Avian Influenza Global Communication Leadership Meeting

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Gordon Hoover
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1 Avian Influenza Global Communication Leadership Meeting June 2008 Cape Town, South Africa AED By: Eleanora de Guzman Country Coordinator AI BCC Vietnam 1

2 Activities: Social Research Definition : Social research is about using scientific methods to measure, describe, explain or predict social and economic phenomena From : UK Government Social Research 2

3 AI BCC Systematically use research to provide evidence to guide AI BCC communication strategy and activities 3

4 How we have used research : Vietnam 1) Baseline situation analysis 2) Pretest communication materials 3) Assess effectiveness of interventions 4) Assess impact of interventions 5) Determine changes in knowledge and practice 6) Probe values and beliefs underlying practice 7) Gather comparative information for overall situation analysis 4

5 1) Baseline Situation Analysis To determine current levels of knowledge, attitudes and practices as basis to guide programming and track changes Baseline Survey Dec 2005 (IRL) sector 4 farmers Quantitative Survey May 2008 (TNS) sector 4 and sector 3 farmers 5

6 Key Results : Baseline Survey 2005, IRL High awareness of AI but poor correct knowledge of signs and prevention measures 95% vaccination rate Vaccination seems to create sense of security; thus, other prevention measures not practiced 6

7 Key Results : Quantitative Survey 2008, TNS Vietnam: Knowledge, I significantly lower knowledge in Sector 4 farmers and need to build knowledge on symptoms in humans beyond fever K1. Events to report as AI outbreak K2. AI symptoms in humans Sudden, massive death of poultry Fever Difficulty breathing Cough Head ache Muscle ache 8 11 Sore throat Vietnam (total), Sector 4: n=802, sampling error: +/- 3.5% (max), unprompted Sector 3: n=404, sampling error: +/- 4.9% (max), unprompted Sector 3 (n=404) Sector 4 (n=802) 7

8 Key Results : Quantitative Survey TNS, 2008 Vietnam: Knowledge, II Good level of knowledge in these areas K3. Persons to report to Animal health worker K4. Actions when someone has AI Village head Bring to a health facility Vietnam (total), Sector 4: n=802, sampling error: +/- 3.5% (max), Sector 3: n=404, sampling error: +/- 4.9% (max) Sector 3 (n=404) Sector 4 (n=802) 8

9 Vietnam: Knowledge (risk prevention poultry), III vaccinations may create a false sense of security as it is the only action considered by most K5. Actions to reduce AI risks in poultry Vaccinate poultry Wash hands when handling poultry Keep in fenced area/pen Change clothes Separate chickens & ducks Seperate new poultry Keep visitors away 6 8 Store manure/fertilizer Vietnam (total), Sector 4: n=802, sampling error: +/- 3.5% (max), Sector 3: n=404, sampling error: +/- 4.9% (max) Sector 3 (n=404) Sector 4 (n=802) 9

10 Vietnam: Attitude (Top Box), II the emphasis on vaccination means other, simple, actions are almost ignored and may have long term ramifications Vaccinate poultry Wash hands when handling poultry A3. Belief in preventive actions Keep poultry in fenced areas for poultry ( very necessary ) Separate new poultry Keep visitors away Separate chickens & ducks Change clothes Store manure/ fertilizer Vietnam (total), Sector 4: n=802, sampling error: +/- 3.5% (max), Sector 3: n=404, sampling error: +/- 4.9% (max) Sector 3 Sector 4 Top rating = Very necessary 10

11 Vietnam: Behavior to protect poultry (unprompted) besides vaccination only few actions top of mind in both Sector 3+4 Vaccinate poultry Wash hands when handling poultry B1a. Activities performed to protect Keep poultry in fenced areas/pen poultry (unprompted) Separate new poultry Separate chickens & ducks Keep visitors away 11 9 Change clothes Store manure/ fertilizer Vietnam (total), Sector 4: n=802, sampling error: +/- 3.5% (max), Sector 3: n=404, sampling error: +/- 4.9% (max) Sector 3 (n=404) Sector 4 (n=802) 11

12 Vietnam: Behavior to protect humans (unprompted) strong need to create behavioral change for human protection Wash hands when handling poultry B2a. Activities performed to protect humans (unprompted) Don t eat dead poultry Don t eat under cooked poultry Burn and bury dead poultry Don t eat poultry blood Wash hand before cooking Don t let children handle poultry Change and wash clothes Vietnam (total), Sector 4: n=802, sampling error: +/- 3.5% (max), Sector 3: n=404, sampling error: +/- 4.9% (max) Sector 3 (n=404) Sector 4 (n=802) 12

