Wojczewski Silvia, Willcox Merlin, Mubangizi Vincent, Hoffmann Kathryn, Peersman Wim, Niederkrotenthaler Thomas, Natukunda Silvia, Maling Samuel, Maier Manfred, Mant David, Kutalek Ruth
Department of General Practice and Family Medicine, Centre of Public Health, Medical University of Vienna, Vienna, Austria.
Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, United Kingdom.
PLoS One. 2015 Apr 2;10(4):e0121766. doi: 10.1371/journal.pone.0121766. eCollection 2015.
Uganda is one of the 57 countries with a critical shortage of health workers. The aim of this study was to determine how the human resources and health service crisis was covered in Ugandan newspapers and, in particular, how the newspapers attributed accountability for problems in the health services.
We collected all articles related to health workers and health services for the calendar year 2012 in the two largest national newspapers in Uganda (collection on daily basis) and in one local newspaper (collection on weekly basis). These articles were analysed qualitatively regarding the main themes covered and attribution of accountability.
The two more urban national newspapers published 229 articles on human resources and health services in Uganda (on average over two articles per week), whereas the local more rural newspaper published only a single article on this issue in the 12 month period. The majority of articles described problems in the health service without discussing accountability. The question of accountability is raised in only 46% of articles (106 articles). The responsibility of the government was discussed in 50 articles (21%), and negligence, corruption and misbehaviour by individual health workers was reported in 56 articles (25%). In the articles about corruption (n=35), 60% (21 articles) mention corruption by health workers and 40% (14 articles) mention corruption by government officials. Six articles defended the situation of health workers in Uganda.
The coverage of accountability in the Ugandan newspapers surveyed is insufficient to generate informed debate on what political actions need to be taken to improve the crisis in health care and services. There exists not only an "inverse care law" but also an "inverse information law": those sections of society with the greatest health needs and problems in accessing quality health care receive the least information about health services.
乌干达是57个卫生工作者严重短缺的国家之一。本研究的目的是确定乌干达报纸如何报道人力资源和卫生服务危机，特别是报纸如何追究卫生服务问题的责任。
我们收集了乌干达两家最大的全国性报纸（每日收集）和一家地方报纸（每周收集）2012年全年与卫生工作者和卫生服务相关的所有文章。对这些文章进行了定性分析，涉及所涵盖的主要主题和责任归属。
两家更具都市性的全国性报纸发表了229篇关于乌干达人力资源和卫生服务的文章（平均每周两篇以上），而地方更具乡村性的报纸在12个月期间仅发表了一篇关于这个问题的文章。大多数文章描述了卫生服务中的问题，但没有讨论责任问题。只有46%的文章（106篇）提出了责任问题。50篇文章（21%）讨论了政府的责任，56篇文章（25%）报道了个别卫生工作者的疏忽、腐败和不当行为。在关于腐败的文章（n = 35）中，60%（21篇）提到卫生工作者的腐败，40%（14篇）提到政府官员的腐败。六篇文章为乌干达卫生工作者的状况进行了辩护。
在所调查的乌干达报纸中，责任报道不足以引发关于需要采取哪些政治行动来改善医疗保健和服务危机的明智辩论。不仅存在“逆向医疗法”，还存在“逆向信息法”：社会中那些健康需求最大且在获得优质医疗保健方面存在问题的群体，获得的关于卫生服务的信息最少。
