AI Comm Meeting 07April DRAFT - · PDF fileAnnex 2: Attendance List.....14 Annex 3: Welcome...
Transcript of AI Comm Meeting 07April DRAFT - · PDF fileAnnex 2: Attendance List.....14 Annex 3: Welcome...
D R A F T
Friday, 7 April 2006 Summit Parkview Hotel
Yangon, Myanmar
Technical Working Meeting on Avian Influenza Communication Page - 2 07 April 2006, Summit Parkview Hotel, Yangon
Table of Contents
Background .............................................................................. 3 Meeting Objectives ................................................................... 3 Overview of Meeting Outcomes ................................................ 3 Summary of Proceedings.......................................................... 4
Welcome and Opening Remarks .................................................... 4
Overview Presentation of AI Risk Communication ............................ 5
Group Work ................................................................................ 6
� Group Work – Step 1: Prioritizing actions for behaviour change and identifying key audiences ....................................... 6
� Group Work – Step 2: Preparation of communication framework/strategy
o Group 1: Prevent animal-to-animal transmission of AI ..................... 8
o Group 2: Prevent animal-to-human transmission of AI ....................10
o Group 3: Prevent human-to-human transmission of AI in a pandemic ..................................................................................11
Brief Presentation of IEC Materials Developed for Educating People .............................................................. 12 Closing Comments and Next Steps ......................................... 12 Annexes
Annex 1: Draft Agenda................................................................13
Annex 2: Attendance List.............................................................14
Annex 3: Welcome and Opening Remarks......................................16
Annex 4: Overview Presentation of AI Risk Communication..............21
Technical Working Meeting on Avian Influenza Communication Page - 3 07 April 2006, Summit Parkview Hotel, Yangon
Technical Working Meeting on Avian Influenza Communication
Friday, 7 April 2006, Summit Parkview Hotel, Yangon
Background UNICEF was recently requested by WHO to facilitate and coordinate efforts related to Avian Influenza (AI) Risk and Behavior Change Communication in Myanmar, in support of joint efforts by Ministry of Health, Ministry of Livestock and Fisheries and many other partners. Given the urgent need to provide the public with information on avian influenza, a Technical Working Meeting on Avian Influenza Communication was held on Friday, 07 April 2006, at the Summit Parkview Hotel in Yangon. Staff from numerous ministries and organizations actively participated in the working meeting, including staff from the Ministry of Health (MOH), Livestock Breeding and Veterinary Department (LBVD) of the Ministry of Livestock and Fisheries, Myanmar Radio and Television (MRTV), Myanmar Maternal Child Welfare Association (MMCWA), Myanmar Medical Association (MMA), Myanmar Red Cross Society (MRCS), as well as staff from JICA, WHO, FAO, UNDP, UNFPA, UNHCR, WFP, the UN Resident Coordinator’s Office, UNICEF, IFRC, PSI, SC UK, AMI, CARE Myanmar, and CBI. The primary purpose of the meeting was to have technical experts from different ministries and agencies involved in avian influenza preparedness and response in Myanmar forge a basic communication framework, pursuant to the Government’s National Strategic Plan for Prevention and Control of Avian Influenza and Human Influenza Pandemic Preparedness and Response. Meeting Objectives The specific objectives of the meeting were to:
1. Identify essential elements for an Avian Influenza IEC and Behavior Change Framework in Myanmar, including: • Prioritization of behavioral objectives; • Identification of key groups to be reached; • Identification of key messages per prioritized objectives and target
audiences; and • Identification of the most effective approaches/channels to reach key
groups with these messages.
2. Determine immediate risk communication actions to raise awareness. Overview of Meeting Outcomes Experiences from other countries already heavily involved in avian influenza communication have demonstrated that unclear or inconsistent communication messages can cause confusion for the public, making it less likely that people will
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adopt a range of beneficial measures to protect themselves and their loved ones. Coordinating communication strategies, and agreeing upon a basic set of key messages, can help parties involved in the fight against avian influenza better ensure that they speak with one voice, lessen this level of confusion, and improve the efficacy of their communication interventions. Participants in the meeting identified key target audiences for avian influenza communication, and prioritized actions for behaviour change to prevent animal-to-animal and animal-to-human transmission of avian influenza, and human-to-human transmission in a pandemic. Following these steps, participatory group work sessions were held to prepare communication frameworks which pinpoint reasons for current behaviours, barriers to behaviour change, and keys for change – including key messages, key advocates and key communication channels. Following this exercise, the group reviewed existing avian influenza materials already developed for Myanmar by MOH, LBVD, PSI, WHO, UNICEF and others. Participants offered brief feedback on the materials, and a brief discussion was held to identify next steps to raise awareness of the risk of avian influenza in Myanmar. Summary of Proceedings Welcome and Opening Remarks
Ms. Carroll Long, UNICEF Representative in Myanmar, stated that the overarching goal of the meeting was to develop a more coordinated, consistent communication framework related to avian influenza. She noted that the Deputy Minister of Health, in his role as Secretary of the National Health Committee and Chairman of the Work Committee for Control of Avian Influenza, has emphasized the need to share information among agencies, and to encourage preventative measures on the part of poultry farmers and general public. Dr. Tin Nyunt, Deputy Director General, National Health Laboratory, Ministry of Health, gave a brief account of the current situation of avian influenza outbreaks in
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the world, and noted that a potential pandemic could cause 2-50 million deaths worldwide. He stressed the importance of community involvement in risk communication, and stated that it is critical to provide basic, key messages to the public. Dr. Than Htun, Director (Admin), Livestock Breeding and Veterinary Department, Ministry of Livestock and Fisheries, briefed the participants about measures taken to control avian influenza within the country since H5N1 was first detected in Sagaing and Mandalay Divisions in February 2006. He noted that newly formed disease surveillance teams, culling teams and disinfectant teams were actively participating in AI control operations, and acknowledged the material assistance and cooperation rendered to the country through various agencies. He also highlighted the need for capacity building for rapid diagnosis of the disease and response to emergencies, as well as the need for laboratories to handle this deadly virus. Overview Presentation of AI Risk Communication Mr. Jason Rush, Communication Officer, UNICEF, reviewed lessons learned in avian influenza communication from around the globe, and highlighted effective communication channels in Myanmar based on UNICEF research findings. He stressed that rapid baseline surveys among target groups are needed to gauge current attitudes and practices among those we aim to reach. He also emphasized the importance of involving target audiences in communication material development, stating that participatory processes help ensure that messages are understood, relevant, effective and culturally and linguistically appropriate. He added that given Myanmar’s diversity, different groups would require different messages and different strategies, and that communities would need to be given a stake in the action. He noted that trust and transparency are essential to risk communication efforts. Finally, he noted the need to think beyond posters and pamphlets, noting that research shows that the most effective communication channels in Myanmar are the electronic media, and interpersonal communication channels. UNICEF’s “Communication Resources Essentials and Tools” (CREATE!) was briefly introduced to the group, and some sample CREATE! materials were shared with participants.
