Recent News Coverage of Sexual and Reproductive Health in Lebanon

Representations of sexual and reproductive health in mass media offer one indicator of women's relative position and value as women in a given society (Bronstein 2005). Media sources also disseminate health messages, influencing people's health choices and health behaviors (Wakefield, Loken, and Hornik 2010). This essay relies on a content analysis of forty-three articles published between August 28, 2015, and June 28, 2017, in Lebanon that used key terms related to reproductive health, sexual health, and breastfeeding. We systematically culled the articles from nine Lebanese newspapers (eight in Arabic) published online.¹ Of these forty-three accounts, nineteen were by men, three were by women, one was coauthored by a man and a woman, and the remaining twenty did not include an author name. With the exception of an account by a woman targeting a male audience, the remainder presumed a female reader. Articles that discussed refugees focused primarily on controlling fertility rates and maternal birth complications. None of the accounts discussed unwanted pregnancies or abortion.

Researchers often use content analysis to analyze newspaper reporting on health issues (e.g., Abdelmutti and Hoffman-Goetz 2009; Clement and Foster 2008; Downe-Wamboldt 1992). We obtained the articles from the Knowledge to Policy Center at the Faculty of Health Sciences of the American University of Beirut, which tracks Lebanese newspaper articles on health topics on a daily basis. We searched for the following key terms: breastfeeding, sex work, international women's day, LGBT, midwife, preterm deliveries, refugees, reproductive health, sexual health, abortion, and Syrian refugees. In examining the articles, we focused on topic, perspective and impression left, mention (or not) of prevention and treatment, target audience, complexity (difficulty of words, length of sentences), ecological level of concern (individual, interpersonal, organizational, community, or policy), and feminist/nonfeminist perspective. Two coders analyzed a random sampling of the accounts obtaining an interrater reliability rate of 92 percent. They coded the remaining articles independently and in duplicate. A third coder reviewed any disagreement or discrepancy.

The International Conference on Population and Development Program of Action describes reproductive health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes" (Center for Reproductive Rights 2013). Gender power differentials directly affect the reproductive health of women by interfering in their autonomous decisions about their bodies and controlling their access to resources and services (Roudi-Fahimi 2003). War and humanitarian crises only aggravate challenges to maintaining reproductive and sexual health as they interfere with services and make people more vulnerable to disease, hunger, displacement, poverty, and violence. In Lebanon the latest high influx of displaced people from Syria has put the health care system under huge pressure (Blanchet, Fouad, and Pherali 2016).

The majority of articles (twelve) on breastfeeding covered the National Campaign to Promote Breastfeeding. The remaining four articles on this topic related to the social pressure around ability to breastfeed, the importance of tightening laws around breast milk substitutes, the importance of incentives to promote breastfeeding, and the relationship between diabetes and breast milk. A quarter of the accounts addressed breastfeeding at an individual level: promoting breast-feeding through incentives, encouraging women to breastfeed as part of skin-to-skin contact, and encouraging women to decrease sugar intake to prevent infant diabetes. Three-quarters of the articles focused on interventions beyond the individual, arguing for making environments supportive for breastfeeding. Most of the articles focused on breastfeeding as a reproductive right and covered the breast-feeding campaign as part of the national agenda, including suggestions to enforce legislation against hospitals that promote formula milk. Breastfeeding embodies the concept of using women's body for the public good (Stearns 1999), with women understood as producers of significant economic value. The breastfeeding campaign advocated for political and institutional recognition of breastfeeding as a "reproductive health right" and a core strategy for "women's economic advancement." It did not view breastfeeding as a personal choice.

Eleven of nineteen articles discussed how...