which Ugandan media frames
women’s reproductive health, by analysing media frames and the factors that influence frame-
building, in order to identify opportunities for an improved practice of health reporting. The study
aims to answer the question of what role the media plays in women’s reproductive health in Uganda.
This qualitative, practice-oriented and exploratory media analysis study is primarily grounded in
constructivism, because it builds on the idea that reality is socially constructed through multiple
channels – media being one of them. The research framework (Annex I) represents the internal logic
of the study (Verschuren & Doorewaard, 2010), and serves as the framework within which Ugandan
media and Ugandan journalists’ experiences are examined. It is a schematic representation of the
research objective and the necessary steps to achieve it.
First, the institutions involved in this study are introduced. In the sections that follow, the methods
and data analyses used to answer the main research questions and the sub-questions will be
elaborated upon. In order to answer research sub-question 1 ‘How is women’s reproductive health
framed in Ugandan media?’, a qualitative content analysis was employed, in the form of a framing
analysis. This method is discussed, and followed by an overview of what type of data was used and
how it was collected. Then, the way in which this data was analysed and how it provides an answer to
research sub-question 1. Next, to answer research sub-question 2 ‘What factors influence Ugandan
journalists’ framing of women’s reproductive health?’, semi-structured structured interviews were
carried out in addition to a colloquium in the form of a dissemination seminar. Finally, the chapter
concludes with ethical considerations, such as the institutional ethics approval that was acquired and
informed consent with respect to human participants.
In Table 3A below, an overview is given of the specific research methods and type of data analyses
that have been used in this study, as well as the type of data that was used and how it was collected.
The leftmost column shows which research question (RQ) the method aims address.
Table 3A. Overview of methods and data analyses.
RQ Methods Data Sources Data collection Analyses
1 Qualitative content
analysis
Newspaper
articles
Purchase on-site Framing analysis &
thematic coding
2 Semi-structured
interviews
Journalists Convenience/
snowball sample
Thematic coding
2 Colloquium
(dissemination
seminar)
Journalists, and
others interested
Convenience/
snowball sample
Thematic coding
3.1 Institutions involved in the study
This study was a collaborative project between the Athena Institute at the Vrije Universiteit
Amsterdam, the Netherlands and the Health Journalist Network in Uganda (HEJNU) in Kampala,
Uganda. The Athena Institute at the Vrije Universiteit Amsterdam is a research institute that focuses
on the analysis of complex societal issues, and the design and implementation of strategies to deal
with those complex issues. The Athena Institute provides bachelors and masters training including the

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Master of Science (MSc) degree programme Management, Policy Analysis and Entrepreneurship in
Health and Life Sciences – the attainment for which this study was carried out. The primary researcher
and writer is Rosanne Anholt, master student specialising in international public health, supervised by
PhD candidate Elsbet Lodenstein. She in turn is supported by the head of the department of
Communication in the Health and Life Sciences, Prof Dr Jacqueline Broerse. The Health Journalist
Network in Uganda (HEJNU) is an independent, non-profit organisation established in 2011. The
organisation represents a national network of about 80 Ugandan journalists specialised or interested
in health reporting. HEJNU’s primary aim is to advance the public’s understanding of health care
issues. The organisation does so through publications, organising meetings between journalists and
researchers, and health journalism conferences. The primary researcher and writer was hosted and
supervised by the President and founder Esther Nakkazi and Vice-President Evelyn Lirri.
3.2 Qualitative content analysis (framing analysis)
In order to answer sub-question 1 ‘How is women’s reproductive health framed in Ugandan media?’, a
qualitative content analysis was carried out. There are many definitions for what a content analysis is
(Macnamara, 2005). This study employs the definition provided by Neuman (1997), who explains
content analysis as a “technique for gathering and analysing the content of text. The ‘content’ refers
to words, meaning, pictures, symbols, ideas, themes, or any message that can be communicated. The
‘text’ is anything written, visual, or spoken that serves as a medium for communication” (pp. 272-273).
The content was analysed according to Entman’s (1993) categories of frame elements: problem
definition; causal attribution; moral evaluation; and treatment recommendation. In doing so, this
study follows the approach taken by Matthes and Kohring (2008), as well as Torwel and Rodney
(2010), who identified framing elements in newspaper stories according to Entman’s frame elements.
As explained in the previous chapter on the study’s theoretical background, descriptions of women in
relation their reproductive health, descriptions of men in relation to women’s reproductive health,
and sources were added as additional framing elements. These seven framing elements were
identified in news messages about women’s reproductive health according to a priori defined codes,
for which the codebook can be found in Annex II. In Table 3B below, the seven frame elements are
shortly described – the more elaborate definitions can be found in the above-mentioned codebook.
These make up the framework for the qualitative content analysis.
Table 3B. An overview of media frame elements and their description.
Frame element Description
Problem definition The central issue under investigation and the most important
actor.
Causal attribution That which is believed to be responsible for the central issue in
the news story.
Moral evaluation Evaluation of the actors responsible and characterisation of their
effects.
Treatment recommendation Treatment for the problem and prediction of their likely effects.
Descriptions of women The way in which women are described in relation to their (own)
reproductive health.
Descriptions of men The way in which men are described in relation to their partners’
Sources Type of sources of information (e.g. people, materials).

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3.2.1 Data sources
Four leading national newspapers were included in this study from which to collect articles about
women’s reproductive health in particular. These include the New Vision; the Daily Monitor; The
Observer; and the Red Pepper. An overview of the newspapers included in this study can be found in
Table 3C below.
Table 3C. Overview of newspapers included in this study.
Newspaper Publication Type Website
New Vision Daily; Saturday and Sunday edition State-owned www.newvision.co.ug
Daily Monitor Daily; Saturday and Sunday edition Independent www.monitor.co.ug
The Observer Tri-weekly (Mo-Wed-Fri) Independent www.observer.ug
Red Pepper Daily; Saturday and Sunday edition Tabloid www.redpepper.co.ug
Previous market research has shown that the English language New Vision (part of the Vision Group) is
Uganda’s most-read newspaper: 64% of readers surveyed reads New Vision (Friedrich Ebert Stiftung,
2012). The New Vision is generally regarded as state-owned and therefore as being predominantly
pro-government. Forty-five percent of surveyed readers read the Daily Monitor, which is regarded as
the main independent daily newspaper; and 33% reads the Red Pepper, a tabloid weekly publication
(Friedrich Ebert Stiftung, 2012). Moreover, both the New Vision and the Daily Monitor have been used
in earlier research on health reporting in the media (MacKian, 2008). In addition to these three
newspapers, the English-language The Observer was added in consultation with the on-site study
team. In contrast to the other three newspapers, The Observer is a tri-weekly publication, which only
comes out on Mondays, Wednesdays, and Fridays. Only English language newspapers were included in
this study due to the inability of the primary researcher to speak local Ugandan languages, a point
which is further discussed in chapter six: discussion and reflection. It may be noted, however, that
although there is a considerable range of local language publications, the New Vision and the Daily
Monitor in particular, can be regarded as Uganda’s leading and most-read newspapers.
3.2.2 Inclusion criteria
Table 3D below provides an overview of the in- and exclusion criteria on the basis on which articles
were selected for analysis.
Table 3D. Overview of inclusion and exclusion criteria.
Inclusion criteria Exclusion criteria
Newspaper New Vision; Daily Monitor; The
Observer; or Red Pepper
Any other newspaper
Publication date Between 1 May and 31 May 2015 Any other publication date
Topic Women’s reproductive health Any other topic
Sub-topic Family Planning; pregnancy;
infertility; abortion reproductive
diseases (RTIs, STIs, HIV/AIDS); or
sexual violence; and emerging topics
deemed to be relevant
Any other sub-topic, such as sexuality,
sexual preferences (e.g.,
homosexuality), and sexual identity
(e.g., transgender, intersex)
Other Must specifically address women’s
reproductive health
If focused on public health in general
or on men’s reproductive health
specifically