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Group Work Participants were divided into three working groups, focusing on:
• Group 1: Preventing animal-to-animal transmission of AI • Group 2: Preventing animal-to-human transmission of AI • Group 3: Preventing human-to-human transmission in a pandemic
Each group contained members with technical expertise in animal and public health, as well as those with communication and/or social mobilization expertise. Group Work – Step 1: Prioritizing actions for behaviour change, and identifying key audiences During the morning session, the working groups identified key audiences to be targeted, and pinpointed key actions needed to prevent avian influenza and a possible pandemic. Outcomes of these group discussions are provided in the table below:
Actions needed for prevention Key audiences Group 1: Prevent animal to animal transmission of AI � Prevent contact between poultry and wild
birds � Always keep your poultry separate from
other animals � Keep poultry fenced � Do not sell/transport sick poultry � Wash hands before and after handling
poultry � Disinfect clothes/foot wares before and after
entering into the chicken house � Report immediately to authority/village
leader if sick poultry found � Burn or bury dead/sick poultry � Give clean food and water to your animal � Keep environment clean of wild bird
droppings � Disinfect the cages after every market � Wash your truck � Wear protected clothes/PPE � Disinfect your truck after every transport � Do not transport sick birds � Keep birds in clean cage � Do not encourage to keep birds as pet
1. Commercial poultry farm workers 2. Domestic fowl workers 3. Market vendors 4. Transporters 5. Personal pet owners
Group 2: Prevent animal to human transmission of AI � Chicken & eggs should be well- cooked � Do not eat the infected chicken & eggs � Wash your hands thoroughly with soap &
water after handling poultry & chicken products
� Separate cutting boards for meat & vegetables
� Do not transport poultry to crowded areas � Do not transport poultry from affected areas � Use safe, hygienic slaughtering practices � Do not sell the dead chickens � Wear PPE � Do not sell the dropping of chicken as
fertilizers � Report cases of sick birds to authorities � Avoid contact with chicken/birds � Properly dispose dead birds � Breed the birds at separate areas � Report suspected influenza-like illness in the
vicinity of poultry outbreaks to health authorities
1. General public - children - parents 2. Health workers - vet - human 3. NGOs 4. Handlers - restaurant & food stalls - domestic poultry 5. Authorities 6. Media
Technical Working Meeting on Avian Influenza Communication Page - 7 07 April 2006, Summit Parkview Hotel, Yangon
Actions needed for prevention Key audiences Group 3: Prevent human to human transmission of AI Priority 1 • Frequent and thorough hand washing with
soap • Maintain food safety/handling (water, etc.) • Stock basic medications, food, water, etc. • No spitting Priority 2 • Restrict movement • Wear masks and properly dispose used
masks • Stay at home Priority 3 • Listen to news on mass media (TV, radio) • Follow the guidelines of local authorities
strictly • Call the hot line for the latest information • Inform the public about hot line numbers Priority 4 • Be alert key signs and symptoms of AI in
human • Contact emergency health team if you have
suspect AI symptoms
• General Public
Group Work – Step 2: Preparation of communication frameworks/strategies
To help develop a consistent, coordinated and effective joint communication framework/strategy pursuant to the Government’s National Strategic Plan for Prevention and Control of Avian Influenza and Human Influenza Pandemic Preparedness and Response, the groups identified current behaviours, reasons for current behaviour, barriers to change and keys for change – including key messages, key advocates, and key communication channels. Outcomes of these groups’ discussions are presented in the following tables, below.
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1: P
REV
EN
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NIM
AL-T
O-A
NIM
AL T
RA
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MIS
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N O
F A
VIA
N IN
FLU
EN
ZA
ST
RA
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T
AR
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A
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IEN
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D
ES
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D B
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AV
IOR
C
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RE
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BE
HA
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FO
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AV
IOR
BA
RR
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IVIT
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ME
SS
AG
ES
A
DV
OC
AT
ES
P
RO
PO
SED
CH
AN
NEL
Com
mercial
poultry farm
w
orkers
� Preven
t conta
ct betw
een
pou
ltry and w
ild bird
s �
Keep
pou
ltry fenced
�
Do n
ot sell/transport
sick pou
ltry �
Alw
ays ke
ep you
r pou
ltry separa
te from
oth
er an
imals
� W
ash
han
ds before an
d
afte
r handlin
g p
oultry
� D
isinfect cloth
es/foot w
ares before and after
enterin
g in
to the
chicken
hou
se �
Rep
ort imm
ediately to
auth
ority if sick pou
ltry fou
nd
� Burn
or bury d
ead/sick pou
ltry
� Som
e contacts w
ith
birds e
xit
� Typ
es of bird
hou
sing ca
n
lead to con
tact (Tw
o types of bird
hou
se 1) S
heltered
hou
se - slated
floor
- caged
hou
se - floor/deep
Litter 2) C
losed h
ouse)
� Lack o
f kn
owled
ge
� Lack o
f tech
nical
know
ledge
� W
illingn
ess �
Low
risk perception
�
Custo
m/
Tradition
� Train
ing b
y LBVD
/ M
yanm
ar Livestock
Fede
ration
� Fa
rmin
g p
ractice packa
ge M
essa
ges
� Keep
your p
oultry
fenced
�
Viru
s can tra
vel fro
m clo
thes an
d
foot ware
�
Wear cle
an cloth
es �
Wash
your h
ands
� Pro
tect your
investm
ent
� Rep
ort imm
edia
tely sick p
oultry to
auth
ority
� Live
stock B
reedin
g
and V
eterin
ary D
epartm
ent
(LBVD
) �
Com
munity lea
ders
� M
ass in
formation
�
Interp
ersonal
Com
munication
Dom
estic fowl
workers
� Preven
t conta
ct betw
een
pou
ltry and w
ild bird
s �
Keep
pou
ltry fenced
�
Do n
ot sell sick pou
ltry �
Wash
han
ds before an
d
afte
r handlin
g p
oultry
� Alw
ays ke
ep you
r pou
ltry separa
te from
oth
er anim
als and
village
chicke
n
� G
ive clean food
and
water to you
r anim
al
� Kee
p en
vironm
ent clea
n
of wild
bird d
roppin
gs
� Rep
ort imm
ediately sick
pou
ltry to village lea
der/
auth
ority
� Som
e contacts w
ith
birds e
xit �
Poultry are m
ixed
with
other a
nim
als su
ch as d
ucks, pigs,
etc.
