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PROMOTING HEALTHCARE REPORTING IN CENTRAL AND EASTERN EUROPE AND EURASIA

Creating an Active Partnership Between Public Health Professionals and Members of the Mass Media

Reviewing the past decade of health systems transition throughout the nations of Central and Eastern Europe and Eurasia offers an opportunity for media professionals to measure their impact on keeping the public informed about health and wellness issues. National media play a specific role in the health reform process, namely to ensure that reform objectives are relevant to public health priorities by highlighting matters of concern to their communities. By providing evidence on healthcare reform successes and failures, the media can help policymakers better comprehend the priorities of real people. The media professional's ethic is, ultimately, to report on stories that reflect the needs and interests of the public.

AIHA has selected a group of 13 mass-media professionals who cover public health issues in these regions to attend USAID's conference, "Ten Years of Health Systems Transition in Central and Eastern Europe and Eurasia," as working journalists, filing a minimum of three stories about the conferences with their respective media outlets. Additionally, at the conclusion of the event each journalist will have the opportunity to apply for an individual grant to create a feature-length documentary based on one or more of the health reform programs discussed at the conferences.

The overarching goal of this project is to offer a framework for mutual exchange and open dialogue between those who are attending or making presentations at the conferences-all potential sources of relevant, timely health information-and the journalists, as well as between members of the mass media group itself.

Participants:

Ms. Galina Alcaz, journalist
Teleradio-Moldova
Chisinau, Moldova

Ms. Ruzanna Amirdjanian, health correspondent
A1+ TV Company
Yerevan, Armenia

Ms. Jolanta Babiliute-Simaskiene, editor-in-chief
Lietuvos Sveikata
Vilnius, Latvia

Ms. Maria Cherneva, journalist
Bulgarian National TV
Sofia, Bulgaria

Ms. Tatiana Efimova, editor-in-chief
Zdorovje Magazine
Moscow, Russia

Ms. Erzsebet Fazekas, health editor
Nepszabadsag
Budapest, Hungary

Ms. Svetlana Fyodorova, producer
KHABAR Television
Almaty, Kazakhstan

Ms. Nazira Khodjieva, national communication expert
SOMONI Health Reform Project
Dushanbe, Tajikistan

Mr. Arben Leskaj, journalist
Albanian Daily News
Tirana, Albania

Ms. Natalia Matvyeyeva, journalist
Fakty
Kiev, Ukraine

Ms. Jelena Sedlak, journalist
Novi List
Rejeka, Croatia

Ms. Natalia Shulepina, correspondent
Pravda Vostoka
Tashkent, Uzbekistan

Ms. Simona Tarziu, journalist
Cotidianul
Bucharest, Romania

For more information on the "Promoting Healthcare Reporting in Central and Eastern Europe and Eurasia" project, contact Kathryn Utan at 202/789-1136 or [email protected]





Creating an Active Partnership Between Public Health Professionals and the Press

by Kathryn Utah.

from AIHA Connections Vol. 7, No. 9 - September 2002 issue. Copyright AIHA 2002

The original version is located at http://www.aiha.com/english/pubs/connect/news79.cfm#features

In a unique effort to link public health advocates and media professionals who cover health-related news, AIHA—with financial support from USAID and assistance provided by WHO/Europe—brought a group of 13 journalists from the NIS and CEE to Washington, DC, July 29-August 2 to attend two

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Kiev journalist Nataliya Matveyeyeva discusses health reform projects with AIHA partners Stepan Mayilo (Kiev/Philadelphia), top photo, and Vyacheslav Veres (L'viv/Cleveland).
(Photo: Vira Illiash)

international conferences on health reform. Their visit marked the initial phase of Promoting Healthcare Reporting in Central and Eastern Europe and Eurasia, AIHA's first formal program geared toward building a strong working relationship among public health professionals, healthcare policymakers, and journalists.

The philosophy behind the project is that to enact effective and sustainable health reform, citizens and policymakers must work together to address common concerns and allocate limited resources efficiently and appropriately. The media can be a powerful vehicle for bridging these often disparate groups by helping decision-makers understand the needs of the populations they serve while at the same time educating the public about the fiscal realities of providing comprehensive healthcare services. Additionally, the media can help increase the health literacy of a population, which can ultimately translate into both improvements in health status and reduction in health-related expenditures.

Underscoring the effectiveness of the project's collaborative, multidisciplinary approach, Jelena Sedlak, a journalist for Novi List in Rejeka, Croatia, says her participation at the conferences helped her gain a much broader view of both the positive and negative aspects of health reform in her country. Noting that the sessions she attended opened her eyes to another point of view—that of the policymakers and clinical professionals who advocate change in regional health systems—Sedlak, explains, "I felt sure that it was the people who were correct in claiming more medical care. Now I realize that, while this might seem right from a citizen's perspective, it doesn't take into consideration the funds available for health services. The cause and effect behind healthcare expenditures has become more obvious to me as a result of what I have learned and I believe it is my duty to explain to my readers the necessity of cutting costs within our health system. That's something that is very different from what I had been doing."

