Behavioural Challenges around Avian Influenza

1
Behavioural Challenges around Avian Influenza

• Evidence from Egypt

2
Map of Egypt
Higher concentration of poultry
Delta
Upper Egypt
Large vulnerable groups rural areas
3
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).

4
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.

5
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.

6
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 childrens contact with poultry
  (cleaning, helping or playing)
• Reporting
• Sick or dead birds
• Similar symptoms of influenza especially after
  handling birds

7
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)

8
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).
• Egypts DHS (forthcoming).

9
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.

10
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.

11
Washing hands with water and soap after cleaning
and feeding poultry
12
Knowledge around protection from AI
13
Knowledge of covering nose and mouth when
handling live / dead birds
14
Practice of covering nose mouth when
slaughtering birds
15
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.

16
Knowledge and Practices of keeping poultry away
from living and sleeping areas
17
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

18
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