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This comparative study brings together academics and practitioners who work in the field of media and elections to provide a set of national case studies and an analysis of the legal and regulatory frameworks that are employed by nation states to ensure that the media perform according to certain standards during election periods. In setting out the legal and regulatory framework each chapter provides an account of the socio-political conditions and media environment in each of the countries and subsequently details the laws that govern the print and broadcast media during election campaign periods. The countries included are France, Germany, Italy, Russia, South Africa, the United States, and the United Kingdom. A set of reflections by a Member of the European Parliament and a set of recommendations for good practice in media and elections are also included. Thus, the book is organized to provide a practical guide so that it can be used as a handbook. Contents: D. Ward, Introduction. T. Perruci, M. Villa, Italy. L.L. Kaid, C.A. Jones United States of America. H. Drück, Germany. A.S. de Beer, South Africa. E. Mauboussin, France. D. Skillen, Russia. A. McNicholas, D. Ward, United Kingdom. K. Junker, Notes From an Election Observer. D. Ward, Conclusion. B-P. Lange, Media and Elections: Some Reflections and Recommendations. Appendices: Internet Sources for Electoral Legislation, Regulation, and Court Decisions. The European Institute for the Media--Media and Democracy Programme. List of Media-Monitoring Missions Conducted by the Media and Democracy Programme of the European Institute for the Media.

Comparing Media Systems Beyond the Western World offers a broad exploration of the conceptual foundations for comparative analysis of media and politics globally. It takes as its point of departure the widely used framework of Hallin and Mancini's Comparing Media Systems, exploring how the concepts and methods of their analysis do and do not prove useful when applied beyond the original focus of their 'most similar systems' design and the West European and North American cases it encompassed. It is intended both to use a wider range of cases to interrogate and clarify the conceptual framework of Comparing Media Systems and to propose new models, concepts and approaches that will be useful for dealing with non-Western media systems and with processes of political transition. Comparing Media Systems Beyond the Western World covers, among other cases, Brazil, China, Israel, Lebanon, Lithuania, Poland, Russia, Saudi Arabia, South Africa and Thailand.

Background Media is a crucial factor in shaping public opinion and setting policy agendas. There is limited research on the role of media in health policy processes in low- and middle-income countries. This study profiles South Africa as a case example, currently in the process of implementing a major health policy reform, National Health Insurance (NHI). Methods A descriptive, mixed methods study was conducted in five sequential phases. Evidence was gathered through a scoping review of secondary literature; discourse analysis of global policy documents on universal health coverage and South African NHI policy documents; and a content and discourse analysis of South African print and online media texts focused on NHI. Representations within media were analysed and dominant discourses that might influence the policy process were identified. Results Discourses of ‘health as a global public good’ and ‘neoliberalism’ were identified in global and national policy documents. Similar neoliberal discourse was identified within SA media. Unique discourses were identified within SA media relating to biopolitics and corruption. Media representations revealed political and ideological contestation which was not as present in the global and national policy documents. Media representations did not mirror the lived reality of most of the South African population. The discourses identified influence the policy process and hinder public participation in these processes. They reinforce social hierarchy and power structures in South Africa, and might reinforce current inequalities in the health system, with negative repercussions for access to health care. Conclusions There is a need to understand mainstream media as part of a people-centred health system, particularly in the context of universal health coverage reforms such as NHI. Harmful media representations should be counter-acted. This requires the formation of collaborative and sustainable networks of policy actors to develop strategies on how to leverage media within health policy to support policy processes, build public trust and social cohesion, and ultimately decrease inequalities and increase access to health care. Research should be undertaken to explore media in other diverse formats and languages, and in other contexts, particularly low- and middle-income countries, to further understand media’s role in health policy processes.

Awareness creation through mass media has the potential to promoted positive behaviors and discourage negative health-related behaviors through direct and indirect pathways. In this study, we examined the association between exposure to mass media and maternal health care services utilization among women in sub-Saharan Africa. We used data from the recent Demographic and Health Surveys (DHS) conducted between 2010 and 2020. A total of 28 countries with a survey dataset within 2010-2020 were included in our study. We included 199,146 women who had ever had a pregnancy in the last five years preceding the survey. Weighting was applied. Multilevel mixed-effect models were considered to account for cluster-level variations and correct inferences. Fixed and random effects estimates were reported. Adjusted odds ratio (aOR) with their 95% confidence intervals (CIs) were used to present the results. Also, we presented the random intercept variations, intraclass correlation coefficient, and model fitness. Women who listened to radio at least once every week (aOR = 1.11, 95% CI = 1.07,1.15) were more likely to attend ANC as against those who did not listen to radio at all. Also, women who watched television at least once a week (aOR = 1.39, 95% CI = 1.33,1.46) were more likely to attend ANC compared to those who did not watch television at all. Women who read newspaper/magazine at least once a week (aOR = 1.27, 95% CI = 1.14,1.41); listened to radio at least once a week (aOR = 1.12, 95% CI = 1.07,1.17); and watched television at least once a week (aOR = 1.32, 95% CI = 1.24,1.40), were more likely to utilize SBA than those who did not read newspaper/magazine; listen to radio; and watch television at all. Women who read newspaper/magazine at least once a week (aOR = 1.35, 95% CI = 1.27,1.45); listened to radio at least once a week (aOR = 1.37, 95% CI = 1.32,1.42); and watched television at least once a week (aOR = 1.39, 95% CI = 1.32,1.47) were more likely to utilize PNC compared to those who did not. The study identified a strong positive relationship between mass media exposure and maternal health care services utilization. Specifically, exposure to radio and television were positively associated with ANC visitations. Moreover, exposure to mass media (newspaper/magazine, radio and television) were positively associated with SBA and PNC utilization. Policymakers and other non-governmental organizations should continuously invest resources in the design and implementation of maternal health service utilization educational programs through all the mass media channels to scale up women's maternal health service services utilization uptake in sub-Saharan Africa.