� Lack o
f kn
owled
ge �
Limited
space
for separa
te fen
cing fo
r pou
ltry �
Not a
cultu
re pra
ctice to sepa
rate
� Lo
w risk
perception
�
Willin
gness
� Lack o
f resou
rces fo
r fencin
g
� Custo
m/
Tradition
� Train
ing b
y LBVD
/ M
yanm
ar Livestock
Federation
�
TO
T for I/N
GO
s and
FBO
s �
Good
pou
ltry fa
rmin
g practice
packa
ge
� To im
prove h
ousin
g
system b
y usin
g
net
Messa
ges
� Kee
p you
r pou
ltry fen
ced
� Viru
s can tra
vel fro
m clo
ths a
nd
foot ware
� W
ear clean
clothes
� W
ash
your h
ands
� Rep
ort imm
ediately
sick pou
ltry to villa
ge leader/
auth
ority
� LB
VD
�
Com
munity lea
ders �
Red
Cross
volunteers
� Fa
ith-b
ased
Orga
niza
tions
(FBO
s)
� M
ass in
formation
�
Sm
all/mass m
edia
� In
terperson
al Com
munication
�
Com
munity cen
tres/ ch
urch
es
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D B
EH
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C
UR
RE
NT
BE
HA
VIO
R
RE
AS
ON
FO
R
CU
RR
EN
T
BEH
AV
IOR
BA
RR
IER
S
TO
CH
AN
GE
A
CT
IVIT
IES
/
ME
SS
AG
ES
A
DV
OC
AT
ES
P
RO
PO
SED
CH
AN
NEL
Market ven
dors
� D
o not sell sick p
oultry
� D
isinfect th
e cages a
fter every m
arket
� Rep
ort imm
ediately if
sick pou
ltry found
� W
ash
han
ds before an
d
after h
andlin
g th
e pou
ltry �
Give clea
n food
and
water to you
r anim
al
� Kee
p en
vironm
ent clea
n
� Rep
ort imm
ediately sick
pou
ltry to auth
ority
� W
holesale m
arkets
are th
e source
s for sp
read of disea
se �
There is a
mix of
chicke
n/ du
cks and
other birds
� Vendors brin
g u
nso
ld
birds b
ack to their
farms
� Pou
ltry contain
ers ca
nnot protect th
e drop
pin
gs
� W
holesale m
arkets
have b
oth killin
g an
d
selling services
� W
aste w
ater released
w
ithou
t treatmen
t �
Ven
dors a
re not
wea
ring an
y protection
�
Contain
ers and
uten
sils are n
ever disin
fected
� Keep
dead an
d alive
pou
ltry togeth
er �
Som
e se
llers kill bird
s on
the sp
ot
� Lack o
f kn
owled
ge
� Lack o
f fin
ancial
resources
� Cle
an bird
cage
� D
isinfect ca
ge everyd
ay
� W
ash
your h
ands
before
and after
han
dling p
oultry
� D
o not b
ring/sell
sick birds
� U
se gloves w
hile
han
dling p
oultry
� City D
evelopm
ent
Com
mittee
� M
uniciple
� M
ass media
� IPC
Tran
sporters
� W
ash
your tru
ck �
Wear p
rotected cloth
es �
Clean
your b
oots and
feet �
Disin
fect your tru
ck after every tra
nsp
ort �
Do n
ot transp
ort sick birds
�
� Veh
icles are not clea
n
� Low
personal h
ygiene
of the tra
nsp
orters �
Lack of kn
owled
ge on
anim
al disease
� Lack o
f kn
owled
ge �
Low
risk perception
�
� D
on’t m
ix pou
ltry w
ith oth
er anim
als especially w
hile
tran
sportin
g
� Clean
your tru
ck everyd
ay
� W
ear mask an
d
clean cloth
es �
Wash
your h
ands
� Protect h
ands w
ith
plastic b
ag
� Rep
ort to auth
ority
LBVD
M
ass media
Personal p
et ow
ners
� Keep
birds in
clean ca
ge
� D
on’t m
ix with
wild
bird
� W
ash
your h
ands
� D
o not en
courage to
keep bird
s as pet
� Keep
birds a
s pet �
�
�
Do n
ot keep b
irds
as pet
LBVD
M
ass media
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AN
SM
ISS
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VIA
N IN
FLU
EN
ZA
ST
RA
TE
GY
T
AR
GET
A
UD
IEN
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D
ES
IRE
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BEH
AV
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C
UR
RE
NT
B
EH
AV
IOR
RE
AS
ON
FO
R
CU
RR
EN
T
BEH
AV
IOR
BA
RR
IER
S T
O
CH
AN
GE
A
CT
IVIT
IES
/ M
ES
SA
GES
A
DV
OC
AT
ES
P
RO
PO
SED
C
HA
NN
EL
Wash
your h
ands w
ith
water &
soap
thorou
ghly after
handlin
g p
oultry &
ch
icken prod
uct.
Not reg
ula
r wash
� Lack o
f water
� Lack of soap
�
Habitu
al �
know
ledge
� Know
ledge
� N
o p
erceptio
n o
f risk
� Econ
omy
Only prop
er hands w
ash
ing w
ith
soap &
water is th
e best protection
(th
ere is no m
edicine!)
