Social media - a notion diversely defined, yet still evolving, have been described as Internet-based applications that build on the ideological and technological foundations of web 2.0 technology that integrate user generated content (Kaplan and Haenlein, 2009). It is worth noting that by nature, web 2.0 provides content production and consumption capabilities and opportunities that were previously hampered by geography, time, physical and social boundaries (Anand, 2013; Flew, 2005; Steenkamp and Hyde-Clarke, 2014; Van Dijk, 2006). Communication is key for any organization to issue instructions and policies, build relations, market productions, bargain with suppliers, and acquire resources (Janet, n.d). Currently, the available social media applications provide for horizontal communication that has enabled interactions between organisations and their stakeholders (Daowd, 2016). This is a new communication shift for organizations (Cetinkaya and Rashid, 2018) whereby organisations are no longer mere disseminators of information but are now opening up for dialogue, while listening to others in conversations (Berger, 2008), which blurs the notion of message control. Social media targets a huge audience especially of the young generation (Baruah, 2012) and reaches more individuals compared to other forms of media with a limited audience (Janet, n.d).

Presently, social media is playing a huge determinative role with in how information is sent and received across the world (Badea, 2014). Moreover, social media espouses interactivity, genuine dialogue, speed, multimodality, user-generated content, mass customisation, horizontal communication, and multi-directionality of information (Neuhauser and Kreeps, 2010). Many organisations are now integrating social media in their communication plans because of the accelerated communication benefits that these platforms offer (Janet, n.d). Social media applications like Facebook enable organizations to engage with their customers in an ongoing dialogue (Goldkind, 2015, p. 380) that helps to build relationships. By using social media platforms, organizations are able to interact with the audience in responding to their comments, messages, and reactions (Janet, n.d). Such direct interaction with the audience ensures that the quality of communication between the organisations and the target audience is improved through clarifications and feedback for accuracy (Badea, 2014). Such interaction is further expanded by the instantaneous nature of social media which helps organisations to share information easily and quickly.

Social media increase the volume and speed of communication, coupled with stimulating discussions on shared interests (Badea, 2014), which is an opportunity for organizational communication but may pose threats and weaknesses in the same measure (Kane, 2017). Social media networks are prone to malicious individuals like hackers and malicious software that compromises the organizational communication process (Jane, n.d). Every organization strives to protect the quality of information it disseminates to the public by being accurate, reliable, reliable and timely (Marques, 2010), considerations that may be affected by the use of social media. Although they are still regarded with some fear and are considered a potential danger within organizational communication, social media influence both the traditional media and the behaviour of media users (Badea, 2014) which makes them important for health communication.

For a long time, the mass media have supported disease prevention and health promotion strategies aimed at improving the quality of life (World Health Organisation, 2009). However, in recognition of today’s changing socio-economic and technological contexts, more open communication platforms and networks for information and knowledge acquisition are needed to enhance greater levels of message engagement (Green et al., 2006,). Thus, advances in digital media and communication technology present significant prospects for addressing major public health issues (Adebayo, 2016). Such optimism is based on the increasing Internet penetration as well as the intrinsic characteristics of social media. For instance, in developing countries phones are the primary source of accessing the internet and this has enabled the recent growth of social media access (Perrin, 2015). Having access to mobile-enabled social media platforms assists people to share knowledge from everywhere and anytime (Kane, 2017a). As such, the health sector has adopted these applications to move awareness and outreach to online and mobile programmes that are consistent with today's audience culture (Hyden and Cohall, 2011). As a channel for health communication, social media is an avenue for endorsement of behavioural options made by a network of friends or followers on social media platforms (Adewuyi and Adefemi, 2016). Despite this widely acknowledged role in accelerating access to information, the usefulness and opportunities provided by social media are still a point of scepticism in most developing countries that are trying to discern which strategies are more effective and efficient for the health sector (Obijiofor et al. 2005). Understanding the adoption of social media to communicate health maybe appreciated based on the theory of communication affordances.