22 | P a g e
Articles from these four newspapers were included in the study when published between May 1 and
May 31, 2015 (first inclusion criteria). All editions were purchased on-site. Newspaper editions were
scanned for articles that addressed reproductive health (the second inclusion criteria) by reading and
re-reading headlines and leads. The lead in a newspaper article is the introductory paragraph (often in
bold) that answers the Who, What, Why, When, and How questions. Since reproductive health is a
broad concept, six concepts from the United Nations Population Fund’s (UNFPA) 2008 Reproductive
Rights and Sexual and Reproductive Health Framework were used as guidelines to decide whether an
article was about reproductive health. The topics include: Family planning (including emergency
contraception); pregnancy (Antenatal, delivery and post-natal care, including emergency obstetrics);
infertility; abortion; reproductive tract infections (RTIs), sexually transmitted infections (STIs) and
human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS); and sexual
violence against women (including traditional harmful practices, such as female genital cutting). The
guidelines were adjusted in iterative fashion, as other reproductive health topics emerged from the
texts but could not easily be placed in above categories, such as menstruation. Initially selected
articles were then carefully read and re-read whether it specifically addressed a women’s reproductive
health issue, or whether it focused more on the health of the general public, in which case it was
excluded. An example here is the exclusion of some articles about breast cancer, or breast feeding,
which addresses women’s health or infant health, but not specifically women’s reproductive health.
Whenever it was ambiguous whether an article needed to be in- or excluded, the article was discussed
with other study team members, and on the basis of this, a decision was made. Doubly published
articles, although included in exploratory quantitative analyses, were excluded from the qualitative
content analysis. Finally, 204 articles were included. Figure 2 below shows the search process and
which articles at what stage were included and excluded, leading to the eventual sample.
* The number of potentially relevant articles (= all articles published in every newspaper edition) was not
recorded.
** Doubly published articles were included in descriptive statistics (n = 209).
Figure 2. A schematic representation (i.e. search tree) of the search process according to the inclusion and
exclusion criteria defined a priori.
n* Potentially relevant articles identified
n* Articles excluded based on title/lead
n* Irrelevant to reproductive health
n* Irrelevant to women’s reproductive health
220 full-text articles retrieved for detailed evaluation
16 Articles excluded based on detailed review
11 Insufficient focus on women’s reproductive health
5 Doubly published **
204 full-text articles included in the content analysis

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Of every selected article, the following information was recorded. The newspaper from which the
article was taken; the date of publication; the sub-topic of reproductive health that it addressed; and
where possible, the name and gender of the author. The latter variable, gender of the author of the
article, allowed for additional exploratory quantitative analyses.
3.2.3 Data analysis
Paper articles were digitalised using a digital camera (Canon EOS 550D) to photograph them, and
subsequently using Microsoft OneNote (2013 edition) ‘copy text from picture’ function, which allows
conversion from image to text. The text was entered into a Word document and checked for accuracy,
and subsequently exported as PDF file, saved according to the article number (1 to 204). These PDF
files were then entered into MAXQDA, a programme for qualitative data analysis (12th
edition). The
articles were then randomised using an online list randomiser (http://www.random.org/lists). This was
done to control for order-effect bias in coding the articles, as they were initially ordered first by
publication date and secondly by reproductive health sub-topic. In MAXQDA, the selected articles
were read and reread, and coded in random order according to the a priori defined codes that can be
found in the codebook. After frame elements were identified, a secondary thematic analysis was done
by means of which concepts could be yielded and subsequently grouped and categorised (Ayres,
2008; Bryman, 2012). This was done so as to reduce the data to disaggregate core themes in the
seven categories of frame elements. This then led to descriptive summaries of how different
reproductive health topics are framed. It is important to note that the secondary, thematic analysis
was carried out for the first four frame elements (Entman’s problem definition, causal attribution,
moral evaluation, and treatment recommendation) separately according to defined reproductive
health topics. Because the way in which, for example, abortion is understood may significantly differ
from the way in which pregnancy and childbirth is understood, it was chosen to analyse these
elements per topic. The remaining three elements (descriptions of women and men, and sources)
were analysed spanning all topics, as the aim was to identify in which way women and men were
described in reproductive health news stories overall, and what sources journalists use. Whereas
these may also differ per topic, it was felt that such in-depth analysis exceeded the available resources
(e.g. time) for this study. Moreover, possible differences in the way women are described along the
lines of different reproductive health sub-topics, also surfaces in the analysis of the causal attribution
element of Entman’s media frames.
3.3 Semi-structured interviews
In order to answer research sub-question 2 (What factors influence Ugandan journalists’ framing of
women’s reproductive health?), semi-structured interviews were carried out. Interviewing is a widely-
used tool to discover people’s perspectives and opinions – it allows them to express their thoughts
and ideas in their own way (Bryman, 2012). Semi-structured interviews in particular offer “participants
the chance to explore issues they feel are important [emphasis added]” because they “unfold in a
conversational manner” (Longhurst, 2010, p. 103). Although semi-structured interviews include a “list
of questions or fairly specific topics to be covered … the interviewee has a great deal of leeway in how
to reply”, which gives the interview process a certain flexibility, allowing the interviewee to bring up
issues not directly asked, and the researcher to ask follow-up questions about anything that comes up
in the interview (Bryman, 2012, 471). In particular, semi-structured interviews create “the possibility
for formulating new or additional questions during the interview … depending on the response, facial
expression or other body language” of the interviewee (Verschuren & Doorewaard, 2010, p. 221).
Moreover, this type of interviewing is considered a monolith method in feminist research (Bryman,
2012), a tradition that “focuses on social justice issues in regard to gendered power relations” (Hardin
& Whiteside, 2010, p. 316). These and other social determinants of women’s reproductive health

