Transforming media coverage of nutrition in Kenya

By Titus Mung’ou

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At the time of writing, Titus Mung’ou was the Advocacy and Communications Manager at Action Against Hunger (ACF) and the outgoing Chair of Kenya’s Scaling Up Nutrition Civil Society Alliance (SUN CSA). He holds a degree in Education (Arts), Postgraduate Diploma in Mass Communication, Masters in Communication Studies, and is currently pursuing a PhD in Communications Studies at the University of Nairobi.

Location: Kenya

What we know: Kenya joined the SUN Movement in November 2012. While Kenya is on course to meet all the World Health Assembly maternal and child nutrition targets, malnutrition remains a significant public health problem.

What this article adds: In Kenya, the SUN Civil Society Alliance (SUN CSA) has engaged in targeted and innovative advocacy to elevate the status of nutrition in government structures, mainstream nutrition as a multi-sector development agenda, and increase nutrition resources (budgets and nutritionists). SUN CSA activities have included development of county-integrated development plans and budgets, nutrition position papers, and establishment of a network of nutrition-interest journalists. Workshops have sensitised political leaders, civil servants, nutrition stakeholders and journalists on their role in SUN. Advocacy impact has included development of specific budgets lines for nutrition programmes in county plans, more county nutritionists employed, more quality media coverage on nutrition issues, including the Global Nutrition Report 2015 launch, and commitment of high-level nutrition champions.

Kenya joined the global movement for Scaling up Nutrition (SUN) in November 2012, thereby committing to addressing malnutrition at scale in a multi-sector approach. To date, Kenya has established six SUN networks, namely Government, United Nations, Donor, Business, Civil Society and Academia. These are harnessing various efforts to meet SUN Movement objectives. The Global Nutrition Report 2015 recognised Kenya as the only country on course to meet the 2025 World Health Assembly (WHA) targets. It notes: “Nearly every country (70 of the 74 for which data exist) is on course to meet at least one of the five global targets. This breadth of performance is good news. However, only one country (Kenya) is on course to meet all five WHA maternal and child nutrition targets, and only four (Colombia, Ghana, Vanuatu, and Vietnam) are on course to meet four targets.” (Global Nutrition Report 2015).

Country situation

Kenya faces the double burden of malnutrition: undernutrition (i.e. stunting, wasting and micronutrient deficiencies) and overnutrition (i.e. overweight and obesity). Although prevalence of undernutrition (and often associated infectious diseases) remains high, there is a considerable concurrent rise in overweight and obesity rates (and associated non-communicable chronic diseases (NCDs)). While some progress has been made over the last years in reducing stunting, the vast majority of regions are still not on course. Currently 26% of children under five years of age are stunted and 11% are underweight, while 4% are wasted. Stunting rates are similar for boys and girls; however there are regional disparities, with the highest level of stunting being in West Pokot, Kitui and Kilifi. Stunting remains more prevalent in the poorest households, although it still exists in the richest.

The estimated number of children under five who are overweight is growing rapidly; the current obesity prevalence is 4.6%. One third (33%) of women of reproductive age are overweight. According to the Kenya Demographic Health Survey 2014 (KDHS 2014), overweight increases with household wealth. Being overweight and obese are considerable risk factors for NCDs such as hypertension, diabetes and cardiovascular diseases. Micronutrient deficiencies (including vitamin A, iron, iodine, zinc and folic acid) are common among women and children, and ensuring adequate micronutrient status in women of reproductive age, pregnant women and children improves the health of expectant mothers and the growth, development and survival of their children.

Mobilising civil societies

The SUN Civil Society Alliance (SUN CSA) has three main issues in focus: advocacy to elevate the status of nutrition in government structures, mainstreaming nutrition as a multi-sector development agenda, and increased nutrition resources (budgets and nutritionists). Two years after its establishment, the SUN CSA has mobilised 44 organisations at national level and 30 others at county level to join the network and advocate for scaling up nutrition. Most CSA members are non-governmental organisations (NGOs) and civil society organisations (CSOs), working in humanitarian, human rights, education, health, consumer and women’s empowerment sectors.

Over the last year, members of SUN CSA have been involved in the development and review of county-integrated development plans and budgets, with a specific focus on health and nutrition components. Kenya’s 2010 Constitution established 47 counties, which are responsible for policy decisions and allocation of resources to institutions in their jurisdiction. Following continual advocacy by SUN CSA and partners, at least five counties have created specific budget lines for nutrition programmes and employed more nutritionists in the 2015/16 financial year. The counties are Baringo, Taita Taveta, Kajiado, West Pokot, Wajir and Mandera.

