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Behavioural Challenges around Avian Influenza
Evidence from Egypt
April 10, 2023 UNICEF
2
Map of Egypt
Delta
Upper Egypt
Higher concentration of poultry
Large vulnerable groups – rural areas
April 10, 2023 UNICEF
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).
April 10, 2023 UNICEF
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.
April 10, 2023 UNICEF
5
Communication TaskThrough 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.
April 10, 2023 UNICEF
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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
April 10, 2023 UNICEF
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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)
April 10, 2023 UNICEF
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). Egypt’s DHS (forthcoming).
April 10, 2023 UNICEF
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.
April 10, 2023 UNICEF
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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.
April 10, 2023 UNICEF
11
Washing hands with water and soap after cleaning and feeding poultry
88.291.689.389.895.1
0
20
40
60
80
100
Total Urban Rural LowerEgypt
UpperEgypt
April 10, 2023 UNICEF
12
Knowledge around protection from AI
16.3
48.1
65.9
26.9
55
0
20
40
60
80
100
Put gloves/plasticpocket or cover
nose & mouth whenhandling live birds
Put gloves/plasticpocket when
handling with deadbirds
Cooking birds atadequate tempe-
rature
Heard of AIvaccines
Put dead birds inplastic bag, throw in
garbage
April 10, 2023 UNICEF
13
Knowledge of covering nose and mouth when handling live / dead birds
13.28.3
13
23.316.2 15.5
26.3
7.410.314.3 18.2 16.3
0
20
40
60
80
100
Urban Rural UrbanGove.
rnorates
Lower Egypt
UpperEgypt
Total
Live birds Dead birds
April 10, 2023 UNICEF
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Practice of covering nose & mouth when slaughtering birds
1.70.71.11.2 2.3
0
20
40
60
80
100
Total Urban Rural Lower Egypt
Upper Egypt
April 10, 2023 UNICEF
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.
April 10, 2023 UNICEF
16
Knowledge and Practices of keeping poultry away from living and sleeping areas
11 10.84
95.391.793.392.5 91.2
15.4 17.7
0
20
40
60
80
100
Total Urban Rural LowerEgypt
UpperEgypt
Knowledge
Practice
April 10, 2023 UNICEF
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Lessons Learned Awareness of AI high, risk perception is lowPromoting 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
April 10, 2023 UNICEF
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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