The theory of communication affordances focuses on how an object’s utility (intrinsic characteristics of social media) is drawn from the perceived environmental cues (Jones, 2003). From a utility perspective, social media offers advantages that are far pulled from what traditional media can do. Whereas traditional communications, such as newspapers, television and radio, are important for setting the agenda on key health matters, they are prone to unidirectional information flows that tend to position receivers of health information as objects (Nakiwala and Semujju, 2018). Social media on the other hand is rooted in a participatory and collaborative culture that generates some form of a social network (Allan 2006; Bivens 2008). Such a network, as Lievrouw (2013) has observed is important for producing user interactions that facilitate information sharing, while providing a feedback loop for user expressions and opportunity for deliberative engagement. Maksymowicz (2014) also argues that such a network does not just accelerate information flow, but extends its reach to specific target sections of the population.

Lievrouw and Maksymowicz’ observations are supported by an audience study on social media and HIV/AIDS communication that established 6 perceived benefit (affordances) that social media brings to health communication that include: (1) access to information, (2) enhanced ability to communicate, (3) having an anonymous identity, (4) a sense of social and emotional support, (5) establishing a virtual community, and (6) geographical reach (Taggart et al., 2015). The affordances approach provides a framework for understanding how web 2.0 technologies are integrated into everyday communication practices, thereby affecting subsequent patterns (Govender, 2011; Schrock, 2015). Therefore, an affordance is triggered by the particular ways in which an actor, or set of actors, perceives and uses an object (Jones, 2003). Rooted in James Gibson's (1986) ideas, the affordances approach espouses the view that the world is perceived not only in terms of object shapes and spatial relationships but also in terms of object possibilities for action. Social media might be used to increase the rate at which the health sector disseminates new information and to further amplify health messages from traditional media sources such as television and radio (Schein et al., 2011). This makes it possible for health information and campaigns to reach more individuals than previously envisioned through cyber space.

Bringing this to bear on health, social media can be useful in accelerating not just health information flow, but also expand the reach of health communication programmes and campaigns. A study on the use of Facebook in HIV/AIDS prevention among young people concluded that Facebook was a popular, affordable and accessible communication platform for young people in Uganda which health communicators need to embrace to further augment HIV/AIDS prevention (Kakooza, 2018). Facebook is the most popular platform globally, with two billion monthly active users and an average of 1.62 billion daily active users (Facebook, 2020). Facebook statistics for Africa indicate over 160 million users (Internet World Stats, 2020), which makes Facebook an important platform for health communication. However, developing countries are still faced with high illiteracy rates as well as poverty and harsh economic situations, limited Internet penetration, high costs of access, and poor telecommunications infrastructure (Jørgensen, 2010). Such factors affect the adoption and use of Facebook for disseminating heath information, since the communication possibilities of a given technology depends on its market demand, technical advances and feedback from the consumers (Goggin, 2011). Moreover, health communication professionals still grapple with failure to effectively deploy social media in their work (Kaplan and Haenlein, 2009) for lack of appropriate information (Youngh, 2011), few users on social media (Oosterveer, 2012) and limited Internet penetration. Consequently, communicative affordances enable research into how intrinsic values and properties of given communication technologies may factor into their adoption and use (Boase, 2008). It is within this framework that this paper discusses how health promoting organisations in Uganda have used Facebook in the communication and promotion of health including the barriers they face in using Facebook to disseminate health information.

Uganda has been recognised for its use of mass media in fighting HIV/AIDS (Stoneburner and Low-Beer, 2004). Although health information is largely channelled through the traditional mass media especially radio whose access on average stands at 72%, access and use of social media platforms in Uganda stands at 77.2% among young adults (Uganda Communications Commission, 2015). Internet World Stats (2020) put the number of Facebook users in Uganda at 2.4 million people which makes it the most popular social network site in Uganda accounting for 55% of users (StatCounter, 2020). This growing popularity of social media in Uganda is attributed to the high number of young people who account for 78% of the total population of 45 million people (Population Secretariat, 2014; World Bank, 2020). Young people are more predisposed to using social media in their social interactions rather than traditional media. This renders traditional media inadequate in reaching the majority of the population in Uganda (Nabwiiso, 2015). Recognising that the biggest percentage of the population in Uganda are young people, the potential to reach and engage with this audience with health information is greater through social media.