� Health
worke
rs � A
uth
orities
� Sch
ool teachers
� Peers
� Religiou
s leaders
� Elders
� Media
� Sch
ools
� Health
centre
s � M
arkets CBO
s/NG
Os
Pou
ltry & eg
gs sh
ould
be w
ell cooked
People
are still
eating b
arbecue
with
blood
&
meat/h
alf-cooked
eggs
� Style
� Social life
� Chea
p
� Available
� Social /p
eer pressu
re �
Econ
omy
� Taste
� Easily a
ccessible
Eat w
ell-cooked food
(pou
ltry &
eggs)
� Gen
eral public
� Hou
sewives
� Resta
ura
nts
� Auth
orities (G
AD
) � S
chools/teach
ers � C
elebrities
� Husb
ands
� Media
� Sch
ools
� Health
centres
� IPC
All severe flu
like illn
ess especially in th
e vicin
ity of pou
ltry ou
tbre
ak re
port to
Health
auth
orities
Not en
ough
rep
orting
� Lack kn
owled
ge abou
t reportin
g
� Lack o
f aw
aren
ess of the
disea
se �
Econ
omics
factors
� Con
cern
� Ig
nora
nce
� O
ther p
ressing
priorities
� MuufiSufwkyfauG;a&m*gonf vlodkY
ul;pufEdkifonf/
� MuufiSufwkyfauG;a&m*gjzpfyGm;vsuf
&Sdaoma'owGif tjyif;zsm;vQif
usef;rma&;XmeodkYowif;ydkYyg/
� Health
worke
rs � V
olunteers (N
GO
s) � A
uth
orities
� Sch
ool teachers
� Religiou
s leaders
� Gen
eral public
� Media
� Health
centre
� Sch
ools
� IPC
� NG
Os
Rep
ort auth
orities in
case of sick birds N
ot en
ough
rep
orting
� Con
cern
� Poverty
� Know
ledge
� Aw
aren
ess
� N
obod
y can give
compen
sation
�
Poverty �
Aw
aren
ess
� MuufemvQif (odkY) MuufaovQif
eD;pyf&mwdarG;ukESifh a'oqdkif&m
tmP
mydkiftzGJUtpnf;udk owif;ydkYyg/
� Local auth
orities
� Vets
� NG
Os
� Media
� Vet
� Auth
orities
Gen
eral public
- child
ren
- paren
ts H
ealth w
orkers
- vet - h
um
an
NG
Os
Han
dlers
- restau
rant &
foo
d stalls
- Dom
estic
poultry
Auth
orities
Med
ia
Avoid
contact w
ith
chicken
/birds Still con
tact with
birds
� H
abitu
al �
Cultu
ral �
fun
� Lack o
f kn
owled
ge ab
out A
I �
Hob
by
Do n
ot stay w
ith bird
s
� Health
worke
rs � V
et � S
chool
� NG
Os
� IPC
� Media
� NG
Os
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RA
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F A
VIA
N IN
FLU
EN
ZA
IN A
PA
ND
EM
IC
S
TR
AT
EG
Y
TA
RG
ET
A
UD
IEN
CE
D
ES
IRE
D B
EH
AV
IOR
C
UR
RE
NT
B
EH
AV
IOR
RE
AS
ON
FO
R
CU
RR
EN
T
BEH
AV
IOR
BA
RR
IER
S T
O
CH
AN
GE
A
CT
IVIT
IES
/
ME
SS
AG
ES
A
DV
OC
AT
ES
P
RO
PO
SED
CH
AN
NEL
Gen
eral public
� Frequ
ent an
d th
orough
han
d w
ash
ing b
y soap
� M
aintain
food sa
fety/ handlin
g (w
ate
r, etc.)
� Safe b
asic medica
tions
and n
eeds
� In
frequ
ent
han
d
wash
ing
with
out soa
p
� N
o food stock
� Spittin
g in
public places
� By n
atu
re/ by
habit
� Sca
rcity of water
non
-ava
ilability
of soa
p
� H
igh com
modity
price
� In
adequ
ate sp
ace for stora
ge
� Lack o
f kn
owled
ge �
Not aw
are of th
e desired
beh
aviou
r
� Thorou
gh h
and
wash
ing w
ith soa
p
can preven
t AI
� AI in
fection can
sp
read th
rough
spittin
g an
d
drop
lets
� M
inister for h
ealth
to make
endorsem
ent
� In
volvemen
t of M
inistry o
f in
formation
�
Religiou
s leaders
� Vide
o actors, actresse
s �
NG
Os/IN
GO
s
� M
ass media
� TV sp
ots and key
signs a
nd sym
ptom
s �
Perform
ance b
y celeb
rities
� Fo
lk media
�
Health
talks �
Billb
oard,
posters/pa
mphlets
� Social m
obilization
throu
gh PA
system in
local m
edia
� In
sert health
messa
ge in
movies/vide
os
Gen
eral public
� Restrict m
ovemen
t �
Wear m
ask and p
roper d
isposal o
f use
d m
ask
� Stay at h
ome
� G
o to market
daily/g
o to crow
ded
places
� D
o not w
ear
masks/visit
frequen
tly to frie
nds an
d
neigh
bou
rs
� N
o m
ask-wea
ring
pra
ctices �
Limited
incom
e �
Feeling
uncom
fortable w
ith m
ask
� W
ear mask to
preven
t tran
smission
Gen
eral public
� Listen
to new
s on m
ass m
edia (TV
, radio)
� Follow
the gu
idelines of
local auth
orities strictly
� Call th
e hot lin
e for th
e latest in
formation
�
Inform
the pu
blic abou
t hot lin
e num
bers
� O
nly 6
0%
of people
listen
to radio �
The rest en
joy oth
er
enterta
inm
ent
prog
ram
me
� Pe
ople
follow
the g
uidelin
es of local auth
orities strictly
� N
o curren
t hot
line a
vailable
� Peo
ple tend to
enjoy
enterta
inm
ent
rath
er than
education
prog
ram
me
� N
on-attractive
media
presen
tation
� Belief on
fate �
Deep-rooted
perception
that
it won
’t hap
pen to m
e �
� W
atch
out sign
s and sym
ptom
s �
Sym
pto
ms o
f AI
are fever (3
8-4
1
degree C
)/chills,
dry cou
gh, sore
throat, e
xhau
stion,
muscle a
che a
nd
pain
s
Gen
eral public
� O
bse
rve ke
y signs a
nd
symptom
s of AI in
hum
an
� Con
tact emerg
ency
health
team if you
have
su
spect AI sym
ptom
s
�
� Lo
w risk
assu
mption
�
�
Technical Working Meeting on Avian Influenza Communication Page - 12 07 April 2006, Summit Parkview Hotel, Yangon
The groups reported back to the plenary on the communication framework they developed. Target audiences, desired behaviour changes and key messages were presented. Brief Presentation of IEC Materials Developed for Educating People Assorted IEC materials on avian influenza were briefly presented to the group, and a short discussion was held regarding the possible interim production and use of selected, existing IEC materials. It was agreed due to certain concerns raised regarding some IEC, and the need to adjust other materials pursuant to field testing conducted by the Central Health Education Bureau, that materials would need to be further refined before being made available for broader distribution. Existing IEC materials on AI
Ministry/ Organization
Type of material Target Audience Remarks
Ministry of Health National Strategic Plan for Prevention and Control of AI and Human Influenza Pandemic Preparedness and Response, MOH
500 copies printed.