24 | P a g e
(Corrêa et al., 2008) are paramount to the concept of reproductive justice (Jaworski, 2009). For this
study, semi-structured interviews were assumed to be a proper method to discover how Ugandan
(health) journalists build (reproductive) health frames. The interviews lasted approximately 60 to 90
minutes, and took place at a location of the interviewee’s preference, such as a café or the HEJNU
office. Interviewees were not rewarded for their participation in the interviews, but travel expenses
were covered by the primary researcher. The interview guide can be found in Annex III.
3.3.1 Participant recruitment
Interview participants were recruited through a combination of convenience and snowball sampling
techniques. Initially, the journalists who authored several of the selected articles were contacted,
seeing that in many cases, their contact details (i.e. e-mail addresses) were provided in the articles. In
addition, potential participants were recommended by HEJNU, from the personal and professional
networks of the study team members. These were all journalists who were a member of the HEJNU
network, or otherwise engaged in health reporting. These potential participants were contacted either
through e-mail or via telephone. Also, contacts were made at several events (e.g. health conferences,
press conferences), after which they were contacted to request their participation in the study. After
the Interview, participants were asked to recommend other possible participants and where possible,
to provide their contact details. These methods combined effectively resulted in a convenience/
snowball sample of journalists. This approach was deemed the most practical in the face of this study’s
limited time and resources. It was ensured that the sample included a relatively equal amount of male
and female journalists, and that it included journalists from both print and broadcast (TV and radio)
media.
3.3.2 Data analysis
The interviews were audio recorded (this procedure as well as informed consent are discussed further
on the section on ethical considerations), after which they were transcribed verbatim. The
transcriptions were entered into MAXQDA (as explained before, qualitative data analysis software)
and thematically analysed to disaggregate core themes, subsequently categorised according to the
five levels on which factors influence frame-building: personal; professional; source-related; and
external. The themes identified were then used to offer a descriptive analysis of how Ugandan (health)
journalists build reproductive health frames.
3.4 Colloquium (dissemination seminar)
To help answer research sub-question 2 (What factors influence Ugandan journalists’ framing of
women’s reproductive health?), a colloquium was organised in the form of a research dissemination
seminar. A colloquium (also known as symposium or workshop) is a powerful strategy to generate
information, characterised by active participation (McAlpine, Weston, & Beauchamp, 2002). The direct
objective of this activity was to obtain collective feedback on the study’s preliminary results as well as
the appropriateness of preliminary interpretations. At the same time, this activity included some
workshop elements in order to provide a direct benefit to study participants as a compensation for
participation. The dissemination seminar was held on July 22, 2015, from 14:00 to 17:00 at the HEJNU
office’s compound in Kampala-suburb Ntinda. The programme included a presentation on women’s
health issues in Uganda by a female expert affiliated with a local hospital and university; a
presentation on the preliminary results of the study by the primary researcher; and an exercise where
journalists were invited to critically analyse newspaper articles. For this exercise, three articles about
family planning that were considered representative of a certain frame, were taken from the
selection. Journalists read these in pairs of three to four persons, after which there was a group

25 | P a g e
discussion. The seminar was open to the public and free of costs. Travel expenses were not
reimbursed.
3.4.1 Participant recruitment
At the end of each interview, participants were informed about the upcoming seminar and promised
they would be sent the invitation as soon as it was available. This invitation (Annex IV) was sent out to
all interview participants about a week and a half before the seminar took place. A reminder was sent
two days before the seminar, and again the day before the seminar. In addition, the flyer was
published on HEJNU’s website, and the invitation was e-mailed to HEJNU members through the
organisation’s mailing list.
3.4.2 Data analysis
During the colloquium, notes were taken of themes and topics that came up during any of the
question and answer sessions or group discussions. These noted informed the reiterative process of
data analysis. Names, affiliations, and contact details of participants were collected in order to report
on their demographics, as well as to contact them at a later stage to provide them with a colloquium
report and a full research report of the study they participated in.
3.5 Ethical considerations
Ethical clearance was applied for and granted by the Uganda National Council for Science and
Technology (UNCST) in the first month of the data collection period (May-July 2015). A separate
application for ethical clearance from the Vrije Universiteit Amsterdam was not necessary, as approval
was granted when the research proposal was approved by the Athena Institute.
This study did not include vulnerable populations. All participants were above the age of 18 years,
which is Uganda’s legal age of consent. All were assumed to have the capacity to give their informed
consent. Moreover, the interview respondents and colloquium participants were asked exclusively
about the performance of their duties in their professional capacity. Informed consent was only
acquired from the interview participants, as the dissemination seminar only served to validate
preliminary conclusions, and did not actively generate data from individual participants. Interview
participants were given two forms. First, they were given the information sheet (Annex V) alongside a
verbal explanation of the purpose of the study. The information sheet contained the contact details of
the primary researcher (i.e. interviewer) as well as those of study team members from HEJNU and the
Vrije Universiteit Amsterdam. Also, it included the contact details of the UNCST, in case the participant
would feel the need to contact someone independent of the study. The information sheet emphasised
voluntary participation, and interview respondents were told that they were allowed to withdraw their
consent at any stage during the interview without being asked any questions on why they no longer
want to participate. They were then given the opportunity to ask questions, in addition to being asked
for permission to audio record the interview for transcription purposes. Subsequently, they received
the informed consent form (Annex VI). Signing the consent form stated that the respondent has read
and understood the information provided by the researcher and included in the information sheet,
and consents to participation in the study. In addition, the interview consent form specifically included
the option to agree to audio-recording of the interview for transcription purposes. This form was
signed by both the participant and the primary researcher (i.e. the interviewer) – after which the
participant received a copy. All but one interviewee participants signed and received (a copy of) the
consent form. One interviewee gave verbal consent to participation in the study, which was audio
recorded.

26 | P a g e
Names of authors of articles that were included in the analysis, do not appear in the report. Names of
people mentioned in these articles have been kept in quoted text, because they were considered to
be already publicly available (e.g. published in a widely accessed newspaper). Anonymity of the
respondents was guaranteed by providing them with an anonymous respondent number (interview
ID). The interviews were coded with this respondent ID and stored accordingly. In no case has data
been stored according to a respondent’s name, and in no case has a name been linked to personal
characteristics or has it appeared as such in this report. Any results reported publicly (e.g. peer-
reviewed article) have not and will not be linked to identifying information of the respondents.
Electronic data (including audio recordings) have been stored securely on a personal password-
protected computer and backed up onto a secure online drive. Hard copy data has been securely
stored at the private address of the primary researcher. Only study team members from either HEJNU
or the Vrije Universiteit Amsterdam have access to raw data material. In no case will information be
withheld from participants. A summary of colloquium proceedings has been e-mailed to all
participants of the dissemination seminar. After the write-up phase was completed, a summary of the
research report was e-mailed to all interview and seminar participants.