With the vision of achieving Universal Health Coverage (UHC) by the year 2030, many sub-Saharan African (SSA) countries have implemented health insurance schemes that seek to improve access to healthcare for their populace. In this study, we examined the prevalence and factors associated with health insurance coverage in urban sub-Saharan Africa (SSA). We used the most recent Demographic and Health Survey (DHS) data from 23 countries in SSA. We included 120,037 women and 54,254 men residing in urban centres in our analyses which were carried out using both bivariable and multivariable analyses. We found that the overall prevalence of health insurance coverage was 10.6% among females and 14% among males. The probability of being covered by health insurance increased by level of education. Men and women with higher education, for instance, had 7.61 times (95%CI = 6.50-8.90) and 7.44 times (95%CI = 6.77-8.17) higher odds of being covered by health insurance than those with no formal education. Males and females who read newspaper or magazine (Males: AOR = 1.47, 95%CI = 1.37-1.57; Females: AOR = 2.19, 95%CI = 1.31-3.66) listened to radio (Males: AOR = 1.29, 95%CI = 1.18-1.41; Females: AOR = 1.42, 95%CI = 1.35-1.51), and who watched television (Males: AOR = 1.80, 95%CI = 1.64-1.97; Females: AOR = 1.86, 95%CI = 1.75-1.99) at least once a week had higher odds of being covered by health insurance. The coverage of health insurance in SSA is generally low among urban dwellers. This has negative implications for the achievement of universal health coverage by the year 2030. We recommend increased public education on the benefits of being covered by health insurance using the mass media which we found to be an important factor associated with health insurance coverage. The focus of such mass media education could target the less educated urban dwellers, males in the lowest wealth quintile, and young adults (15-29 years).

Background South Africa was the first sub-Saharan African country to implement a sugar-sweetened beverage (SSB) tax called the Health Promotion Levy (HPL) in April 2018. Given news media can increase public awareness and sway opinions, this study analyzed how the media represented the HPL, including expressions of support or challenge, topics associated with the levy, and stakeholder views of the HPL. Methods We performed a quantitative content analysis of online South African news articles related to the HPL published between January 1, 2017 and June 30, 2019. We coded the presence or absence of mentions related to health and economic effects of the HPL and HPL support or opposition. Prevalence of these mentions, overall and by source (industry, government, academics, other), were analyzed with Pearson χ 2 and post-hoc Fisher exact tests. Results Across all articles, 81% mentioned health, and 65% mentioned economics topics. 54% of articles expressed support, 26% opposition, and 20% a balanced view of the HPL. All sources except industry expressed majority support for the HPL. Health reasons were the most common justifications for support, and economic harms were the most common justifications for opposition. Statements that sugar intake is not related to obesity, the HPL will not reduce SSB intake, and the HPL will cause industry or economic harm were all disproportionately high in industry sources (92, 80, and 81% vs 25% prevalence in total sample) ( p  < 0.001). Statements that sugar intake is related to obesity and non-communicable diseases were disproportionately high in both government (46 and 54% vs 31% prevalence in total sample) (p < 0.001) and academics (33 and 38% vs 25% prevalence in total sample) ( p  < 0.05). Statements that the HPL will improve health and the HPL will reduce health care costs were disproportionately high in government (47% vs 31% prevalence in total sample) ( p  < 0.001) and academics (44% vs 25% prevalence in total sample) ( p  < 0.05), respectively. Conclusions Industry expressed no support for the HPL, whereas academics, government, and other sources mainly expressed support. Future studies would be improved by linking news media exposure to SSB intake data to better understand the effects news media may have on individual behavior change.