MOH’s Central Health Education Bureau
TV spots Posters Pamphlet
General public (targeting sub-groups, including children, food preparers, etc.)
Produced by CHEB, initial field testing conducted
Ministry of Livestock and Fisheries
Booklet on Prevention and Control of Avian Flu in Small Scale Poultry Poster
Jointly produced by JICA
PSI Posters Pamphlet Flipchart
PSI staff
WHO Pamphlet General Public An overview of avian influenza and its risks
UNICEF Posters Pamphlets
General Public (targeting sub-groups, including children)
Prototype materials not yet field tested
Closing Comments and Next Steps The group agreed on the follow-up actions: • To share the meeting report among participants; • To adhere to common key messages developed at meeting (‘one voice’); • To form an avian influenza communication working group to coordinate material
development, KAP studies, pre-testing of materials, and to share information; UNICEF to schedule regular meetings;
• To quickly conduct a Knowledge-Attitudes-Practices (KAP) study of poultry farmers; and • To identify training needs regarding avian influenza communication, and to work on the
development of interpersonal communication toolkits/guidelines.
Technical Working Meeting on Avian Influenza Communication Page - 13 07 April 2006, Summit Parkview Hotel, Yangon
Annex 1: Draft Agenda Technical Working Meeting on Avian Influenza Communication
Friday, 7 April 2006, Summit Parkview Hotel 10:30 – 10:45 Welcome and Opening Remarks MOH, LBVD, UNICEF 10:45 – 11:15 Overview presentation of AI Risk Communication
• Overarching Goal & Objectives • How do we get there? • Communication for AI – CREATE
Mr. Jason Rush Communication Officer UNICEF
11:15 – 12:15 Group Work 1: Prioritizing actions for behaviour change and identifying
key audiences Group 1: Prevent animal to animal transmission of AI Group 2: Prevent animal to human transmission of AI Group 3: Prevent human to human transmission in a pandemic
12:15 – 13:15 Lunch 13:15 – 14:30 Group Work 2: Preparation of communication framework/strategy
Identifying reasons for current behaviour, barriers to change and keys for change (Key messages, key advocates and key communication channels)
14:30 – 15:00 Report back to plenary on group works and discussion 15:00 – 15:15 Coffee/tea break 15:15 – 15:45 Brief presentation on IEC materials developed for
educating the public Different partners
15:45 – 16:30 Discussion on the interim production and use of selected existing IEC
materials on AI 16:30 – 16:45 Closing comments and wrap-up
Meeting Objectives: 1. To identify essential and critical elements for a comprehensive
Avian Influenza IEC and Behavior Change Framework: • Prioritize behavioral objectives (actions)
• Identify key groups to be reached
• Identify key messages (information) per prioritized objectives and key groups
• Identify most effective approaches/channels to reach key groups with messages
2. To determine immediate risk communication actions to raise
Technical Working Meeting on Avian Influenza Communication Page - 14 07 April 2006, Summit Parkview Hotel, Yangon
Annex 2: Attendance List Ministry of Health
1. Dr Tin Nyunt, Deputy Director General, National Health Laboratory
2. Dr. San Shway Wynn, Deputy Director General, Public Health
3. Dr Daw Khin Than Oo, Director, CHEB
4. Dr Mya Than Nwe, Director, Epidemiological Unit, Lower Yangon Div. Health Department
5. Dr Khin Maung Lwin, Deputy Director, CHEB
6. U Aung Kyaw Kyaw, Assistant Director, CHEB
7. Daw Khin Su Hlaing, Health Education Officer, CHEB
8. Dr Win Tin, Assistant Director, Central Epidemiological Unit
9. Dr Tin Sabae Aung, Medical Officer, NHL
10. Dr Htar Htar Lin, Medical officer, CEU
Ministry of Livestock and Fisheries
11. Dr Than Htun, Director (Admin), Livestock Breeding and Veterinary Department
12. Dr Myat Kyaw, Deputy Director, LBVD
Ministry of Information
13. U Htein Win, Staff Officer (Radio), MRTV
14. Daw San San Oo, Staff Officer (Radio), MRTV
I/NGOs
15. Daw Shwe Sin Myint, Head of Division (Communication), MRCS
16. U Yar Zar Kyaw, Operations Officer, MRCS
17. Mr Sam Connor, Deputy Country Director, PSI
18. Daw Suziena Htun, Communication Manager, PSI
19. Daw Aye Aye Khine, Risk Management Officer, SC UK
20. Dr Thidar Pyone, National Medical Officer, AMI
21. Dr Khin Aye Myint, Project Manager, CARE Myanmar
22. Dr Min Ko Ko Maung, CARE Myanmar
23. Mr Makoto Tajima, Project Formulation Advisor, JICA
24. U Phyo Wai Kyaw, Information Officer, CBI
25. Dr Than Oo, CEC Member, MMCWA
26. Dr Aye Aye Thein, Joint-Secretary, GP Society, MMA
27. Ms Evelyn Paasa Lacsina, Health Training Delegate, IFRC
Technical Working Meeting on Avian Influenza Communication Page - 15 07 April 2006, Summit Parkview Hotel, Yangon
UN
28. Mr Stephan Jost, Public Health Administrator, WHO
29. Dr Myo Paing, National Professional Officer, WHO
30. Dr Ye Tun Win, AI Focal Point for FAO
31. Mr Umesh Ghimire, Vulnerability Advisor, UNRC
32. Ms Julie Belanger, Response Coordination Officer, UNRC
33. Daw Nan Mon, Senior Secretary, UNDP
34. Daw Sint Sint Khin, Senior Secretary, UNDP
35. Dr Soe Kyaw, Programme Assistant, UNFPA
36. Mr Gaurab Tewari, Programme Officer, WFP
37. Daw Swe Swe Win, Programme Assistant, WFP
38. Mr Francois Renaud, APO, UNHCR
UNICEF
39. Ms. Carroll Long, UNICEF Representative, UNICEF
40. Ms. Elke Wisch, Senior Programme Officer, UNICEF
41. Mr. Jason Rush, Communication Officer, UNICEF
42. Dr. Anne Vincent, Chief, Health & Nutrition, UNICEF
43. Mr. Waldemar Pickardt, WES, UNICEF
44. Daw Nyunt Nyunt Thane, Project Officer, UNICEF
45. U Aung Htun, IEC Consultant, UNICEF
46. Dr. Yin Yin Aung, Project Officer, UNICEF
47. U Win Zin Oo, Project officer, UNICEF
48. Daw Aye Aye Than, Assistant Communication Officer, UNICEF
49. Daw Angela B. Thaung, Communication Assistant, UNICEF
50. Daw Khin Moe Moe Aung, Information Assistant, UNICEF
51. Dr Tin Htut, Asst. Project Officer (HIV/AIDS), UNICEF
52. Daw Ni Ni Latt, Project Assistant, UNICEF
53. Daw Thanda Aung, Project Assistant, UNICEF
54. Naw Wah Dee Moo, Secretary, UNICEF