27 | P a g e
CHAPTER 4
MEDIA FRAMES RESULTS
To answer the first research question ‘How is women’s reproductive health framed in Ugandan
media?’ a qualitative content analysis (framing analysis) was carried out on selected newspaper
articles. The following sections discuss the results of this analysis. First, descriptive statistics with
regards to the sample of newspaper articles is presented This is followed by the analyses of media
frames per reproductive health topic. Third, the ways in which women and men were framed in
relation to their or their partners’ reproductive health is analysed. Lastly, this chapter examines what
type of sources have been used in stories on women’s reproductive health.
4.1.Article attributes
In this section, attributes of the selected articles will be discussed. First, quantitative data with regards
to the origins of selected newspaper articles is addressed. Second, quantitative data with regards to
the gender of the authors of selected articles is examined where possible. Third, quantitative data
with regards to the reproductive health topics in selected articles is examined.
Table 4A. Overview of articles collected according to their origin
Newspaper Number of
editions
Number of
articles
Number of articles as
percentage (%) of total
Average number of
articles per edition
New Vision (NV) Total
 New Vision
 Saturday Vision
 Sunday Vision
31
21
5
5
83
63
13
7
39.7%
30.1% (75.9% of NV total)
6.2% (15.7% of NV total)
3.3% (8.4% of NV total)
2.7
3.0
2.6
1.4
Daily Monitor (DM) Total
 Daily Monitor
 Saturday Monitor
 Sunday Monitor
31
21
5
5
68
51
12
5
32.5%
24.4% (75% of DM total)
5.7% (17.6% of DM total)
2.4% (7.4% of DM total)
2.2
2.4
2.4
1
Red Pepper (RP) total
 Red Pepper
 Saturday Pepper
 Sunday Pepper
31
21
5
5
39
31
6
2
18.7%
14.8% (79.5% of RP total)
2.9% (15.4% of RP total)
1.0% (5.1% of RP total)
1.3
1.5
1.2
0.4
The Observer 13 14 6.7% 1.1
Unknown origin - 5 2.4% -
Total 106 209 100% 2
As can be seen in Table 4A above, a total of 209 articles on women’s reproductive health issues were
collected from four Ugandan newspapers. Most of these articles (83 articles; 39.7%) came from the
New Vision, including its Saturday and Sunday editions. As a runner up, 68 articles (32.5%) originated
from the Daily Monitor and its weekend editions. Thirty-nine articles (18.7%) came from the Red
Pepper or its weekend editions, and 14 articles (6.7%) were published in The Observer. Five articles
(2.4%) are from an unknown origin due to an administration error2
. Because The Observer is a tri-
weekly paper, only 13 editions in total were published in the month of May, whereas the New Vision,
Daily Monitor, and Red Pepper published 31 editions in May (21 daily editions, five Saturday, and five
Sunday editions). In total, 106 newspapers were purchased in May, generating a total of 209 articles,
2
Articles were cut out and relevant information was recorded. These five articles were included, and then
excluded, after which the information was deleted. After secondary consideration, the articles were again
included, but information on their origin was unfortunately impossible to retrieve.

28 | P a g e
which amounts to a total of two (1.97) articles on women’s reproductive health per newspaper
(regardless of the edition).
Table 4B. Overview of authors’ gender according to newspaper origin
Newspaper Number of
articles
Gender NS* Male writer(s) Female
writer(s)
Mixed
genders
New Vision (NV) Total
 New Vision
 Saturday Vision
 Sunday Vision
83
63
13
7
16 (19.3%)
13 (20.6%)
3 (23.1%)
0
34 (41%)
27 (42.9%)
6 (46.2%)
2 (28.6%)
28 (33.7%)
19 (30.2%)
4 (30.8%)
5 (71.4%)
5 (6%)
5 (7.9%)
0
0
Daily Monitor (DM) Total
 Daily Monitor
 Saturday Monitor
 Sunday Monitor
68
51
12
5
11 (16.2%)
11 (21.6%)
0
0
37 (54.4%)
26 (51%)
6 (50%)
5 (100%)
17 (25%)
11 (21.6%)
6 (50%)
0
3 (4.4%)
3 (5.9%)
0
0
Red Pepper (RP) total
 Red Pepper
 Saturday Pepper
 Sunday Pepper
39
31
6
2
10 (25.6%)
9 (29%)
1 (16.7%)
0
15 (38.5%)
12 (38.7%)
2 (33.3%)
1 (50%)
13 (33.3%)
9 (29%)
3 (50%)
1 (50%)
1 (2.7%)
1 (3.2%)
0
0
The Observer 14 5 (35.7%) 2 (14.3%) 6 (42.9%) 1 (7.1%)
Unknown origin 5 0 5 (100%) 0 0
Total 209 42 (20.1%) 93 (44.5%) 64 (30.6%) 10 (4.8%)
* Not specified.
As can be found in Table 4B above, for 42 articles (20.1%), the gender of the writer was not or could
not be specified. In 74 articles (35.4%) there was at least one female writer. One hundred and three
(49.3%) articles had at least one male writer. Ninety-three (44.5%) were written exclusively by one or
more male writers, whereas only 64 (30.6%) articles were written exclusively by one or more female
writers. Ten articles (4.9%) were written by multiple writers of different genders (mixed). Results
indicated that most articles on women’s reproductive health topics are written by men.
The reproductive health topics covered in the selected articles were established according to the
coding scheme (Annex II). As discussed in the methodology chapter, the total number of articles
included in the qualitative content analysis is 204. It is important to note that some articles addressed
multiple topics.
Chart 4A. Reproductive health topics addressed in selected articles.
Topics
Abortion Family Planning Menstruation
Health Conditions Sexual Violence Maternal Health

29 | P a g e
Maternal Health
Miscarriage (In)fertility
Pregnancy Childbirth
General/Other Maternal Healthcare
Health Conditions
RTIs, STIs, HIV/AIDS Cervical Cancer, HPV
Obstetric Fistula General/Other
Chart 4B. Topics included under maternal health. Chart 4C. Topics included under health conditions.
The above Charts 4A, 4B, and 4C show that more than half of all articles addressed maternal health
(114 articles; 55.9%). Within this topic (see Table 4B), the sub-topics miscarriage (two articles; 1%) and
(in)fertility (two articles; 1%) were discussed the least. Pregnancy (18 articles; 8.8%) and childbirth (16
articles; 7.8%) were addressed more often. These were followed by the sub-topic maternal mortality
(13 articles; 6.4%). Most articles within the topic of maternal health however, were about maternal
healthcare services (60 articles; 29.4%). This sub-topic included three main themes: midwifery (31
articles; 15.2%); (maternal) healthcare services (24 articles; 11.8%); and traditional birth attendants
(TBAs; five articles; 2.5%). In addition, a sub-topic general maternal health/other was added to include
three articles (1.5%) that could not be assigned under another sub-topic.
Sexual violence was addressed considerably often (52 articles; 25.5%) and included topics such as
(gang) rape cases, including one high profile case that accounted for 15 articles, or 7.4% of the total
number of articles and 28.8% of all articles on sexual violence (will be discussed later); and female
genital mutilation (FGM). Health conditions (see Table 4C) were also addressed relatively frequently
(35 articles; 17.2%) and included sub-topics such as sexually transmitted infections (STIs), reproductive
tract infections (RTIs), HIV/AIDS (15 articles; 7.4%); cervical cancer and HPV (eight articles, 3.9%);
obstetric fistula (seven articles, 3.4%); and general reproductive health/other (five articles; 2.5%).
Family planning (10 articles; 4.9%) and Menstruation (10 articles; 4.9%) were not frequently discussed,
and the topic least addressed was Abortion (four articles; 2%).
4.2 Media Frames
In the following sections, the way in which the six main topics (i.e. abortion; family planning;
menstruation; health conditions; sexual violence; and maternal health) were framed, are discussed
according to the first four framing elements: problem definition; causal attribution; moral evaluation;
and treatment recommendations. Table 4C presents an overview of the way in which reproductive
health topics were framed according to the frame elements identified in the selected articles.