Within the context of social constructivist views, we sought to explore what opportunities Ugandan organisations dealing in the dissemination of health information obtain from Facebook, and why it is challenging for organisations to use Facebook in health communication. This study took a qualitative analytic approach, for both data collection and analysis to generate knowledge heeding to an understanding of the subjective meanings and experiences about the research question (Creswell, 2013). The study sample included seven Ugandan organisations that were purposively selected considering their involvement in health education, promotion and communication in the country as well as having an active Facebook page — which was the subject of this study. The choice of these organisations reflects the current health programming in Uganda that is focused around reproductive health, HIV/AIDS prevention and treatment and Malaria control. These selected organisations are leading health communication interventions in these programme areas in partnership with the country’s Ministry of Health. The study involved ten key informants who were purposively chosen from these organisations, taking into consideration their work portfolios of management, field implementation, communication and advocacy. The table below provides a summarised profile of the respondents and the subject of the in-depth interviews.

In terms of ethics, permission was obtained from the organisations that were engaged in this study and all respondents voluntarily accepted to participate in the study by signing informed consent forms as advised by Coughlan and Perryman (2015). The seven Facebook pages of the organisations under study were open and publicly accessible, indicating no specific expectation for privacy. However, the focus of the study was limited to owning an active Facebook account by the organisation. This study was carried out in Uganda in 2017 with approval from the Uganda National Council for Science and Technology.

The study used in-depth interviews that employed a semi-conversational approach that allowed for the intensive exploration of insights. Interviews lasted up to an hour in each case, and they were all recorded for proper management of data. The interviews were designed to solicit information regarding organisational experiences of using Facebook in health education/communication in order to answer the first research question on how health organisations have used Facebook for health information. The interviews also focused on whether organisations had a social media strategy and how the use of social media impacted the work of communicating health. To answer the second research question, participants were asked about the constraints their organisations encountered in their use of Facebook for health education and communication.

The study used thematic analysis, starting with the transcription of the recorded audio material from the in-depth interviews. This helped in building a researcher-data relationship that provided insights on how the data related to the ideas in the literature and theory. We read through each of the transcripts in their entirety several times in order to get immersed in the details and make sense of the in-depth interviews as a whole (Creswell, 2013). We then coded and categorised the data, which enabled us to establish patterns and commonality in the views of different participants (Struwig and Stead, 2015) as presented in this paper.

From the analysis, Facebook is put to four basic, but complementary uses: (i) complementing traditional channels of communication, (ii) providing interactive health learning (iii) encouraging user participation in health discussions and (iv) enabling specific audience targeting. In complementing other means of communication, participants noted that Facebook and social media in general are used as part of the wider media mix for disseminating health information. From our review of Facebook pages for example, we found that some of the organisations had a sizable number of followers. For example, by August 2020, one of the organisations had 22,195 followers while another had 3,344 followers who receive and sometimes comment on information posted on the page. Organisations also used Facebook to share instant communication about field and community outreach activities, to inform their online audiences without fear of financial and other practical difficulties:

The above finding suggests that the use of social media does not present restrictions as the case is with traditional media, including payment for space or time. Another respondent was of the view that Facebook caters for a number of options through which health information can be shared online.

Thus, social media in general can provide complementary exposure to health information for the public and allows agencies to reach even more audience at little or no cost.

In regard to interactive learning, the analysis revealed that organisations rely on Facebook as a tools to teaching the public and users about health, which is done through not just interaction with experts, but also through providing instructive learning materials on their platforms. It was noted that online users are also able to learn from each other, when they meet online, through engagement about information posted on the organisations’ platforms. Participants noted that in doing so, Facebook provides an opportunity for people who have similar health interests to meet, share, and dialogue about issues they are concerned about and also learn from each other.

Participants described how their online followers were able to send in questions and inquiries about various health topics and expect a response from the organisation’s representative from time to time. It is possible through interaction on Facebook to guide users through their health decision making process, which they said is practically difficult in the traditional media context. These online interactions can be in real-time and are not hampered by distance between the users and the health organisations as this participant observed:

The open and participatory nature of Facebook was seen as an opportunity for users to create a network based on mutual health interests which further allows for collective learning as the quote below illustrates:

Organisations used Facebook to facilitate user participation in health discussions whereby followers could debate key health issues and voice their opinions and concerns about messages they see online.

As such, Facebook gives organisations the opportunity for reading raw emotions and fast feedback from their users, which in turn allows them to adjust their interventions and to deliver services in ways that suit user preferences: “We are able to read and relate to raw emotions with people [freely] speaking their mind,” one participant observed. Another said:

Participants noted that previously the mainstream media provided limited opportunities for members of the public to engage in debates concerning their health, mainly because of the need to adhere to certain operational rules. One participant noted that members of the public can talk about their health through cyberspace while remaining anonymous, which gives organisations an opportunity to hold conversations with those affected by health issues. This “assists the intended audience to reflect as individuals and discuss as communities about their solutions to health challenges [that] they are facing” (R10). This helped to stimulate further the conversation about issues of concern.

