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Fostering an ecosystem for accountability in Pakistan - The media's role in the accountability of health services

Palladium’s Empowerment, Voice and Accountability for Better Health and Nutrition (EVA) project aims to empower, organise and facilitate citizens and civil society to hold the governments of Punjab and Khyber Pakhtunkhwa to account for the delivery of quality Reproductive, Maternal, New-born, Child Health and Nutrition services. As part of this broad goal, EVA works with Pakistan’s media sector to build the capacity of journalists to produce stories on health issues and supports a programme to create a cadre of entertainment-information script writers. These activities are on behalf of EVA by the Centre for Communications Programmes Pakistan.

EVA works with Pakistan’s media sector to build the capacity of journalists to produce stories on health issues.

In the first of our EVA case studies we explore the media’s role in the accountability of health services. Click on the DOWNLOAD button for full publication.

For those who have ever been involved with a development project that worked with the media (or tried to work with the media!), you’ll be familiar with the conventional wisdom that the sector cannot be persuaded to write about poverty, education, healthcare issues, women’s rights etc. Instead the standard approach of projects and INGOs is to produce content themselves, and then try to persuade various media entities to grant them subsidised or free airtime; this is both costly and unsustainable.

Nonetheless, there is a good reason for this conventional wisdom; the majority of the TV and print media in much of Africa, Asia and the Middle East is driven by commercial interests and the politics of owners and editors. ‘Eyeballs’ are what determine content. The sexier and more sensational, the higher the sales and the more chances outlets have of selling advertising space. This is particularly true in an age in which online media increasingly threatens the market-share of print and television. At the same time, the conventional wisdom also serves a select few international organisations who specialise in media work. Indeed, it has turned into a self-perpetuating myth, justifying their market domination, funding and approaches.

However, our recent research explores how a UK Aid funded social accountability project in Pakistan is challenging these conventions and turning the mainstream approach to media for development on its head. To do this, it seeks to refocus Pakistan’s media on its traditional role as one of society’s primary accountability watchdogs. Much of the credit for this approach goes to the leadership of an innovative local organisation; the Centre for Communications Programmes Pakistan (CCPP).

Rather than ignoring reality, CCPP accepts the challenge of working with its country’s fast moving, commercially minded media sector. It aims to confront the widely held assumption that ‘no one wants to read about healthcare issues, and that they’re much more interested in sensational stories about celebrities and terrorism’ by demonstrating to the sector’s gatekeepers (bureau chiefs and outlet owners) that, done with an eye to the political determinants of poor service delivery, health stories can be commercially successful. Moreover, it seeks to show the sectors’ gatekeepers that healthcare stories can educate viewers as to their rights and pathways to accountability. This is achieved by covering the plight of those stuck with inefficient or corrupt services, and by starting conversations around who or what may be responsible; topics that were previously considered unsellable or, in some cases, too hot to handle.

As part of this work, the project has trained journalists (English and Urdu medium, at the national and district level) in human rights-based reporting. It has also conducted workshops focussed on aiding them to navigate the political economy of their own institutions, including how to persuade the sectors’ gatekeepers that health stories are commercially viable and socially useful. The first intake to these trainings are currently mentoring junior journalists in their respective regions. This approach not only fosters sustainability by building the capacity of a cadre of journalists and editors who will continue to write and publish content long after the project ends, it also assures that stories are ethically researched and professionally reported.

Another way in which EVA challenges the conventional wisdom is how it deploys funds for high-cost, impactful education-entertainment. Broadly understood, entertainment-education involves the embedding or wrapping up of educational information/messaging in entertainment. The general idea is to introduce audiences to beneficial information and behaviours in accessible formats, and through stories that contain characters or situations which resonate with their everyday lives. As new and cheaper technologies bring media to the masses – with television alone reaching 65% of Pakistani households – serials, radio shows, music and feature films can all be used as vehicles for entertainment-education. However, television dramas, radio shows and feature films are extremely expensive. From scriptwriting, to production and to airtime; the current focus on value for money and quick demonstrable wins for tax-payers of foreign aid makes supporting education-entertainment hard to sell.

To overcome such obstacles, EVA has adopted a brokering approach. This began with training a cadre of screenwriters in education-entertainment. It then moved onto funding the production of a single pilot episode of a student drama. It is now engaged in efforts to partner writers with major production houses. Central to this are the social and political capital accrued by EVA’s wider networks, and EVA’s advanced understanding of the media sector’s needs. This staged approach has led to two student scripts being bought-up by major media groups for production and airing during prime-time, with the other scripts currently under negotiation. EVA is also in discussion with major academic institutions across the country to explore the possibility of embedding its scriptwriting curriculum into their annual syllabuses.

Through such activities, EVA sees its role as both building the skills of journalists and scriptwriters interested in tackling routinely overlooked issues, and leaving behind sustainable structures to incubate future generations of media professionals. Such an approach accords with a raft of recent literature (here and here) on the role of the media in creating an enabling environment for accountability in developing country contexts.