30 | P a g e
Table 4C. An overview of media frames.
Sub-topic Problem
definition
Causal
attribution
Moral
evaluation
Treatment
recommendations
Abortion Dangerous
procedure with
adverse
consequences
Misconceptions
cause for
unsafe
abortions
Equated with
murder of
innocent life
Do not abort,
rather prevent
pregnancy
Family
planning
Lack of uptake,
and possible
adverse
consequences
Male resistance
to family
planning
Urgency
through
statistics, FP
itself a solution
Visit doctor in
case of symptoms
Menstruation Menstrual
Hygiene Day,
girls’ school drop-
out
Menstruation
taboo
Inadequate
menstrual
hygiene barrier
to health rights
NGO projects
Health
conditions
Having RTIs, STIs,
or HIV/AIDS,
cervical cancer
rising, Obstetric
Fistula Day
Women’s own
behaviour,
medical causes
only for fistula
None Medical
treatment,
behaviour
change, NGO
projects
Sexual
violence
FGM/C, specific
rape cases, &
high profile case
Peter Wemali
Norms & values
(only FGM/C),
perpetrators
Some strong
condemnations
Punishment of
perpetrators
Maternal
health
International Day
of the Midwife,
pregnancy and
childbirth as
dangerous, status
of motherhood
and maternal
mortality figures
Men for
pregnancy,
inadequate
healthcare
system, and
women’s own
behaviour
None Men’s
involvement,
midwives
recruitment and
retention, NGO &
gov’t projects
4.2.1 Abortion frames
Abortion was understood as a generally dangerous procedure, and selected articles focused on the
possible adverse consequences. They covered issues such as uncontrollable bleeding, using
descriptions like ‘immense pain’ and ‘suffering’, or featuring detailed accounts of wounds acquired
through an unauthorised abortion. Other articles covered abortion-related death cases. The extent of
abortion as a public health issue was also covered, emphasising that Uganda’s high need for post-
abortion care signifies a serious problem. With respect to the main actors, articles about abortion
were mainly about the women who had an abortion, or those who were considering to have one.
Abortion (attempts) was attributed to misconceptions among women, or men denying responsibility
for a pregnancy. The particular cultural belief that children are a gift for one’s partner makes
pregnancy undesirable in case men turn down this ‘gift’. In one case, abortion (and subsequent death)
was attributed to the former student’s fear of being discovered and expelled by her school’s board,
which had a policy of expelling unmarried pregnant students.
Strong moral evaluations were evident in articles on abortion. The foetus or baby was enshrined as a
representation for the innocent life, and abortion equated to murder, and the woman having the
abortion equalled to murderer. This was justified through legal and religious arguments, signalling

31 | P a g e
abortion is against Ugandan Law (with some exceptions), against Christian beliefs (the Bible), and
against the general Ugandan public’s opinion. The excerpt below is an illustration of this:
“Do not abort (murder), unless you want to live with that guilt for the rest of your life” (Article
002, ‘I want to abort his baby’, Daily Monitor, 7 May 2015).
Treatment recommendations focused on pregnancy prevention. These included abstinence,
education, and use of family planning. In case of pregnancy, one is urged to consider the
consequences:
“You should have in mind the consequences of the decision you want to make. Are you ready to
face the repercussions that come with abortion? Remember you are risking your life because
unsafe abortion kills. Sometimes, women get post-abortion depression, where they feel haunted
and guilty yet this may not go away for the rest of your life. You will never forgive yourself for
ending such an innocent life. Also consider the resources you have before you go for the
abortion. If they are not enough, you risk barrenness if you go for substandard services where
your uterus may get [ruptured] and you will never bear any children for the rest of your life”
(Article 002, ‘I want to abort his baby’, Daily Monitor, 7 May 2015).
In summary, abortion is framed as a dangerous procedure that likely results in death or debilitating
health conditions. Abortion is equated with murder of an innocent child – which is against Ugandan
law and Christian religion. Preventing pregnancy seems to be seen as the most viable solution.
4.2.2 Family planning frames
Family planning was understood in terms of its lacking uptake, and the possible adverse consequences
of certain methods. The lack of family planning uptake and high unmet need was explained in terms of
the search for male children as heir; (violent) male resistance to family planning; and the lack of funds.
Possible adverse consequences of certain contraceptive methods focused on the experience of
symptoms such as pain, constant bleeding, or wounds on genitals around the time of menstruation.
One article for example, emphasised possible severe negative health outcomes of intra-uterine
devices (IUDs), including perforation during insertion. Family planning articles had various main actors,
such as NGOs, or women and girls.
Low family planning uptake was seen as being caused by cultural factors, such as men’s negative
perceptions of family planning in relation to their wish to have a high number of children, and the
cultural perception of women without boy children as ‘useless’. Family planning methods were
understood as the possible causes of adverse health outcomes. This was explained as a mismatch
between the contraceptive method and the individual women’s body.
Moral evaluations about family planning were less pronounced than for the issue of abortion,
journalists primarily used numbers to put weight to their arguments. For example, maternal mortality
statistics were used to promote the use of family planning:
“Every year, about 6,000 Ugandan women die from pregnancy-related causes, which could be
reduced up to 70% (4,200) with increased family planning uptake” (Article 011, ‘Search for heirs
a challenge to family planning’, New Vision, 12 May 2015).
Treatment recommendations for the low uptake of family planning focused primarily on human rights
awareness raising, and education of men on family planning benefits. With regards to family planning-
related health problems, solutions included seeking medical treatment, and caring for oneself
properly. In addition, family planning itself was described as a treatment recommendation: as a

32 | P a g e
strategy against maternal mortality; as an investment with great economic return; and as a way to
‘propel Uganda into a window of opportunity’.
In summary, family planning is understood in terms of Uganda’s unmet contraceptive need on the one
hand, and as procedures with possible adverse health consequences on the other. Low uptake is
instigated by male resistance and exclusive male inheritance rights. Statistics were used to emphasise
the importance of family planning. Treatment recommendations were either human rights-based or
medical in nature.
4.2.3 Menstruation frames
Menstruation was primarily understood as the cause for girls’ dropout in school and related,
Menstrual Hygiene Day on May 28 – including the NGO and government projects as well as
celebratory activities surrounding this international day. Other articles focused on physical and
emotional health during menstruation – some ridiculing hormone-induced emotional behaviour. Main
actors in these stories were either women themselves, or government/NGO/or private sector actors
that were working on menstrual hygiene projects.
Menstruation, as a source of girls’ low self-esteem, was seen as the cause of school drop-out, primarily
because of cultural taboos surrounding menstruation. Menstrual hygiene management was seen as
crucial for women and girls’ dignity, their rights to health and education, and the ‘fulfilment of their
dreams’. This is illustrated in the following excerpt:
“...poor menstrual hygiene management (MHM) practices, which endanger the lives of girls and
women and have serious effects on their ability to contribute to the flourishing of Uganda”
(Article 022, ‘Menstrual hygiene management: restoring girls’ rights to health and education’,
Daily Monitor, 28 May 2015).
Causes of menstruation-related health problems were described from a medical perspective, and
included hormones, the particular contraceptive method used, cervical cancer and other health
conditions, including jargon such as “trichomonal or monilial infection”. Moral evaluations were
limited to menstrual hygiene being a human rights issue.
Whereas treatment recommendations included focused on national budgets, awareness-raising and
project implementation, women and girls themselves however, remained passive recipients of
organisations’ efforts around them. The following excerpt illustrates this:
“While a lot has been done to address the gaps in menstrual hygiene management, girls are still
grappling with challenges surrounding this subject. Hence there is still much work to be done. It
is the responsibility of all stakeholders to prioritise MHM in programming and respective
government sectors. Menstrual Hygiene Management should be included in school health
curricula and also ensure that school WASH facilities cater for the needs of girls. Sanitation
campaigns at the national, community and school levels should incorporate menstrual hygiene
management to address issues faced by girls regarding this issue. This will ultimately contribute
to girls’ realisation of their rights to education and health” (Article 022, ‘Menstrual hygiene
management: restoring girls’ rights to health and education’, Daily Monitor, 28 May, 2015).
Treatment recommendations for menstruation-related health problems included seeking advice from
a medical professional, and to maintain a healthy diet and lifestyle.
In summary, the international Menstrual Hygiene Day on 28 May featured prominently in articles on
menstruation. The focus was therefore on menstrual hygiene facilities at schools to combat girls’