13 Summary USAID Indicators 1-4 The indicators are set out according to the USAID standard and are summarized in the tables following. Note that indicator 5 and 6 are represented on both Knowledge and Practice. All questions were asked in an unprompted format. K1 K2 K3 K4 K5 K6 K5 K6 Key Questions (unprompted) Vietnam Sector 3 % Vietnam Sector 4 % Identifying a possible outbreak of AI (massive and rapid death of poultry) AI sign in humans (at least 3 correct answers) To whom an AI outbreak should be reported (only correct answers counted) Action to take with AI victims (take to health facility) Knowledge about ways to decrease AI in poultry (at least one activity) Knowledge about ways to decrease AI in humans (at least one activity) Action taken to decrease AI in poultry (at least one activity) Action taken to decrease AI in humans (at least one activity)

14 Summary USAID Indicators 5 6 (Knowledge) K5 Knowledge about ways to decrease AI in poultry (unprompted) Vietnam Sector 3 % Vietnam Sector 4 % 1 Vaccinate poultry against AI Keep in fenced area or pen Separate chickens and ducks Keep new poultry separate for 2 weeks Wash hands with soap before handling poultry Change clothes when coming from other farm Keep visitors away from your poultry Store manure from other farm for 3 weeks 4 5 K6 Knowledge about ways to decrease AI in humans % % 1 Wash hands with soap after handling poultry Wash hand with soap before cooking Change and wash clothes after handling poultry Do not let children handle poultry or eggs Do not eat duck or geese blood pudding Do not eat under cooked poultry or eggs Don t eat poultry that has fallen dead Burn and bury dead poultry

15 Summary USAID Indicators 5 6 (Practice) K5 Action taken to decrease AI in poultry (unprompted) Vietnam Sector 3 % Vietnam Sector 4 % 1 Vaccinate poultry against AI Keep in fenced area or pen Separate chickens and ducks Keep new poultry separate for 2 weeks Wash hands with soap before handling poultry Change clothes when coming from other farm Keep visitors away from your poultry Store manure from other farm for 3 weeks 7 6 K6 Action taken to decrease AI in humans % % 1 Wash hands with soap after handling poultry Wash hand with soap before cooking Change and wash clothes after handling poultry Do not let children handle poultry or eggs Do not eat duck or geese blood pudding Do not eat under cooked poultry or eggs Don t eat poultry that has fallen dead Burn and bury dead poultry

16 2) Pretest communication materials To determine appeal, comprehension, believability and personal empathy of messages and materials Pretest of 2 posters, 2006 (in-house) Pretest of 2 TV spots, 2006 (TNS) Pretest of 2 leaflets, 2006 (in-house) Pretest of 4 DAH materials, 2006 (in-house) 16

17 3) Assess effectiveness* of interventions To determine whether the training activity was effective in improving trainees knowledge and skills Pre and post-test of trainees before and immediately after training * Whether objectives of training to improve knowledge and skills achieved 17

18 Key Results : Pre and post test scores of trainees Organization Before After Training Training VNFU 74.3% 95.3% VIPA 77.4% 94.2% VFA 60.2% 89.0% VWU 78.9% 93.2% 18

19 4) Assess impact* of specific interventions To determine whether training has positively affected performance after training, once trainees are back in their communities Assessment of Post-training follow-up activities January 2008 (Nielsen) * Whether knowledge and skills gained after training are used during interpersonal communication 19

20 Key Results : Post-training survey Nielsen 2008 All trainees report that they have conducted communication on AI; majority still continue to conduct Women s Union staff tend to discuss AI during group discussions 65% of trainees initiated discussions 39% and 29% of trainees conducted AI communication once a month and once a week, respectively 20

21 Key Results : Post-training Survey Key problems faced during AI communication : Difficulty for audience to understand concepts (40%) Farmers too busy to attend (36%) Audience said poultry vaccinated so no need for other measures (25%) Too many people in the group, hard to get everyone s attention (17%) Venue too noisy and uncomfortable (14%) Trainee not perceived as credible person on AI (10 21

22 5) Track changes over time To determine changes in knowledge, attitudes and practices over time Follow-up KAP Survey May 2007 (IRL) 22

23 6) Probe Values and Beliefs To probe and understand values and beliefs which influence practices based on surveys Qualitative Study of Duck Farmers (TNS, 2008) 23

24 Key Results : Farmers Perceptions Most farmers are deeply attached to their ducks and believe they know their flock very well Duck farmers rarely communicate with vet or local authorities, only when they come for vaccination They do not inform local authorities immediately about the death of their ducks, only when it occurs in very large numbers Farmers tend to rely on their own experience when treating sick ducks; only when their treatment fails will they consult the vet 24

