RESUMEN

Trusted interactions are crucial in health systems. Trust facilitates effective healthcare by encouraging patients to seek and adhere to treatment, enabling teamwork among health professionals, reducing miscommunication and medical errors, and fostering innovation and resilience. The COVID-19 pandemic underscored the importance of trust, highlighting the challenges in establishing and maintaining it, especially during crises when trust in authorities and health systems is vital for compliance and safety. However, trust is complex, varying with context and experiences, and is dynamic, easily lost but hard to regain. Despite its importance, trust is often overlooked in health policy and difficult to measure. Health systems and policy-makers must recognize the importance of trust, measure it effectively, understand how it is built or eroded, and act to maintain and restore it. This involves acknowledging the past experiences of marginalized groups, involving communities in decision-making, and ensuring transparency and integrity in health practices and policies.

Asunto(s)

RESUMEN

Modern agriculture relies on pesticides to maximise outputs. While many highly hazardous pesticides (HHPs) are banned in places like the European Union due to concerns about harm to the environment and human health, their use continues in many low- and middle-income counties (LMICs). Pesticide suicide is a public health problem unique to countries where HHPs are used, and Sri Lanka has successfully implemented several HHP bans as part of a suicide prevention strategy. On 27 April 2021, the Sri Lankan government announced an imminent import ban of all fertilizers and pesticides which was later revoked in November 2021. The aim of this article was to explore the media framing of the import ban as it pertained to pesticides. Guided by Entman's typology of frame functions, we analysed newspaper articles from nine Sri Lankan newspapers (N = 102) between 20 April to 31 October 2021. Overall, most framings were supportive of the ban, captured by framings that articulated the ban through a health, environment, and organic farming narrative. Framings that foregrounded farmer or industry livelihoods and the pesticide market were primarily adopted to express opposition to the ban. The presence of frames opposing the ban within media articles increased over time during the study period. There was a greater proportion of opposing frames in private newspapers compared to government (78% vs 22%). Many of the articles analysed described the widespread impact of the ban, but only 11% of articles represented the voices of policy end users. This study adds understanding to the ways communication via outlets like mainstream newspapers may shape public support or opposition to pesticide bans in a LMIC. Mass media is an under-recognised factor in policy implementation and this study may inform planning to implement pesticide bans in other countries.