Opening Doors, Opening Minds
As part of its overarching goal to provide an ongoing framework for mutual exchange and open dialogue among medical professionals, policymakers, and members of the mass media, AIHA sponsored the 13 journalists at USAID's conference, "Ten Years of Health Systems Transition in Central and Eastern Europe and Eurasia," and AIHA's conference, "Celebrating 10 Years of Partnership Success." Most members of the media group were selected from the European Health Communication Network (EHCN), which was established by WHO/Europe in 1997 to provide a forum for communications professionals and public health advocates to find effective ways of collaborating to improve public access to relevant health information. Participants included print and broadcast professionals who attended both conferences as working journalists and agreed to publish a minimum of three features on the health reform projects highlighted during the event. Members of the group will also be given the opportunity to apply for a grant to research and produce a more in-depth feature or other media-related project based on one or more of the health reform programs they learned about while in Washington.

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US Media Panel participants Rita Rubin (USA Today), Joe Campbell (American University), and Brenda Wilson (National Public Radio) at Sunday's opening reception.
(Photo: Cable Risdon/Cable Risdon Photography)

Setting the stage for the week ahead, the journalists from the NIS/CEE attended an informative discussion presented by a panel of US media professionals including Jessica Berman, medical reporter, Voice of America; John Grassie, executive producer, Discovery Health Channel; Rita Rubin, health and medical writer, USA Today; Nancy Shute, senior writer, US News & World Report; and Brenda Wilson, senior correspondent and editor, National Public Radio. Moderated by Dr. Joe Campbell, assistant professor at American University's School of Communication, the panel shared their experiences with reporting on health issues in the United States. The discussion was followed by an animated question and answer session, during which the role of healthcare reporters and the differences between media in various countries were discussed.

Explaining that the conferences provided an overwhelming wealth of opportunities to broaden her knowledge of health reform projects going on in her country and throughout the region, Jolanta Babiliute, editor-in-chief of the Vilnius-based Health of Lithuania, states, "Attending the conferences gave me a more global perspective on health issues that will allow me to report on things in a more interesting and informative way. Mass media outlets bridge the gap between decision-makers and the general public. For our citizens to become more knowledgeable about health concerns, journalists who write about such issues must have access to primary sources of information."

For Babiliute and the other journalists in the group, attending the international conferences gave them the chance to make professional contact with high-level ministry officials, public health experts, healthcare administrators, representatives of donor organizations, and medical professionals who have first-hand knowledge of every step of the reform process. "I was able to meet with Russian Health Minister Yuri Shevchenko—something that would have been virtually impossible in another setting," Babiliute notes.

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Erzsebet Fazekas (right), health editor of the Hungarian daily newspaper Nepszabadsag, conducts an interview during a break from conference sessions.
(Photo: Cable Risdon/Cable Risdon Photography)

Sharing her perspective as both a healthcare provider and a government official, Dr. Olena Sulyma, chief neonatalogist of Ukraine, underscored the value of working closely with media professionals, using her own experience as an example. "I think it is important to show how programs such as those implemented at AIHA's Neonatal Resuscitation Training Centers are making a real difference by decreasing mortality and morbidity rates among newborns. In fact, the cost of caring for an infant with central nervous system damage—something that is, in most cases, easily preventable—is nearly 200 times greater than the cost of preventing the damage by using modern resuscitation techniques." And that, she notes, is something worth writing about.

"Involving the journalists in these two conferences is a very important idea because the sessions highlighted not only medical issues, but social and financial matters as well," Sulyma states. Given the budgetary constraints faced by healthcare systems in the region, journalists must be aware of all aspects of the issues they write about—not just one side of a story—so they can present an accurate, balanced picture to their readers, she concludes.

Sedlak agrees that actively supporting the journalists and involving them in the

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AIHA Executive Director James P. Smith chats with Dr. Dilbar Nazhmutdinova (center), director of the Tashkent Women's Wellness Center, and Natalia Shulepina, correspondent for the Uzbek national daily newspaper Pravda Vostoka, at the opening reception for the USAID conference.
(Photo: Cable Risdon/Cable Risdon Photography)

conferences helped reinforce the idea that the media and public health advocates should work together to keep the public informed about matters that have an impact on their wellbeing and to ease the often difficult transition that accompanies the reform process. "The face-to-face contacts I made at the events have helped me develop a more trusting relationship with representatives from the Ministry of Health. I believe that we all gained a sense that we are working together toward the same goal, rather than in opposition of one another," she says, voicing her opinion that this interaction was especially useful for potential sources who may be less fearful that members of the media are only interested in reporting negative stories thanks to the personal contact initiated during the week.







Looking at Both Sides of the Story
At the conclusion of the USAID conference,

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Josep Figueras shares his thoughts on how health professionals and members of the mass media can work together to keep the public well-informed during a luncheon meeting Wednesday afternoon.
(Photo: Cable Risdon/Cable Risdon Photography)

Josep Figueras, director of WHO's European Observatory on Health Care Systems, met with the journalists to summarize some of the key outcomes of the event and to encourage the journalists to continue the spirit of collaboration that had already taken root.