25 Key Results : Duck Farmer Study on Vaccination Vaccination is adhered to by all farmers interviewed; however, some farmers esp. in the south use a lower dose for fear that young ducks may die of a heavy dose Vaccination makes farmers feel very secure about the health of their ducks and are less likely to practice other preventive measures vs. AI 25

26 Key Results : Duck Farmers Study on Free-ranging In the south, free-ranging plays an indispensable role since it saves up to 50% of the cost of feed Some farmers in the south free-range for long distances, some even across communes Fencing is not top of mind as an important measure vs. AI 26

27 Key Results : Duck Farmers Study Farmers have heard about AI, mainly from TV, but few can describe correct symptoms nor know about treatment Farmers think that AI is not relevant to them since they don t expect their ducks to catch AI; they never witnessed an AI case in their area 27

28 7) Provide overall situation analysis To compare information on key areas of knowledge and practices from several researches and provide an overall analysis to guide strategic planning and programming Summary of Key Results from AED, Unicef, CARE, ABT Surveys

29 Key Results : Comparison of Surveys Have you heard of avian influenza AED/ IRL ABT Yes 96% 98% 29

30 Key Results : Comparison of Surveys Signs of AED/IRL Unicef/ CARE** ABT AI in chickens known IRL * Sleepiness 68% 79% 51% Restlessness 75% Loss of appetite 59% 60% 62% 51% Diarrhea 21% 18% 24% 37% Ruffled feathers 32% 56% 43% 9% Sudden death 42% 22% Sudden death in large numbers 19% 40% 16% 30

31 Key Results : Comparison of Surveys Signs of AI in Ducks known AED/IRL CARE** ABT Sleepiness 63% 52% 66% Loss of appetite 67% 58% 52% Diarrhea 6% Ruffled feathers 36% 46% 23% Sudden death 38% 18% Sudden death in large numbers 22% 48% 5% 31

32 Key Results : Comparison of Surveys Perceived risk of their poultry getting AI ABT, 2.5 CARE, 2.6 UNICEF, 3.1 AED, Very unlikely Very likely *Measured on 1 to 7 scale with 1 as VERY UNLIKELY 7 as VERY LIKELY 32

33 What Rs do to prevent AI in poultry Prevention Measure practiced AED/ IRL Unicef/ IRL ** CARE** ABT Vaccinate poultry vs. AI 92% 89% 63% Keep in protected environment (enclosed area) 44% 49% 17% Keep in good condition (clean water, food, housing) 34% 63% 40% Disinfect, sprinkle powdered lime around cage, pen 36% 58% Separate chickens from ducks 33% 23% 5% Keep poultry in separate area from living space 84% Wash hands with soap before and after handling poultry 24% 39% 2.5% Remove feces from bird-rearing areas at least once a week 15% 33

34 Number of preventive behaviors vs. AI in poultry practiced Percent of Rs by number of behaviors reportedly practiced to prevent AI in poultry Number of behaviors practiced AED/ IRL ABT 0 14% 7% 1 37% 35% 2 25% 30% 3 15% 21% 4+ 9% 7% 34

35 Vaccination practice Whether poultry vaccinated AED/ IRL CARE Yes 94% 76% 35

36 Whether Rs will report an AI outbreak in their farm Whether Rs will report an AI outbreak AED/ IRL CARE ABT Yes 90% 88% 84% 36

37 To whom an outbreak will be reported Who to report to, if R will report AED/ IRL CARE** Animal Health Worker 68% 73% Head of Hamlet or hamlet 14% Local authority 9% 58% 37

38 Challenges in research 1) Market research agencies still viewed with suspicion by some government and donors; academic bodies seen as more credible 2) AI Program managers need to monitor and observe implementation of activities of research agencies and provide proper technical guidance 3) Perception of credibility of findings from qualitative research needs to be strengthened especially among animal health community 4) Research needs to be disseminated so that it influences policy and practice 5) Finding of key research need to be re-packaged in a compelling way for public (what story is it telling?) 38

39 Lessons Learned 1) Giving your government counterparts opportunities to observe interviews in the field is an excellent way to win them over (especially for qualitative research) 2) It is important to carefully review questionnaires and sampling to ensure your information needs and where they come from are met 39

AVIAN INFLUENZA: How to Protect Yourself When You Slaughter or Prepare Poultry at Home. How does avian influenza spread?

AVIAN INFLUENZA: How to Protect Yourself When You Slaughter or Prepare Poultry at Home How does avian influenza spread? Even though you cannot see it, the H5N1 virus (also known as avian influenza) can