The erosion of public trust in health information and government communication, particularly during crises like the Covid-19 pandemic, highlights a critical challenge in how health policies are transmitted and received. This study examines the dramatic shift in public sentiment toward Covid-19 vaccination in South Africa during 2021, a period that saw a decline from initial high acceptance to significant hesitancy. We argue that a process of social media selection allowed extreme views to proliferate as official sources retreated. Our findings suggest that sustained or increased mainstream media engagement, particularly from official sources like government and health authorities, could have mitigated the dominance of anti-vaccine narratives and have crucial implications for government communication and public health policies in the digital age. We collected and classified 482,450 original tweets about vaccination. We show that, by the end of 2021, Twitter activity was characterized by a progressive surge in anti-vaccination tweets and a decline in pro-vaccination and factual information, particularly from mainstream media. This shift mirrors the decrease in actual vaccination rates. Employing agent-based modeling, we simulated counterfactual scenarios to assess the impact of media presence on vaccine discourse. The results indicate that sustained or increased media engagement could have mitigated the dominance of anti-vaccine narratives. Conversely, a simulated media downturn led to a steeper decline in pro-vaccination content. The findings suggest that mainstream news media play a crucial role in shaping public perceptions of and support for health policies and that their disengagement creates an informational void exploited by misinformation.

Background Future emergencies from climate degradation or diseases are likely, prompting ongoing investment in emergency readiness and learning from country responses. South Africa’s healthcare system, divided into public and private sectors, required a coordinated, intersectoral response to the COVID-19 pandemic. A coordinated action that the South African government took was adapting competition regulations. The South African Department of Trade, Industry and Competition on 19 March 2020, published a block exemption (easing of competition rules) for healthcare to promote standardization of practices across the health sector and facilitate agreements between the National Department of Health and the private sector to ensure adequate service delivery to all South Africans. Methods We assessed how much coverage the block exemption for healthcare received in the media and if the scope included details of what the exemption meant, how stakeholders and the public could use it, and the resulting public sentiment. We conducted a media content analysis to select, screen and assess the media material. Online and social-media articles in the public domain from 19 March 2020 to 19 March 2021, in English were considered. Results We analysed 22 online media articles that matched our inclusion criteria. Twenty of these reflected a positive sentiment, and two were negative. Media reported on the COVID-19 block exemption in healthcare only in the first three months of our study period. The articles primarily communicated what the block exemption meant, focusing on allowing collaboration, the purpose of the exemption, the activities granted under the exemption and the actors to whom it applied. It’s estimated that these media articles could have been read by up to 432,003 people out of a total population of just under 43 million people over the age of 15 years. Conclusion In times of crisis, the media has a significant responsibility to provide accurate information to the public. However, the accuracy and reliability of such information depends on the quality of official sources on which the media relies. Our research shows that very few media reports were available about the block exemption for healthcare. While the government implemented the exemption, it did not communicate its purpose directly to the public. Our research highlights the need for better communication between policymakers and the media.

This study investigated the association between comprehensive HIV/AIDS knowledge and HIV testing among men in sub-Saharan Africa (SSA). Data were taken from the most recent (2010–2019) Demographic and Health Survey men’s recode files of 29 countries in SSA. A total of 104,398 men who had complete information on all the variables of interest were included in the study. The outcome variable was HIV testing. A multilevel logistic regression analysis was conducted to determine the association between comprehensive HIV/AIDS knowledge and HIV testing. The results of the fixed effects model were presented as adjusted odds ratios (AORs) with 95% confidence intervals (CIs). The average prevalences of HIV testing and comprehensive HIV/AIDS knowledge among men in SSA were 53.5% and 50.8% respectively. Rwanda and Niger recorded the highest (93.6%) and lowest prevalences (9.8%) respectively. The prevalence of comprehensive HIV/AIDS knowledge among men in the 29 countries was 50.8%, with the highest in Rwanda (76.4%) and the lowest in Benin (31.1%). Men who had no comprehensive HIV/AIDS knowledge were less likely to test for HIV compared with those who had comprehensive HIV/AIDS knowledge (AOR=0.59, CI: 0.57–0.60). Men who were older than 20 years, married or cohabiting, with at least secondary education, in the richest wealth quintile, exposed to mass media, used condoms and with multiple sexual partners were more likely to test for HIV. To improve HIV testing among men in SSA, this study recommends that policymakers and stakeholders step up comprehensive HIV/AIDS knowledge sensitization and education using effective tools such as mass media.

Academic interest in scientists who regularly appear in the media dates back to Rae Goodell’s seminal book “The visible scientists”, in which she lists distinct characteristics of visible scientists, including being controversial, articulate, colorful, and reputable as a scientist. Visible scientists thus share relevant media-related characteristics that stand out in their portrayal as a group and are reminiscent of other celebrities’ characteristics. However, questions arise: what is special about the celebrity being a scientist? How many and what types of scientists fall into this category? What are the peers’ and the public’s expectations towards the social role of the visible scientist? To date, work on visible scientists has focused on theorizing them in the context of the relationship between science and its publics and empirical studies have mainly sought to characterize visible scientists and focused on single countries. This paper fills research gaps on the public perception of and expectations towards visible scientists as well as comparative studies by surveying publics in Germany and South Africa. Our data shows that Goodell’s criteria also apply to how respondents see and expect visible scientists to be. Interestingly though, a majority of non-responses to the request to name up to three visible scientists currently living in the respective country demonstrates that, overall, scientists are rather invisible to the public. Visible scientists remain a rare phenomenon despite changing media environments and a recent pandemic. In conclusion, we suggest that “visibility” (rather than “celebrity”) is the more appropriate term to refer to the temporary phenomenon of scientists who become visible in the public sphere.