Agreeing that public health professionals—especially those who occupy high-level positions—often have a very negative view of the media, Figueras explained "Because we are afraid, we say the media is against us, that you trap us and misrepresent what we say, but that is not true," he told the group. "The truth is that we don't always understand your agenda and you don't always understand ours. That is a shame because there are many, many ways that we can work together with regard to healthcare reform, while at the same time giving you 'sexy' health-related messages that can sell newspapers."

Acknowledging the importance of using the mass media to facilitate positive change throughout the region, Figueras continued, "You are playing a huge role in health reform by educating and informing individuals on both sides of the process. The bottom line is that no country in the region can finance universal coverage and there is no single solution that will solve the problems our health systems face. But, as journalists, you can open the lines of communication between policymakers and the public so that realistic expectations about what services should be included in your nation's basic health package can be developed."

He went on to cite a long list of topics that fall under the aegis of healthcare—quality of care, health systems financing, health-related NGOs, and the role of individuals and communities in the reform process, for example—that are rife with stories begging for media coverage. By highlighting parts of the healthcare system that are ineffective, bringing these flaws to the attention of policymakers, and suggesting strategies for implementing improvements, reform can take root on local, regional, and national levels. "If these types of stories are covered in a constructive fashion, they can give citizens the tools they need to push their governments to commit legally and legislatively to establishing the framework necessary to implement sustainable change. It is not enough to simply write that the citizen is all-important. You must also convey the idea that health is a fundamental part of democracy and an open society; it is a basic human right and citizens must push at the systems that don't work, forcing change."

But forcing change—especially in societies where individuals historically had no voice in matters of the state—is, to say the least, an uphill battle. Some of the journalists responded to Figueras' call to action by underscoring the fact that many policymakers are distrustful of the media and seem unwilling to listen to what they have to say.

Readily acknowledging that the path to reform is indeed a difficult one, Figueras countered, "Your concerns are valid. Politicians get votes for opening hospitals, not for going after rich, powerful tobacco and alcohol companies. But, societies are starting to place a greater value on their own health and on the future health of their children so things are changing. As journalists, you are in the unique position of being able to help forward-thinking politicians spread the message of optimism for a healthy future." And that, he concluded, "is a message that will sell papers."

Adding the Public to the Partnership
At a time when health and quality of life increasingly depend on a person's knowledge and lifestyle choices,

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Svetlana Fyodorova, an Almaty-based news producer for KHABAR Television, chats with Kazakh Minister of Health Zhaksylyk Doskaliev before conducting an interview.
(Photo: Vira Illiash)

an active collaboration between the health and media sectors is a highly effective way to put this knowledge where it has the opportunity to do the most good—in the hands of individuals. According to WHO, the concept of health literacy relates to the capacity of people to understand health-related information and to use it to make lifestyle choices that will enhance their health and quality of life. As people gain knowledge they become, in effect, informed consumers who are better equipped to navigate effectively in healthcare settings. Health literacy then, is an essential component of a healthy community. But, even in information-dominated societies, many people still do not have access to accurate and comprehensible facts—a prerequisite to making responsible decisions concerning healthcare issues. This only serves to underscore the value of making scientifically sound health information available to the general public by creating an active partnership involving media professionals and the health sector.

Explaining that the process of health system transition in Tajikistan could be eased by increasing public knowledge of health-related issues and the budgetary concerns that drive current policies, Nasira Khodjieva, a national media expert with the SOMONI Health Communication Project, says, "As the government works to implement cost-effective approaches to meeting the healthcare needs of the population, new ways of involving individual people must be explored." An open exchange of current and relevant information is the key to a well-informed population and public outreach programs and media exposure provide easy access to the widest range of people, she continues.

The need to educate and inform the public is a driving force that pushes all the journalists who participated in the project. The opportunity to discuss the problems they face as they seek out accurate, timely, and relevant health-related information increased the bond formed among members of the group. "Not only are the professional challenges we face quite similar, the problems of our health systems are also essentially the same," Babiliute concludes. "For us, the intense cooperation was very beneficial. We exchanged ideas about how to best transfer the information presented at the conferences to our readers and also discussed ways we can work together in the future. Very often, journalists are not invited to these types of events. As a result, the information available to us is not necessarily what we are looking for. But, this experience opened my eyes to the value of closer international collaboration. In fact, it has already helped to lay the groundwork for future collaboration with some of my media colleagues throughout the region."

On their final day in Washington, members of the journalist group toured Johns Hopkins Hospital and School of Medicine where they met with Steve Thompson, CEO of Johns Hopkins International, and Dr. Szabolcs Dorotovics, managing director for JHI's European programs, as well as several physicians and nurses involved in innovative procedures such as living-donor liver transplant surgery.

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Members of the journalist group listen to a presentation by Hopkins gastroenterologist Sergey Kantsevoy. (Photo: Vira Illiash)

Natalia Shulepina (Uzbekistan), Ruzanna Amirdjanian (Armenia), and Maria Cherneva (Bulgaria) take notes during a tour of Johns Hopkins Hospital in Baltimore, Maryland. (Photo: Vira Illiash)

     

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