Technical Working Meeting on Avian Influenza Communication Page - 16 07 April 2006, Summit Parkview Hotel, Yangon
Annex 3: Welcome and Opening Remarks
Remarks by Ms. Carroll C. Long UNICEF Representative in Myanmar
Opening of the Technical Working Meeting on Avian Influenza Communication
Dr. Tin Nyunt, Deputy Director General, National Health Laboratory, Dr. Than Htun, Director of the Livestock Breeding and Veterinary Department, Distinguished colleagues: Thank you all for being here today, at such short notice, for this Technical Working Meeting on Avian Influenza Communication. Under the Government’s National Strategic Plan for Avian Influenza, the Ministry of Health and Ministry of Livestock and Fisheries have been playing leading roles in avian influenza prevention within the human health and animal health sectors, respectively. Within the United Nations, our response in Myanmar and around the globe is being driven by WHO and FAO, who have been tasked with these responsibilities. In Myanmar, UNICEF was recently requested by WHO to facilitate and coordinate efforts related to avian influenza risk communication, in support of joint efforts by the Government, the U.N. and other partners. I am happy to inform you that UNICEF has just received funding from the Government of Japan to support avian influenza risk communication efforts in Myanmar over the course of the year. Experiences from other countries have shown us that unclear or inconsistent communication messages about avian influenza can cause confusion for the public, making it less likely that people will adopt helpful protective measures. Coordinating communication strategies, and agreeing upon a basic set of key messages, can help all parties involved in the fight against avian influenza better ensure that they speak with one voice, lessen this level of confusion, and improve the effectiveness of their communication interventions. Our goal today is a simple one: to develop a more coordinated, consistent communication framework related to avian influenza. To that end, today we will jointly identify key objectives and key messages that can provide the basis for more comprehensive communication strategies down the road – strategies we hope can be developed in cooperation with communities. Obviously, the objectives and messages we develop today will not be prescriptive. They can, however, provide us with an important starting point to help strengthen avian influenza prevention activities in Myanmar.
Technical Working Meeting on Avian Influenza Communication Page - 17 07 April 2006, Summit Parkview Hotel, Yangon
The Deputy Minister of Health, in his role as Secretary of the National Health Committee and Chairman of the Work Committee for Control of Avian Influenza, has stressed the need to share information with the public and between various agencies, and has particularly emphasized the need to encourage preventative measures on the part of poultry farmers and laypeople. Some good initiatives and activities to that end are already underway. Still, there are some remaining challenges and concerns before us, including the need to agree on:
• consistency, packaging and delivery of key messages; and • effective communication approaches that help us ensure we reach key audiences
in key localities. I hope today will be a starting point for addressing these challenges, and working in closer collaboration on avian influenza communication in the future. UNICEF stands ready to work with all of you here today to protect Myanmar’s families from avian influenza, and enhance the quality of their lives. Thank you for the energy, ideas and enthusiasm you’ll be contributing to today’s meeting.
Technical Working Meeting on Avian Influenza Communication Page - 18 07 April 2006, Summit Parkview Hotel, Yangon
Speech by Dr Tin Nyunt, Deputy Director General National Health Laboratory
Ministry of Health Good morning country representative from UNICEF, WHO and other UN organizations, Officials from Ministry of Livestock & Fisheries and Ministry of Health, Local & International NGOs, distinguished guests, ladies & gentlemen. It is a great honor for me to deliver an opening remark on behalf of D.O.H on technical working meeting on Avian Influenza communication. First of all I would like to say that nature has presented us with a daunting challenge the possibility of an influenza pandemic. This is an infectious disease highly pathogenic Avian Influenza (HPAI) H5N1 caused outbreaks in Asia since December 2003, among the chicken and birds. That was followed by transmission to humans. Avian Influenza outbreak among birds has now spread to (36) countries including Europe up to date, WHO reported (110) deaths out of (199) (7th April, 2006) laboratory confirmed cases resulting in a motility rate of more that 50%. In-addition to this human tragedy, severe economic loss due to death and culling of infected birds, chicken is escalating. The potential pandemic is expected to cause a low of 2-7 million to high 2-50 million deaths worldwide, in addition to the immense social and economic disruption. Thus all the member state of the WHO are working towards pandemic preparedness and response to combat the threat of a potential pandemic. We have an opportunity of prepare ourselves to face the challenge of the impending pandemic, we need to strengthen early warning systems and reporting, upgrading of laboratories, stock piling of antivirals & PPE. Furthermore, community involvement is very important effective risk communication is essential to inform public and mitigate panic. We should convey clear basic key communication messages to the public, through trained personals at all levels. I hope this meeting will give fruitful discussions and could be able to workout comprehensive avian influenza IEC and behaviour change framework. Finally I would like to pay my sincere thanks to UNICEF one of the member of international coordination and logistic and supply sub committee of Myanmar national strategic plan for prevention and control of AI and human influenza pandemic preparedness and response. Thanks.