The CSA has developed and presented six position papers on various nutrition issues. These include the Draft Kenya Health Policy 2014-2030 and Health Bill 2014; identified and sensitised over six county nutrition champions. The network is supporting the SUN Government Focal Point and nutrition sector actors to disseminate the National Nutrition Action Plan, develop County Nutrition Action Plans and a national Nutrition Advocacy, Communications and Social Mobilisation Strategy. These activities are vital in promoting the country’s nutrition agenda.

With support from the SUN Multi-Partner Trust Fund (MPTF), Population Reference Bureau (PRB), ACTION Global Health Advocacy Partnerships and individual members, SUN CSA has conducted 11 nutrition advocacy trainings and workshops in nine counties. The workshops have served as platforms to sensitise political leaders, civil servants, nutrition stakeholders and journalists on their role in SUN.

Nutrition visibility in the media

The goal of SUN CSA is to place nutrition on both the media and political agendas in order to increase funds for nutrition and to mobilise communities to embrace good nutrition practices. In Kenya, the role of the media in influencing policy decisions on health and nutrition is very important. Through the media, the public is sensitised on good nutrition, malnutrition cases, benefits of eating locally produced nutritious foods, exclusive breastfeeding and baby-friendly facilities, among other issues. Members of Kenya’s SUN CSA support the Ministry of Health to ensure media coverage of nutrition events (almost 100 per cent media coverage), with some participating in media talk shows and discussions on topical issues.

Although the impact of the media on nutrition policies and achievement of WHA targets has not been studied, the catalytic role of the media in six counties targeted by SUN CSA resulted in more allocation of resources to nutrition. Sustained media advocacy and press articles on the need for more funds for nutrition was undertaken during the budgeting process, thereby influencing key decision-makers to act. Due to limited funds for media advocacy, sensitisation of journalists in the remaining 41 counties of the country remains a tall order, but is necessary to build capacity to push on key nutrition issues. Using local media benefits and influences both the public and the decision-makers who rely on the stations for their daily news.

Building capacity of journalists

Informed by recommendations from previous media workshops, SUN CSA organised national and county-level media trainings targeting journalists specialising in health and nutrition reporting. The aims were to sensitise journalists on nutrition programmes in Kenya and their role in SUN, to build journalists’ capacity to report nutrition stories, and to strengthen the relationship between media practitioners and nutrition experts.

A national media workshop conducted by SUN CSA in February 2015 brought together nine journalists and three Community Health Workers (CHWs) from Nairobi and Embu counties. The journalists were drawn from the Nation Media Group, Kenya Broadcasting Corporation, Standard Group, Science Africa and freelancers. Topics covered included introduction to the SUN Movement; Kenya’s nutrition landscape and nutrition policy framework; and nutrition as a media agenda. The facilitators were drawn from the SUN CSA and Media for Environment, Science, Health and Agriculture (MESHA). Subsequently, with evidence and recommendations from media workshops conducted at the national and county levels, SUN CSA trained more than 25 journalists based in rural areas on nutrition reporting in May 2015. While a science reporters’ network in Kenya exists, most journalists in the network do not have the skills to cover nutrition activities. Thus the key outcome of the SUN CSA county nutrition advocacy workshop in May 2015 was the establishment of a network of journalists interested in reporting nutrition stories. Members began a social media group (WhatsApp group: Nutrition Journalists) to share nutrition stories, alert each other on upcoming events and seek comments from experts on technical issues. At least three members of SUN CSA guide discussions on the social media platform.

Key recommendations from the media workshops conducted by SUN CSA include:

• Mobilise funds for research and fieldwork logistics to enable journalists to write quality stories. As a follow-up, CSA supported 15 journalists to cover nutrition stories in June 2015 in Baringo, Kajiado, Machakos and West Pokot counties. As a result, there was extensive reporting of nutrition stories in digital and print media. Major TV stations like Citizen, Nation and Kenya Television News (KTN) aired human-interest stories on nutrition, reported by the trained journalists. Most of the journalists submitted more than six stories within the month to their media stations. Besides improved quality of nutrition stories in the media during the period, the number of nutrition articles reported in the media increased from June 2015, according to Media Monitoring Report. To date, the journalists continue to report nutrition stories and often promote specific nutrition agendas when interviewing decision-makers in counties (see Box 1 for selection of articles generated).

• Establish nutrition database accessible to journalists. The Nutrition and Dietetics Unit and partners working on the Advocacy, Communication and Social Mobilisation strategy are providing technical support to and documentation of best practices (see Nutrition Health).

• Build the capacity of journalists to cover nutrition case studies and surveys.

• Establish social media accounts to enhance sharing of nutrition news. The Nutrition and Dietetics Unit social media accounts have been revamped and provide timely information on nutrition.

• Initiate a competition for journalists reporting nutrition stories.

• Sensitise media editors on nutrition issues in order to increase nutrition coverage (see Box 2).

