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Document Sample
Behavioural Challenges
around Avian Influenza
Evidence from Egypt
Map of Egypt
Delta Higher concentration
of poultry
Upper Egypt
Large vulnerable
groups – rural
areas
March 21, 2012 UNICEF
2
The Current Situation
• Backyard breeding is widely prevalent.
• Poultry is a major source of protein for
Egyptians and a source of income for many
families, especially in rural areas.
• Among the highest vulnerable population (the
poorest groups) owning poultry, a large part
live in rural Upper Egypt.
• However, the concentration of poultry birds is
greater in the northern governorates (Delta).
March 21, 2012 UNICEF
3
The Current Situation – Human Cases
• February 2006, first H5N1 outbreak in poultry
and first human case in March 2006.
• H5N1 has been detected in 22 of 36
governorates.
• To date, 43 infected human cases, 19 deaths,
majority among women and children.
• Contact with birds:
– 89% in household, 5% in commercial farms,
and 5% other means.
March 21, 2012 UNICEF
4
Communication Task
Through media and inter-personal outreach as well as
advocacy efforts, ensure that:
general public is aware of AI and means to
avoid getting infected.
vulnerable groups are aware of and know how
to protect themselves, their family and their
birds from AI.
policies and services exist for people to be
motivated to practice key preventive actions.
March 21, 2012 UNICEF
5
Key behaviours promoted
Cleaning
Hand washing after handling birds.
Cleaning of poultry areas.
Protection
Avoid buying from lay merchants.
Coverage of nose and mouth during handling poultry
Keeping special clothes, shoes when in contact with poultry
Safe cooking
Safe slaughtering
Safe disposal of wastes and dead birds
Poultry vaccination
Separation
Keeping poultry away from living area or bedrooms
Avoiding poultry roaming in streets
Separating of different kinds of poultry
Avoiding children’s contact with poultry (cleaning, helping or playing)
Reporting
Sick or dead birds
Similar symptoms of influenza especially after handling birds
March 21, 2012 UNICEF
6
Communication strategies
• Community outreach through radiats to reach
vulnerable populations
• Mass media for sensitizing/reaching general
public
• School based interventions
• Training of trainers to ensure outreach workers
are equipped with complete and accurate
knowledge
• Media/journalist training for wider and in-depth
coverage
• Mobilization of religious/social leaders (yet to begin)
March 21, 2012 UNICEF
7
Available Evidence
MOHP Pilot KAP survey (September, 2006).
MOHP/UNICEF Baseline / KAP National survey
(June, 2007).
FAO/WFP study (September, 2007).
Qualitative community study (UNICEF,
forthcoming).
Egypt’s DHS (forthcoming).
March 21, 2012 UNICEF
8
Awareness of AI
• Overall, around 9 in 10 respondents reported
exposure to AI messages through some source
across regions.
• Primary source of information is TV - more than 95%
watch TV daily for about 2.5 hours on average.
March 21, 2012 UNICEF
9
Perceptions related to AI
• There is a strong agreement among respondents that
getting avian influenza would be very serious with a
mean score of 4.7.
However,
• The perception is that they are at lower risk of getting
infected; a mean score of 2.1.
March 21, 2012 UNICEF
10
Washing hands with water and soap
after cleaning and feeding poultry
95.1
100 89.8 89.3 91.6 88.2
80
60
40
20
0
Total Urban Rural Lower Upper
Egypt Egypt
March 21, 2012 UNICEF
11
Knowledge around protection from AI
100
80
65.9
55
60 48.1
40 26.9
16.3
20
0
Put gloves/plastic Put gloves/plastic Cooking birds at Heard of AI Put dead birds in
pocket or cover pocket when adequate tempe- vaccines plastic bag, throw in
nose & mouth when handling with dead rature garbage
handling live birds birds
March 21, 2012 UNICEF
12
Knowledge of covering nose and
mouth when handling live / dead birds
100
80
60
40 26.3
23.3
14.3 16.2 18.2 15.5
20 13.2 10.3
8.3 7.413 16.3
0
Urban Rural Urban Lower Upper Total
Gove. Egypt Egypt
rnorates
Live birds Dead birds
March 21, 2012 UNICEF
13
Practice of covering nose & mouth
when slaughtering birds
100
80
60
40
20
1.2 2.3 1.7
1.1 0.7
0
Total Urban Rural Lower Upper Egypt
Egypt
March 21, 2012 UNICEF
14
Where do households keep their
poultry?
• Generally, 46% of households keep their poultry
caged outside home (plot, yard, roof or balcony).
On the other hand:
16% of home breeders keep poultry in a yard / plot outside
a cage.
12% keep poultry inside one of the rooms in the house
and outside a cage.
10% keep poultry in front or beside the house
10% keep poultry on the roof outside a cage.
5% keep poultry at the middle of the house.
March 21, 2012 UNICEF
15
Knowledge and Practices of keeping
poultry away from living and sleeping
areas
92.5 91.2 93.3 95.3
100 91.7
80
60
Knowledge
40 Practice
17.7
20 15.4
11 10.8
4
0
Total Urban Rural Lower Upper
Egypt Egypt
March 21, 2012 UNICEF
16
Lessons Learned
Awareness of AI high, risk perception is low
Promoting epidemiological correct practices need
to be balanced with social realities and existing
practices
Behavioral interventions to affect backyard
poultry practices is challenging.
Compensation policies and surveillance systems
impact behaviours
Strengthening the “change agents” capacity to
engage with communities is critical
March 21, 2012 UNICEF
17
To Stop AI at Source, Communication
for ...
Enhance reporting – by addressing negative
incentives, issues around stigma when reporting
leads to culling
Improve bio-security – small, medium, large
producers involved in marketing and processing
chicken by engaging with communities incl. role of
children
Marketing chain restructured – identify risk points
along the chain during poultry movement
March 21, 2012 UNICEF
18