Lastly, participants talked of using Facebook for specific audience targeting, which they said involved reaching out to particular sections of the public whenever necessary. They said that Facebook allowed them direct individual messaging, which is uncommon in traditional communication, as well as public messaging whenever they want to reach out to a wider audience. In one of the organisations, the participant described how they had been able to interest young people and the youth to go for HIV/AIDS testing as well as encourage them to live positively and healthy, if they were HIV positive. In another organisation, a participant described how specific audience targeting had helped his organisation to reach out to sexual minorities, who he said had been often ignored in the mainstream communication campaigns that focus on HIV/AIDS as he explained:

He explained that his organization used Facebook to reach out to the gay community and commercial sex workers who he described as most-at-risk populations, but not easily reachable. He noted that Facebook provided a safer channel to reach out to such closed groups within the population. This gives organisations the opportunity to receive and act on a diverse range of views to stimulate learning and actions, sometimes beyond the expectations of these organisations.

The foregoing withstanding, our analysis showed that a number of barriers still hindered the use of Facebook in dissemination of health information and implementation of health campaigns by the organisations in this study. The barriers included: (i) limited content management skills, (ii) difficulty in monitoring and evaluation, (iii) limited participation (iv) Loss of control over messages and (v) information overload. These are explained below.

Proper use of Facebook is encumbered by the lack of content management skills. During our review of the Facebook pages of the organisations involved in this study, almost all the Facebook pages maintained the traditional-monologue media style. Other Facebook pages looked unattractive while several retained the static, noticeboard style that is characteristic of printed materials, such as posters and newspapers, commonly used in communicating health information. In some cases, there was limited or no effort to provide interactive content. This was also the view of some participants as the following quotes indicates:

Some participants said that while social media requires engaging and interactive formats, this was not being done: “Messages developed for radio discussions are the very ones that are posted on social media” (R10). This makes it hard for the users to interact or even share this form of content.

Another barrier expressed by participants was the difficulty in monitoring and evaluation of Facebook health communication content, especially in terms of the impact and outcomes for health behaviour and actions. It was established that some organisations lacked impact reporting tools that can be used for Facebook-based health interventions. One participant disclosed that most health communication initiatives in Uganda are donor funded with strict requirements for demonstration of returns on investments. This was still difficult in social media communication. The concern pointed to a lack of clear appreciation of how social media outputs can be assessed and evaluated. For example one participant wondered about what to evaluate: “Is it a well-discussed post or thread” (R2). The majority of the organisations also reported a lack of clear strategy and plan to guide their use and evaluation of social media content. Despite this, one of the participants revealed that his organisation was engaged in evaluation of short-term, but not long-term social media campaigns.

In general, the foregoing discussion shows that the organisations involved in this study still find difficulty in monitoring and evaluating social media-based content in relation to the goals of their interventions.

The third obstacle, limited interaction, concerned the lack of participatory approaches in the way organisations used Facebook in their communication of health information. In particular, this study found that Facebook pages of many organisations remained non-interactive, in same way it is in mainstream media. For example, we noted that there was a lag in timely updates of content on health campaigns. As observed from the Facebook page of one campaign, a follower commented that: “No more posts and updates, what is wrong with Obulamu (the campaign) this year?”. Therefore, while social media is built on the principle of timely message engagement, the long lapses that the organisations were taking to respond to queries and to answer questions from their users stood in the way of facilitating learning among members of the public they aspired to communicate with.

Such intermittent posting of content and audience engagement thus highlights the need to adhere to good practices of timely social media engagement.

As regards to message control, some participants mentioned that there was fear among some organisations over the loss of control over messages when they are posted on social media. They opined that once messages are shared on social media, organisations lose control over them. “There is no way one can monitor counterproductive distortions or comments that are not shared on your page” (R10). Organisations are weary of the speed at which messages travel on social media that makes it hard to follow them including all discussions that are triggered off.

In the end, health communication programmers lose control over messages and of all distortions and misinformation that result from them.

Participants viewed the high volume of information and clutter on Facebook as an obstacle especially because much of it often comes with inaccurate information. The findings revealed that given the enormous volume of information, health information faces high competition for attention.