Technical Working Meeting on Avian Influenza Communication Page - 19 07 April 2006, Summit Parkview Hotel, Yangon
Speech by Dr. Than Htun, Director (Admin) Livestock Breeding and Veterinary Department
Ministry of Livestock and Fisheries Status of Avian Influenza Control in Myanmar
Distinguished Guests Ladies and Gentlemen: Good Morning! I would like to brief about the control Status of Avian Influenza in Myanmar. Since the later part of 2003, HPAI has been ravaging in the Asia and Pacific region. Myanmar was non infected country until February 2006. Starting from the 1st week of February to early part of March the suspected AI was notice in Shwebo, Kantblu and Khin Oo townships in Sagaing Division and Pyigyidagon Township in Mandalay Division. HPAI, H5N1 was detected from both diagnostic laboratories, regional laboratory, Mandalay and central laboratory, Yangon. The prompt information was given to World Animal Health Organization (OIE), Regional and local FAO on the incidence of H5N1. The specimens were also sent to National Institute of Animal Health (NIAH) Bangkok, Thailand and Geelong Australia the reference laboratories for further confirmation. Ladies and Gentlemen: There were totally 12 townships occurred AI in the southern part of Sagaing Division and Mandalay Division. These townships were confined as restricted zones and the movement control, temporary close down of market and disease investigation in the poultry farms were undertaken under the guidance and assistance of local authorities. Disease surveillance team, culling team and disinfectant team were formed and actively participated in AI control operation. The local administrative authorities took alert and restrictively banned the movement of live chickens and eggs in the respective area of the country. The notification for the public and all stakeholders had been circulated. Notification on public awareness was announced on news paper and Myanmar television. The announcement of bird flu incidence in the news and television was continuously published. For emergency use, PPE, disinfectants, field used equipments and education posters were provided from FAO, JICA and Reference laboratory from Geelong, Australia. FAO and JICA sent experts on epidemiology and disease diagnosis on HPAI to incorporate with LBVD staff for effective disease control of AI. The LBVD in cooperation with the health department, other related departments and organizations actively performed the activiti es for the disease investigation, slaughtering, disinfestations, movement control and public awareness in the AI affected areas. As of 6th April 2006, the mortalities of chicken and quails amounted to (9,206) and (5,606) and the destroyed birds (326,384) and (311,105). And 98,580 of poultry eggs and (76,758) of quail eggs were also destroyed. From the beginning of the day before yesterday 5th April 2006, no more chicken died and destroyed in the infected areas of 12 townships and it was seemed to under control status of AI in that areas affected. Unfortunately another case of AI was accidentally occurred at one poultry farm in Kyaukse Township, Mandalay division. All birds
Technical Working Meeting on Avian Influenza Communication Page - 20 07 April 2006, Summit Parkview Hotel, Yangon
of infected farms and at high risk within a kilometer radius of infected farm were destroyed. Totally 6000 birds were destroyed. The case was reported as under control status. Our technical personnel dealing with the disease has to operate under very resource limited environment. Nevertheless, we try within our own means and some assistance from multilateral organizations like FAO, OIE and WHO. Some emergency assistance was also extended to us from JICA and Aus AID. We still need to build up our capacity to be able to effectively carry out our rapid diagnosis of the disease and the capacity to response to emergencies. We also need laboratories with reasonable bio-safety level to handle this dangerous virus. We will enhance surveillance of Avian Influenza and establish an early warning system. We welcome various International Organizations and Agencies to cooperate for controlling and preventing activities on AI. Thank you very much for your kind attention.
Technical Working Meeting on Avian Influenza Communication Page - 21 07 April 2006, Summit Parkview Hotel, Yangon
Annex 4: Overview Presentation of Avian Influenza Risk Communication
By Mr. Jason Rush, Communication Officer, UNICEF
Technical Working Meetingon Avian Influenza Communication
7 April 2006
• Brief Overview of Avian Influenza Communication – Key Concepts
• Objectives of today’s AI Communication Coordination Meeting
• Lessons learned in AI Communication
• Brief introduction to CREATE!
• Group Work
Brief Overview ofAvian Influenza Communication
Key Concepts
The Challenge Before Us
• Encouraging preparedness and precautionary behavior without needlessly frightening
(how to shake people out of their apathy without scaring them to death)
The Path Forward1. Gauge Current Attitudes and Practices Among
Those We Want to ReachWe therefore need Baseline Surveys among main target groups – particularly backyard poultry farmers. Need to know about, for example, their:
• media/information access and usage (television, word of mouth, etc.)
• reasons for not keeping poultry caged/cooped• AI awareness• source(s) of AI information• awareness of AI symptoms in poultry• degree of willingness to report outbreak• personal precautions being taken• precautions taken to protect poultry• actions with sick birds
The Path Forward
2. Involve Target Audiences in Communication Material Development
• This participatory process helps ensure that messages are understood, relevant, effective, and culturally and linguistically appropriate.
• Different groups require different messages and strategies. (children, national races, etc.)
The Path Forward
3. Take Advantage of Anxiety• Anxiety can motivate precautionary thinking and
precautionary action• We want to take care, of course, not to provoke a
sense of fatalism, or to overwhelm people with yet another problem that leads them to tune out and go into denial.
Technical Working Meeting on Avian Influenza Communication Page - 22 07 April 2006, Summit Parkview Hotel, Yangon
The Path Forward
4. Build Trust – Be Transparent• Trust is a key to the success of early detection,
which lies at the heart of prevention efforts.• Trust and transparency are also essential to
fostering behavior change.• We build trust by acknowledging uncertainty, and
refraining from overly reassuring (e.g., “all is well”). Provide reassurance based on sound information.
The Path Forward
5. Give People A Stake In The Action• Encouraging people to take action on the issue
gives greater weight to preparedness measures. • People are less likely to act on information they
receive and take responsibility for their safety if they have no control over their situation.
The Path Forward
6. KISSing Rule• The higher the level of concern, the greater the
need to simplify language/messages• A few words or a single image can have more
impact than an in-depth exposé.
The Path Forward
Five ‘C’s of communication:• Clear• Correct• Consistent• Creative• Coordinated
SEPARATE WASH COOK
Objectives ofToday’s Meeting
Development of a consistent, coordinated and effective joint communication framework/ strategy pursuant to the Government’s National Strategic Plan for Prevention and Control of Avian Influenza and Human Influenza Pandemic Preparedness and Response.