33 | P a g e
dropout rates, which were attributed to cultural taboos around menstruation. Solutions were
described within a framework of an existing NGO, government, or private sector project.
4.2.4 Health conditions frames
The topic ‘health conditions’ consisted of 35 articles divided among four sub-topics: STIs, RTIs, and
HIV/AIDS (15 articles, 42.9%); cervical cancer and HPV (eight articles, 22.9%); obstetric fistula (seven
articles, 20%); and general reproductive health (i.e. ‘other’; five articles, 14.3%).
Articles about STIs, RTIs, and HIV/AIDS focused primarily on HIV/AIDS. It was understood as a medical
issue, and articles focused on ways of transmission (unprotected sex; extramarital sex; sexual relations
between a younger girl and an older man; sex workers; and mother-to-child-transmission (MTCT)),
and proper use of ARVs. Some other articles addressed other STDs, such as Herpes, Gonorrhoea,
Chlamydia, and Syphilis. These were likewise medical in nature and focused on treatment. Cervical
cancer was viewed in the light of ‘a leading cause of death among women’. These stories focused on
statistics, stories of overwhelmed hospitals, and Ugandan celebrities who passed away as a result of
cervical cancer. Other stories focused on cervical cancer detection and the national Human Papilloma
Virus (HPV) vaccination programme. Articles about obstetric fistula frequently featured the
International Day to End Obstetric Fistula on 23 May, with its theme: ‘End fistula, restore women’s
dignity’. The topic was understood as a health conditions from which many women in Uganda
continue to suffer. Articles reproductive health in general discussed reproductive disease symptoms,
such as vaginal dryness. The main actors in these stories were either women themselves, or NGO or
government actors.
Causes of RTIs, STIs, and HIV/AIDS were predominantly behavioural in nature. They included having
unprotected sex, having multiple sexual partners, teenage relationships, and alcohol (abuse). HIV in
particular was traced back to girls’ (older) dating partners, and sex workers. Other explanations for
RTIs and STIs were more biological in nature, such as skin-to-skin contact, or considered psychological
and emotional factors, such as home/relationship stress. This mixture of factors and emphasis on
behavioural causes is illustrated in the following excerpt:
“According to Dr. Lubega Chris a general medical practitioner with Seeta Medical Centre,
HIV/AIDS is the most common STD. Passed through body fluids such as blood, semen, vaginal
fluids, and breast milk, it has been ranked number one. However the doctor said the act of
indulging in sexual intercourse with infected persons without protection is the major cause for
the increase in new cases of this disease” (Article 131, ‘Doctors rate most common STDs’, Red
Pepper, 14 May 2015).
Although some biological factors were mentioned as causes for cervical cancer, causal attributions
were predominantly behavioural in nature. They included such as women’s ignorance on the need to
have regular check-ups, and early exposure to sexual intercourse or having multiple sexual partners:
“Ms Jenny Rose Akello, the assistant health officer for Gulu district, said the fight against cervical
cancer is still a challenge due to ignorance of women. ‘Majority of women in the district do not
understand what cervical cancer is and are caught unawares when the symptoms begin showing
up in later stages’ said Ms Akello. Dr Hope Kusasira of Gulu Regional Referral Hospital said
cancer among young girls is brought by early exposure to sexual intercourse. ‘Prevalence of
cervical cancer in Gulu is high because most girls start having sex at an early age and through
sex, it is easier for one to catch the infection,’ he said” (Article 126, ‘9,000 cases of cervical
cancer listed yearly – expert’, Daily Monitor, 5 May 2015).

34 | P a g e
In contrast, causes attribution for obstetric fistula were primarily biomedical. Difficult, prolonged,
and/or obstructed labour was considered the direct cause of obstetric fistula, exacerbated by factors
such as age. Some factors at the community levels are mentioned as risk factors, as is illustrated by
the following excerpt:
“In Uganda, however, despite the availability of OF [obstetric fistula] repair facilities for almost a
decade, the problem persists. This is associated with general under-development of community
health services structures and widespread poverty, lack of education and culture traditions that
are entrenched in the lives of majority of Ugandans. In rural areas, the prevalence rate is higher
due to inadequate facilities for pre and post-natal care. In addition, long distances, high cost of
care, ignorance and poor nutrition make women more vulnerable to OF. Although it is certain
that victims of this preventable condition can be found across the length and breadth of the
country, there appears to be a concentration of victims in rural hard to reach areas” (Article 062,
‘Intensify sensitisation of rural women on obstetric fistula’, Saturday Monitor, 23 May 2015).
In general, all types of health conditions were generally not evaluated against a moral background, but
were presented in a rather neutral manner.
For RTIs, STIs, and HIV/AIDS, treatment recommendations included ‘getting’ medical treatment, and
behaviour strategies for prevention, such as the ABC strategy (Abstain, Be faithful, use a Condom).
With regards to MTCT, treatment recommendations focused on NGO programmes. For cervical
cancer, treatment recommendations similarly involved medical interventions (prevention or
treatment), or behaviour change, such as self-examination and being faithful. For obstetric fistula,
solutions focused on NGO or government programmes, as well as family planning, and family support.
Interestingly, one article provided a list of hospitals offering fistula treatment.
In summary, ‘health conditions’ included STI, STIs, and HIV/AIDS, cervical cancer, and obstetric fistula.
Whereas RTIs, STIs, and HIV/AIDS and HPV/cervical cancer were attributed to behaviour, obstetric
fistula was explained in medical terms. Treatment recommendations for health conditions included
predominantly medical treatment (‘go to a doctor, and get treatment’) or behavioural change (‘use
condoms, or abstain’). Only for obstetric fistula there were detailed what the government or NGOs
could do to address this public health issue.
4.2.5 Sexual violence frames
Fifty-two articles addressed sexual violence – about one quarter of all articles. Sexual violence was
understood according to three sub-topics: cultural practices (primarily female genital
mutilation/cutting FGM/C); specific cases of sexual violence – many in which an arrest of (a)
perpetrator(s) was made; and the high profile defilement case of Uganda Athletics Federation (UAF)
Police Coach Peter Wemali. This latter case accounted for 15 articles in total (28.8% of all articles
about sexual violence; 7.4% of total number of articles).
Articles on cultural practices mainly discussed FGM/C as an amoral, degrading practice that is in
conflict with both culture and religion. Some articles also discussed early marriage as a harmful
traditional practice. Articles that addressed specific cases of sexual violence were mainly about who
the victim was, who the perpetrator(s) was/were, what happened, and whether the police made any
arrest(s). In many cases, personal information (name, age, occupation) was released of both the victim
and perpetrator(s). The high profile defilement case of UAF Police Coach Peter Wemali primarily
considered case proceedings and details from the ongoing investigations. The case, brought to light by
male athlete Moses Kipsiro, concerned the multiple rapes of underage female athletes and
subsequent infection with HIV. The main actors in these articles were the sexual violence perpetrators.