This requires organisations to be creative in the way they package and repackage health information in order to maintain interest and attention from their target of online users. The availability of good content, timely responses and engagement on social media is what makes it popular. “Everyone in the organisation should be encouraged to engage in the sharing of these messages” (R2). But one participant advised that pinning and boosting messages on Facebook, following comments, likes or sharing these messages makes them readily available for access on Facebook. This promotes health messages in a way that more people will be able to receive them directly and more frequently so as to solve the message clutter challenge.

The study set out to interrogate how Facebook is used for health communication and the challenges that hinder its use in the dissemination of health information in Uganda. The study established that when health organisations in Uganda deployed Facebook in their work, they used it for specific audience targeting, complementing legacy media, providing interactive health learning and encouraging user participation. In addition, Facebook is less costly compared to traditional forms of mediated communication and free from the restrictions and obstacles that are characteristic of the former. This is supported by the affordances approach which postulates that the use of a given platform is enhanced through the various ways such a platform may be used to facilitate communication (Jones, 2003). This suggests that social media traditional media in complements and allows agencies to reach even more audiences with little or no cost involved.

The affordances of complementary message exposure, interactive learning, participatory message engagement, and specific audience targeting as established by the study support the view that Facebook can be used to increase and amplify the rate at which health information can reach more individuals through the cyberspace. This implies that cyber communication is distinct, with user agency opportunities that are rather different from what can be achieved in traditional media. The communicative affordances approach supports such theorisation that the use of social media, like Facebook, can bring benefit to communication programmes in many areas including health. This makes Facebook an important channel for communicating health information to a varied audience. The interaction and engagement among social media users builds into a social network as a trusted point of reference for credible engagement, which is an opportunity for quality of communication.

The findings in this paper indicate that some health organisations have also taken to the use of Facebook, albeit with a number of concerns and constraints. The study revealed a number of acknowledged constraints, which means the full potential of Facebook, in health communication, education and promotion is still out of reach for Ugandan organisations. For example, participants viewed Facebook and social media in general as hard-to-work with, particularly because they lacked specialised skill in managing social media (health) content. This attitude affects the way Facebook will be deployed by organisations as a medium for communicating health. It is here that (Badea (2014) cautions organisations to assess whether social media is necessary for their brand and their preparedness to implement social media in their wider communication plan. This is not surprising given that studies from elsewhere have shown that working with social media for any form of organised and deliberate communication efforts can present challenges (Flew, 2005; Steenkamp and Hyde-Clarke, 2014; Van Dijk, 2006). The study established that Facebook as a medium is constrained by information overload and loss of message control and credibility.

Such factors attributed to the medium (Facebook) could be managed basing on the organisation’s culture towards engaging Facebook for health communication. Organisations need to decentralize and enable employees to make prompt decisions which may in return increase customer satisfaction and business competitive advantage (Cetinkaya and Rashid, 2018). The study revealed that health organisations in Uganda have prohibitive social media guidelines to maintain control over health messaging. Such guidelines are not in tandem with the reality that social media platforms provide an opportunity for each individual to be in charge of their communication needs. It is possible for organisations to manage information overload and loss of message control by empowering their employees to be true ambassadors of the organisations to timely respond to feedback and build message credibility (Banuta, 2011). The findings established that health organisations in Uganda are not used to timely message responses and engagement that social media attracts. This concern has been raised by Schein et al (2011) citing inconsistence in social media messaging with unopposed viewpoints that counter core public health recommendations. Addressing message inconsistences and distortions calls for building of a trusted team that is empowered to continuously engage and direct the advocacy as intended. This gives an opportunity to health communicators to engage with their audiences by guiding the users through questions, clarifications, or thoughts as they interact with the message as well as share within their network.

Understanding online audiences is also key. This is important in determining the type of messaging that could work for particular sections of online audiences. Findings in this paper indicate that Ugandan health organisations use Facebook and social media in general as notice boards, an approach akin to what is common with traditional unidirectional communication. Doing so disregards the dynamic nature of both social media and the online audiences. As noted earlier, social media offers a wide range of interactive capabilities (Anand, 2013; Kaplan and Haenlein, 2010), which, coupled with the vitality of online users, calls for a great deal of effort in routine messaging, timely updates, and answering people’s concerns in order to maintain interest and engagement.

