RESEARCH SUMMARY Title: Nigeria Qualitative Report Study location: Three Nigeria states: Lagos, Kano, and Aba Study dates: June 2008 (presentation date) Introduction Objectives: A baseline study targeting the Nigerian community, aimed at establishing and understanding attitudes, behaviors, and practices towards Avian Influenza. The specific qualitative objectives were as follows: • Establish existing knowledge, attitudes and perceptions the community has towards Avian Influenza • Establish existing prevention methods of Avian Influenza amongst the community members • Establish community knowledge of the programs/interventions on Avian Influenza o Establish community perceptions and attitudes towards the Avian Influenza programs/interventions o Establish sources of information and means of disseminating information on Avian Influenza within the community. Methodology: Community members (opinion leaders, health officers, local administrators, and poultry farmers) participated in face-to-face, in-depth, exploratory interviews. The study instrument consisted of a semi-structured discussion guide, which allowed free flow of information and in-depth probing. All interviews lasted approximately 1 hour. Key findings • Poverty is the main community concern, manifested through lack of access to education, food, health, shelter and lack of information. • Poor management of public resources by politicians combines with high rate of unemployment amongst youth to aggravate the situation. • Nigeria has poor infrastructures for education, health, and transportation and has trouble providing basic amenities such as water, shelter and electricity. • The health sector lacks sufficient facilities and qualified personnel to manage existing demand. • Cost of health services deters many from seeking services from mainstream health centers. Many are more likely to pt for self-medication or “native” traditional doctors. • Formal health facilities are far from communities and difficult to reach given poor roads. • Public attitudes toward health policies are negative due to existing myths. • Corruption in the health sector includes diversion of government drugs by public hospital staff. • Public has a poor attitude towards sanitation and are reluctant to participate in prevention campaigns despite awareness of the importance of prevention. • Government officials assert that existing health structures are sufficient to cater to Nigerians’ needs, even in event of a flu pandemic. • Civil leaders feel the current health system needs improvement. • There is high awareness of avian flu amongst poultry farmers and community experts due to 2006 outbreak and subsequence national emergency and media campaigns. • AI is not a main concern to the government and community at large. Other life challenges take priority, such as economic hardship, education, and infrastructure problems. • According to the government’s hierarchical structure for reporting an outbreak, the public should report to the local government and/or traditional leaders, who in turn report to the federal health authority. In practice, the public usually opts to report incidents to veterinarians who are either in the public or private sector. • Prevention and treatment of AI is likely to be a challenge, given the lack of in-depth information on AI symptoms in comparison with other bird disease symptoms. • Poverty, culture, and religious practices create additional barriers to prevention and treatment of AI. • The community as a whole does not have capacity to manage an AI pandemic emergency. Infrastructures are poor and no facilities are in place. Recommendations • Create awareness and educate the community on AI symptoms, impacts on humans, prevention, and treatment. Mass media and public rallies would be appropriate. • Create systems to involve the local community in tackling emergencies. • Create policies to compensate poultry farmers in an event where there is loss of income due to AI. • Encourage farmers to form micro-finance groups to support drugs and other activities aimed at preventing AI. • Building partnerships between NGOs and government to marry expertise and experience of the former with the latter’s ability to mobilize. • Government must step up education activities to counter existing myths about health services. Use of religious leaders to help break resistance.