35 | P a g e
The occurrence of FGM/C was attributed to cultural beliefs, and norms and values that promote
gender-based violence. Sexual violence cases on the other hand were primarily blamed on the
perpetrator(s). Only in some cases were other factors mentioned as contributors, such as drugs,
poverty, and unsafe areas lacking street lighting. Interestingly, in most cases of child sexual abuse, it
was the father of the victim who was described as the one to come forward to report the crime. The
abuse in the Wemali case was attributed to Peter Wemali himself, and to Moses Kipsiro for blowing
the whistle.
Moral evaluations of FGM/C took the form of emphasising the harmful consequences:
“Females who have under gone FGM feel extreme pain while giving birth, and because of this,
most females are shunning marriage and pregnancy, thus affecting the marriage institution in
the Sebei region. Sex as ordained by God within a marriage is also being shunned because of the
pain that is felt by those who have undergone FGM. It’s one of the worst forms of gender
inequality; it affects child birth, contributing to the high maternal deaths” (Article 169, ‘His
Grace the Archbishop’s message on the eradication of female genital mutilation’, Sunday Vision,
17 May 2015).
The sexual violence cases (excluding the high profile case of Peter Wemali) did not have many clear
moral evaluations. Some stories did spark outrage and caused readers to send letters expressing their
frustration, but in general the moral evaluations were fairly modest:
“Ndiita further added that Pastor Ben didn’t stop at raping the minor but unfortunately infected
her with HIV/AIDS” (Article 192, ‘Pastor defiles, infects minor’, Red Pepper, 29 May 2015).
Peter Wemali’s case however, was clearly evaluated against a moral background. These criticisms
were targeted mainly against the UAF, as the following two excerpts illustrate:
“’Our children are being raped, they are being beaten and no one from UAF is helping. We are
here crying but the UAF leaders are in Kampala celebrating’” (Article 157, ‘Athletics bosses must
resign – Kapchorwa boss’, Daily Monitor, 26 May 2015).
“’They are beating, raping and defiling our children and nobody in the federation seems
bothered. Why should our children care for Uganda if the federation doesn’t? Our children will
only run to earn income but not to represent Uganda in international races,’” (Article 160,
‘Boycott looming’, New Vision, 26 May 2015).
(Explicit) criticisms were not only targeted against the UAF, but also against Peter Wemali himself:
“According to Cheptoris Sam Mangusho the LCV chairman of Kapchorwa, Wemali has a
poisonous penis and that he cannot spare any female specie on earth. ‘I pray day and night that
Wemali is hanged by the rope, let him face death or life imprisonment because he has bonked
over 60 women, 30 are juveniles while the rest are married women, students and for that matter
we want him hanged” (Article 170, ‘How coach infected 60 athletes with HIV’, Red Pepper, 4
May 2015).
Treatment recommendations for FGM/C and other harmful traditional practices focused on legal
action by the governmental, as well as including men and boys in advocacy efforts. For sexual
violence cases, the primary solution was bringing the perpetrator to justice:
“However police have vowed to carry on with their work without fear or favour. ‘It’s true we
have some pressure, but by virtue of the tasks assigned to us by the state, we have to act
professionally, otherwise where are we taking this nation if we behave as savages,’ the DPC

36 | P a g e
[District Police Commander] hit back” (Article 182, ‘Mayuge “medical doctor” in coolers’, Red
Pepper, 28 May 2015).
In the Wemali’s case, case-specific recommendations were made, including the resignation of the
UAF presidency, HIV testing for all athletes, and Peter Wemali’s imprisonment.
To summarise, the central issues in articles on sexual violence included harmful traditional
practices such as FGM/C; specific cases of sexual violence ((gang) rape, murder) and arrests made
of perpetrators of sexual violence acts; and finally, the specific high profile case of UAF’s Peter
Wemali. Sexual violence cases in particular were understood from a traditional criminal justice
perspective. Whereas the continuation of FGM/C was attributed to cultural norms and values, in
cases of rape, the perpetrator(s) was held accountable. Moral evaluations were particularly strong
in the Wemali case. Treatment recommendations focused primarily on punishment of sexual
violence perpetrators.
4.2.6 Maternal health frames
Finally, the maternal health topic accounted for more than half of all articles: 114 articles (55.9%). This
included the sub-topics: pregnancy (18 articles, 15.8%); childbirth (16 articles, 14%); miscarriage (2
articles, 1.8%); general maternal health/other (3 articles, 2.6%); maternal mortality (13 articles,
11.4%); (in)fertility (2 articles, 1.8%); and maternal healthcare services (60 articles, 52.6%). Three
topics made up the maternal healthcare services category: traditional birth attendants (TBAs; 5
articles); reproductive healthcare (24 articles); and midwifery (31 articles). Some stories had multiple
topics.
Pregnancy was repeatedly described as a vulnerable condition, as illustrated by the following excerpt:
“’Although a mother may not have any complications, pregnancy is a delicate condition and a
mother needs to be supported to come out healthy, with a healthy baby,’ Andabati explains”
(Article 121, ‘Why a pregnancy woman should have at least four medical check-ups’, New
Vision, 11 May 2015).
Childbirth was similarly described as ‘dangerous’ and ‘frightening’, and there seemed to be a focus on
the need for facility delivery with skilled assistants. These stories often featured NGO or government
programmes, or national events such as the Joint Nordic National Day Celebrations (21 May 2015)
which revolved around maternal health. More entertainment-focused articles were about celebrity
couples sharing the joyous news of their new born baby.
Maternal mortality was understood primarily in terms of the high national rates (statistics) and the
challenges this posed to the country:
“She [First Lady and Minister for Karamoja Affairs Janet Museveni] said that Uganda’s greatest
challenge in the health sector is to reduce maternal and newborn deaths, which stubbornly
remain unacceptably high” (Article 046, ‘First Lady lauds Church’s contribution to health sector’,
New Vision, 4 May 2015).
Besides general discussions about Uganda’s maternal mortality, other articles narrated specific cases
in which mothers died in childbirth. In these cases, death was considered to have been preventable.
Miscarriage was understood as ‘devastating’, and ‘worrying’, and infertility as ‘a nightmare’ - which
emphasises the importance placed on motherhood.
Articles about maternal healthcare services included stories about TBAs, Uganda’s healthcare system,
and the midwifery profession. First, articles about TBAs were polarised: some portrayed them as being

