1. Behavioural Challenges around Avian Influenza Evidence from Egypt

2. February 13, 2014UNICEF 2 Map of Egypt Delta Upper Egypt Higher concentration of poultry Large vulnerable groups – rural areas

3. February 13, 2014UNICEF 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. February 13, 2014UNICEF 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. February 13, 2014UNICEF 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. February 13, 2014UNICEF 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. February 13, 2014UNICEF 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. February 13, 2014UNICEF 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. February 13, 2014UNICEF 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. February 13, 2014UNICEF 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. February 13, 2014UNICEF 11 Washing hands with water and soap after cleaning and feeding poultry

12. February 13, 2014UNICEF 12 Knowledge around protection from AI

13. February 13, 2014UNICEF 13 Knowledge of covering nose and mouth when handling live / dead birds

14. February 13, 2014UNICEF 14 Practice of covering nose & mouth when slaughtering birds

15. February 13, 2014UNICEF 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. February 13, 2014UNICEF 16 Knowledge and Practices of keeping poultry away from living and sleeping areas

17. February 13, 2014UNICEF 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. February 13, 2014UNICEF 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