The study also established that organisational factors that constrain the use of Facebook in communicating health information in Uganda include: low appreciation of social media, lack of social media strategy, poor social media management skills, failure to undertake effective monitoring and evaluation, and failure to keep up with social media’s electric participatory culture. Organizations have to adapt their communications strategies to incorporate user generated content and feedback in collaborating and co-creating content with target audiences (Schein et al., 2011). Health communication programmers ought to appreciate that social media is a different forms of interpersonal communication, offering socialistic characteristics at both the individual and community levels. This means that organisations need to create a structure where social media is a core in their business processes (Cetinkaya & Rashid, 2018) including in health interventions. The challenge, however, is for organizations to make their structures flexible and harmonized to successfully integrate social media into their communication policy (Badea, 2014). Organisations need to adopt to the participatory culture that is commonly exhibited online and on social media platforms.

It is clear that to fully utilise Facebook, Ugandan health organisations (and others that are in countries in a similar situation like Uganda) need to institute particular change actions, including being more interactive and to patiently engage users in health discussions that concern them, while online. This calls for a proactive social media strategy that can fulfil this strategic goal for organisations. Social media is a timeless platform that require dedicated communication personnel to handle interaction and engagement for health interventions. This forced some organisations in Uganda to recruit social media managers in sustaining message continuity, interaction and engagement in health communication efforts. In addition, organisations need to keep abreast with and improve on the appropriate packaging of health content for social media, in ways that make it accessible, interactive and appealing to online users. Organisations ought to acquire more knowledge and increase their ability in using social media for health communication (Fusi & Feeney, 2016). There is need to build capacity for social media use and management among health communication practitioners as the ever-changing social media tools demand that skills building is key. Social media may become the strength of an organisation when it is used to develop a relationship with the target audience as well the capacity of its employees (Cetinkaya and Rashid, 2018). Personnel in management who hold key decision-making positions in organisations need to be retooled to appreciate the contribution of Facebook and other social media in health communication interventions. Organisations develop a deeper appreciation and understanding of social media to effectively plan for its use in health interventions (Betsy et al., 2015).

Deploying Facebook for effective communication of health, including monitoring and evaluating, requires a social media strategy that should guide organisations on what to achieve with online efforts. The study established that some organisations were not decided on how to deploy Facebook in their work, especially on how to monitor and evaluate their online efforts. Moreover, some organisations were still grappling with how to manage social media content because they lacked a social media policy. A social media strategy can guide on whether an organisation wants to use social media to engage with people, for public relations or to pass out information. Such a strategy would help organisations to determine their interests and those of their online users in relation to the overall goal of deploying social media for communicating health information. If the foregoing constrains and challenges can be nipped, it is possible for health organisations in Uganda and elsewhere in developing countries to usefully deploy Facebook and social media in general to enhance the benefit of health communication especially for the virtual community.

There is a growing interest in deploying Facebook in health communication interventions in Uganda. This is cognizant of the fact that social media are the current media platforms that must be embraced for contemporary health communication. By interrogating how health organisations in Uganda use Facebook and what barriers they experience, the study established that Facebook provides opportunities for enhancing the dissemination of health information. The study established that social media opportunities for health communication are constrained by both the medium and organisational factors. We argue for the improvement in the culture of organisations towards the use of Facebook and generally social media in health communication. This calls for social media capacity building of key decision makers in organisations, retooling of staff in social media content management skills, and the establishment of social media managers within the organisation structure. Such effort will improve the appreciation of social media as a credible platform for health information and will pave way in handling the medium constraints that have been discussed in this study. In contributing to the growing body of knowledge, this paper has provided practical solutions in order to harness the potential and positioning of social media platforms in the promotion of health programmes and information. Instead of solely relying on traditional media and communications, organisations should learn how to work within the expanding scope of new media opportunities and capabilities.

Our study was limited, given that it focused on a small number of health organisations. In the case of Uganda, further research is needed that can address: practical experiences of the use of social media in health communication; the advantages that accrue across social media platforms as well as what makes each platform distinct in their deployment in communicating health information. Further, there is need for an inquiry into the nature of message interaction between health programmers and online audiences to fully appreciate the opportunities as well as the constraints that are triggered by the participatory nature of social media. However, beyond the particular case of Ugandan organisations, this study provokes a deeper empirical investigation into the prospect for social media-based health campaigns in the developing world.