37 | P a g e
responsible for maternal mortality – one article included a case in which a TBA was arrested after one
of her ‘patients’ died in labour – whereas other articles argued they fill an important gap in the
healthcare system. Second, articles about maternal healthcare considered primarily the poor
condition of the maternal healthcare system in Uganda, such as adverse working conditions,
overwhelming numbers of patients, and legal proceedings of negligence cases. A particular scandal
that received considerable attention was the case of so-called ‘mama kits’, which contain essential
material for a clean and safe delivery, which were not being ordered by health workers. This resulted
in mama kits expiring and subsequently having to be destroyed. Third, articles about the midwifery
profession predominantly revolved around the International Day of the Midwives (5 May 2015),
themed: ‘midwives for a better tomorrow’, and the Swedish embassy’s ‘#midwives4all’ campaign.
Midwives were repeatedly described using military metaphors, such as ‘critical cadres’ and ‘heroes’ at
the ‘forefront’ of maternal health. Other articles focused on Uganda’s shortage of midwives as per
WHO guidelines.
Causal attributions varied between sub-topics. Adverse health outcomes related to pregnancy or
childbirth were attributed to women’s vulnerability. In more sensational pieces on celebrity couples,
pregnancy was attributed the man’s ‘hard work’:
“Congs though for the sweat! You can teach some of us to perform our night duties well” (Article
033, ‘Baby bloom for Ugandan referees’, Red Pepper, 19 May 2015).
Causes for maternal mortality were primarily considered to be systemic in nature, i.e. inadequate
performance of the healthcare system, including professional negligence, lack of staff, and long
distances to healthcare facilities. Successes on the other hand, were mainly attributed to projects
securing certain facilities, such as ambulances. Other causes for maternal mortality were behavioural:
“Dr. Frank Mugisha Kaharuza, the executive director of the Association of the Obstetricians/
Gynaecologists of Uganda, adds that many maternal deaths are due to preventable causes such
as women not delivering at health facilities and unplanned pregnancies” (Article 077, ‘Maternal
deaths high, but preventable’, New Vision, 11 May 2015).
Poor maternal healthcare was attributed to structural issues such as staff shortages, insufficient
funding, and corruption. Successes, on the other hand, ascribed to particular governmental or NGO
projects, or foreign investments. Midwives were portrayed as heroes for several explicit reasons,
including Uganda’s shortage of midwives, the lack of public appreciation for them, and their significant
role in ensuring safe childbirth. TBAs’ contribution to maternal mortality statistics was attributed to
their assumed lack of skills and adequate equipment.
Treatment recommendations likewise varied between the different sub-topics. With regards to the
‘vulnerable’ period pregnancy and childbirth, partners’ proactive involvement was considered crucial.
One other article encouraged men to conduct tests to find out whether the child is truly theirs. Other
recommendations addressed women and considered lifestyle changes, such as maintaining a balanced
diet and working out. They were likewise advised to access pre-, peri-, and post-natal care in time. For
maternal mortality, treatment recommendations focused on government securing training and
recruitment of midwives, as well as strengthening the structures to retain them, and promoting
midwifery as a career at secondary schools. For maternal healthcare services, treatment
recommendations addressed the systemic changes necessary to make services more efficient. A
considerable part of this concerned midwives – solutions around this topic included not only
recruitment, but also ‘re-branding’ of the profession and creating incentives for health workers to
work in remote areas. TBAs on the other hand, were encouraged to give up practice and to only
recruit expecting mothers to nearby health facilities.

38 | P a g e
To summarise, pregnancy and childbirth were described as a dangerous time during which women are
particularly vulnerable. Motherhood was seen as status-enhancing, whereas miscarriage and infertility
were described as ‘a nightmare’. Maternal mortality in Uganda was illustrated predominantly
according to statistics, and blamed partly on the healthcare system. Healthcare challenges were
attributed to staff, whereas success were attributed to (foreign-funded) government and NGO
projects. Addressing the shortage of midwives was one of the most predominant treatment
recommendations, which included recruitment; re-branding the profession; and the prioritisation of
health worker retention.
4.3 Frames of men and women in relation to women’s reproductive health
Table presents 4D presents overview of the way in which women are described in relation to their
reproductive health, and how men are described in relation to their female partners’ reproductive
health. These frames are subsequently described in the sections below.
Table 4D. An overview of descriptions of women and men.
Descriptions of women Descriptions of men
Vulnerable, suffering, and dying Perpetrators of sexual violence
Passive recipient Non-supportive to partner
Responsible for adverse health outcomes Supportive to partner
‘Passive agent’ Normative descriptions of involvement
Victims of women’s behaviour
4.3.1 Frames of women in relation to their reproductive health
In the 204 articles about women’s reproductive health, women featured in 183 articles (89.7% of total
amount of articles) in relation to their own reproductive health. Four themes were identified with
regards to the role women play: women as suffering; women as the direct object (passivity); women
as responsible (for their own adverse health outcomes); and women as so-called ‘passive agents’.
Chart 4D below visually summarises the way in which women featured in articles about women’s
Chart 4D. The way in which women featured in articles on women’s reproductive health.
0
10
20
30
40
50
60
70
Vulnerable,
suffering
Passive Responsible for
adverse health
outcomes
Passive agent
Percentage

39 | P a g e
Women as vulnerable, suffering, or dying featured in at least 116 articles, which is 56.9% of the total
number of articles (n = 204), and 63.2% of the articles that featured explicit descriptions of women
with regards to their reproductive health (n = 183). These descriptions were characterised by concepts
like ‘suffering’, ‘vulnerable’, and ‘helpless’ – concerning, for example, dying in childbirth, or sexual
violence:
“In 1979, Anena’s mother suffered the cruellest form of death a mother can ever have, dying in
labour. “She died of over bleeding after delivery at Mulago National Referral Hospital,” recalls
Anena with a frown” (Article 061, ‘Inspired by tragedy to become midwife’, Sunday Monitor, 10
May 2015).
“What about the girl whose life he ruined forever? How wounded is that child’s soul? How
shattered is her body? At 10, a girl’s body is still developing and what does Ayorekire [the
perpetrator] do? He interrupts her growth by defiling her when he has a wife and three children”
(Article 198, ‘Six years for defiling a 10 year old?’ New Vision, 19 May 2015).
Women were also described as a passive, receiving entity – the direct object of government or
international efforts to improve reproductive health outcomes. This was the case in at least 48
articles, which is 23.5% of the total number of articles (n = 204), and 26.2% of the articles that
featured explicit descriptions of women with regards to their reproductive health (n = 183).
Particularly prominent was the description of (pregnant) women as having had their lives saved by
midwives – midwives being the ones to make a crucial difference in women’s lives:
“Andersson said midwives deserve respect and recognition as they play a pivotal role in maternal
and new born health, he said they make a difference between life and death for new born babies
and their mothers” (Article 071, ‘Lira midwife honoured’, New Vision, 20 May 2015).
In 24 articles – 11.8% of the total number of articles (n = 204), and 13.1% of the articles that featured
explicit descriptions of women with regards to their reproductive health (n = 183) – women were
described as being responsible for their adverse reproductive health outcomes, such as cervical
cancer:
“‘Prevalence of cervical cancer in Gulu is high because most girls start having sex at an early age
and through sex, it is easier for one to catch the infection,’ he said” (Article 126, ‘9,000 cases of
cervical cancer listed yearly – expert’, Daily Monitor, 5 May 2015).
Lastly, in 35 articles – 17.2% of the total number of articles (n = 204), and 19.1% of the articles that
featured explicit descriptions of women with regards to their reproductive health (n = 183) – women
were depicted as a so-called ‘passive agent’. In these articles, practical, concrete advice was given to
women such as what to do to keep healthy, what symptoms to look out for, or when to consult a
doctor:
“All women above 25 years who are or have ever been sexually active, need to go for regular
check-ups for cancer of the cervix. This will help to detect effective treatment” (Article 151, ‘Who
should get the HPV vaccine?’ Daily Monitor, 11 may 2015).
“The commonest emergency pill in Uganda is the Postinor-2 tablet which may be sold in different
quantities of 750 (micro grammes) or 1.5 gms and different pharmacies and drug shops sell
them between shs8,000 and Shs10,000. There is a problem however, of fake drugs and before
you buy the tablet you should check the expiry date and also find out if it has been approved by
the National Drug Authority. One 1.5g tablet should be taken as soon as possible or preferably

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