Nutrition visibly in the media

A media visibility study conducted by media monitoring firm Reelforge covering the period May 2014-May 2015, commissioned by SUN CSA in June 2015, found that: “Media coverage on nutrition related issues was highest on radio in terms of frequency during the period. This was attributed to the high number of outlets/channels. Television had the highest share of advertising for nutrition products and services value equivalents [value of non-advertisements on nutrition, e.g. news and feature stories, whose value is calculated using advertisement rates] despite a lower number of (nutrition) stories compared to other media types.”

Recommendations from the media visibility report included:

• Nutrition actors should push for more coverage by regional and rural radio stations in particular to help address the malnutrition situation in the country, especially in areas most affected by malnutrition such as West Pokot and Turkana counties. This aims to encourage demand for health facility services and support adoption of optimal feeding practices. Current media coverage is skewed to urban areas.

• Increase efforts to profile nutrition stories in major media channels, such as television and print (newspapers) targeting key decision-makers in the country. Media sensitisation of leaders is expected to influence their decisions on development plans and budgets relevant to nutrition.

• Research findings on nutrition issues attract high media interest and coverage. Nutrition actors should support or partner with research firms to conduct nutrition surveys and inform the public regarding malnutrition trends in the country. Such data will act as evidence for planning and budgeting purposes.

• Most advertisements cited by the media as nutrition items were largely promotion of ‘nutrition’ products by herbalists; sensitisation on what constitutes good nutrition is needed.

Launch of Global Nutrition Report 2015

SUN CSA engaged Africa Practice on behalf of SUN networks to support media coverage of the launch of the Global Nutrition Report 2015 in Kenya. Africa Practice drafted the press release, op-ed for newspapers and media tool kit, among other items. The event brought together various stakeholders in Kenya, including politicians and representatives from SUN CSAs in East Africa from Uganda, Tanzania, Ethiopia, Rwanda and Burundi. Invitations were coordinated by SUN CSA. SUN CSA members documented and disseminated a report on the launch. Five nutrition-trained journalists from counties supported by SUN CSA were invited to join Nairobi-based journalists to report the launch. Thereafter, various media interviews and talk shows featured nutritionists who disseminated GNR 2015, with wide media coverage including:

• 23 journalists from print, radio, television and bloggers covered the event;
• GNR featured in 22 articles in print, online, radio and television, which translates to a PR value of Ksh.14,960,655 (USD149,607);
• Over 1,000 tweets were generated using the primary hashtag #NutritionReport, while others used the hashtag #GlobalNutritionReport.

Links to some media articles are shown in Box 3.

Article in The Star newspaper highlighting the issue of stunting

Politicians and the media agenda

Kenya’s nutrition stakeholders have embarked on the mobilisation of diverse players to integrate nutrition in their programmes and on the sensitisation of political leaders to elevate the status of nutrition and allocate more resources to nutrition programming. These can be achieved by positioning SUN in an office with powers to coordinate other ministries to implement nutrition programmes – the Office of the President.

SUN CSA and partners work closely with politicians to discuss topical issues through the press. A number of national and county leaders are invited to advocacy workshops, where they address specific issues relevant to their counties and make commitments to support efforts to tackle malnutrition. Some politicians and decision-makers often feature in the media discussing nutrition issues during major health events, while others write opinion pieces for the print media. Examples are given in Box 4.

Examples of the impact of such advocacy include:

• During a SUN CSA and Food and Agriculture Organisation (FAO) nutrition advocacy workshop in West Pokot County in August 2014, the County   Government leaders committed to prioritise food and nutrition issues in the County Integrated Development Plan and budget. The need for legislation and employment of more nutritionists in a county where one nutritionist serves 85,331 people were echoed by the Deputy Governor, Hon Titus Lotee, and the Speaker of the County Assembly, Robert Katina. Subsequently, in the County’s 2015/16 financial year, the Government allocated more funds for staff working in the nutrition department.

• In June 2015, Kajiado County Government announced the creation of a specific budget line for nutrition programmes. This followed sustained advocacy campaigns by SUN CSA through support from the US-based PRB. So far, three other counties (Baringo, Wajir and Mandera) have increased budget allocations for nutrition programmes.

• At least six counties supported by SUN CSA have identified nutrition champions, including the county first ladies (wives of governors). SUN CSA conducted the first County Nutrition Champions Workshop on 16 December 2015 in Nairobi.

Conclusions

SUN Civil Society Alliance plans to mobilise journalists to join the network of journalists reporting nutrition that was established in May 2015, mobilise resources to strengthen nutrition media advocacy, build capacity of technical staff to work with the media, lobby media editors to create regular nutrition programmes, and identify nutrition champions in the media who will increase the profile of nutrition.

For more information, contact: Titus Mung’ou 

References

Global Nutrition Report 2015. Synopsis, page 3.