Why?
• Coordination of communication strategies minimizes duplication of efforts, enhances the efficacy and quality of interventions, and helps us identify gaps.
How do we get there today?
Objective 1: prevent animal to animal transmission of AI
Objective 2: prevent animal to human transmission of AI
Objective 3: prevent human to human transmission in a pandemic
Different cross-sectoral groups will work on achieving one of the following objectives:
Technical Working Meeting on Avian Influenza Communication Page - 23 07 April 2006, Summit Parkview Hotel, Yangon
Immediate Objective• Clarifying modes of transmission (identify risks)• Prioritizing behavioral objectives (desired actions) for
prevention/containment• Describing current situation (current behaviors, reasons,
barriers to change)• Identifying key groups to be reached• Identifying key messages (information) per prioritized
objectives and key groups• Identifying key advocates for behavior change• Identifying most effective channels/activities to reach key
groups• Outlining a joint way forward
1. Identifying modes of transmission
Examples include:
• Poultry coming in contact with infected migratory birds
• Close, hands-on contact with sick birds
• Slaughtering/preparing infected poultry
• Droplets (sneeze, cough, etc.)
2. Defining desired behavior (generally and amongst different groups)
Examples of desired behaviors:• Avoid contact with sick or dead poultry
• Keeping children away from all birds
• Handle and slaughter all poultry safely (wear mask, gloves, use disinfectant)
• Cook poultry and eggs thoroughly
• Wash hands with soap before and after handling live poultry and preparing for cooking
• Report sick/dead birds immediately to the authorities
• If you experience flu-like symptoms, promptly seek professional medical treatment
3. Describing current behavior
Examples might include:• Handling poultry in unsafe manner
• Not washing hands after handling poultry/meat/eggs
• Selling/consuming sick birds
• Not cooking eggs well
• Not reporting dying birds to authorities
• Not covering cough
4. Identifying reasons for current behavior
Examples might include:
• Low / no sense of real risk
• Worry re: loss of income
• Lack of understanding re: safe behavior
5. Identifying barriers to change
Examples might include:
• Poverty
• Custom / habit
• Lack of information / knowledge
• Lack of hygiene facilities
6. Identifying key groups to be reached
Examples of target groups:
• Backyard poultry farmers
• Children (in and out of school)
• Food preparers (household and restaurant)
• General public
7. Identifying key messages / activities
Key messages might include:• Sick or dying birds can make people seriously ill• Protect children by keeping them away from all birds• Washing hands regularly is the best protection against bird flu• Putting poultry in coops/pens helps protect them against bird
flu• Cooking poultry and eggs thoroughly kills dangerous germs• Not all infected birds show symptoms
Key activities might include:• Reporting incentives• Volunteer networks
Technical Working Meeting on Avian Influenza Communication Page - 24 07 April 2006, Summit Parkview Hotel, Yangon
8. Identifying key advocates
Key advocates might include:� Community vets/livestock officials/volunteers� Local health communicators� Midwives and nurses� Teachers� Faith-based organizations� I/NGOs� Experts/ministry officials� UN officials� Celebrities� Village leaders
9. Identifying most effective communication channels / activities
Key communication channels / activities might include:� Television (spots, testimonials, news features)� Radio spots� Print media (inserts, articles)� Video shorts (for parlors and cinemas)� Schools� Pagodas, churches, mosques� Interpersonal communication channels (vets, health workers,
volunteers, local leaders, etc.)� Traditional IEC (brochures, pamphlets, posters, billboards,
etc.)
Communication framework/strategy
Community health talks and other IPC
IPC with vets, health workers, volunteers, local leaders, etc.
Electronic media (PSAs, testimonials, sub-themes in programs)
Schools (building on hygiene education)
Newspapers features and ads
Video shorts
Traditional IEC
Ministry of Livestock, MOH, health communica-tors, village leaders, teachers, FBOs, I/NGOs, WHO, FAO, UNICEF, celebrities, etc.
Keep children away from birds
Sick or dying birds can cause illness to people
Wash hands following contact with birds/eggs/ raw meat
Keep poultry away from homes
Coop poultry
Risk education measures (media and IPC)
Reporting incentives?
Poverty
Low or no sense of risk
Custom/ Habit
Lack of hygienic facilities
Lack of space
Sick birds not uncommon, normally consumed and normally pose no threat (lack of understanding re: risks)
Loss of income
Limited availability of affordable meat/protein sources
Lack of understanding re: safe handling
Close living conditions with poultry
When birds sick, people still eating, selling, transporting
Unsafe handling of live and dead birds and poultry products
Don’t touch wild birds, or sick / dying poultry (Don’t eat, sell, transport)
Proposed Channel
AdvocatesActivities/ Messages
StrategyBarriers to Change
Reasons for Current
Behavior
Current Behavior
Desired Behavior
Lessons Learnedfrom Other Countries
Lessons Learned from Other Countries
1. Socio-economic conditions lead many people to not report and hide their poultry – compensation can be a barrier to behavior change
2. Marginalized groups less willing to seek professional medical care when symptoms arise
3. People are generally reluctant to adopt range of protective measures – “old habits are hard to break”
4. Mixed communication messages have caused confusion unsynchronized, unclear, conflicting, confusing, inconsistent, inaccurate
5. While social mobilization has enormous potential for immediate impact, it alone is insufficient (food security, economic, virus control issues also key)
Effective Communication Channelsin Myanmar – UNICEF Research Findings
1. Overall, television is the leading mass communication medium, followed by radio and print media. Posters, brochures rate insignificant, comparatively.
2. Many poor families – those most likely to be in intimate contact with poultry – have no regular access to media.
3. There are lower rates of mass media access among different ethnic groups.
Effective Communication Channelsin Myanmar – UNICEF Research Findings
4. Leading sources of information on health issues are, in order:� family/friends and health centers/medical providers
(approx. equal)� television� radio and IEC (approx. equal)� teachers/schools (leading source amongst children)� papers/journals
Effective Communication Channelsin Myanmar – UNICEF Research Findings
5. Leadings sources of health knowledge are, in order:
� health talks� education programs � television� health workers� hospitals/clinics� other leading sources include radio, IEC, video
Main lesson: interpersonal communication channels and electronic media need to be main areas of focus (as opposed to posters and brochures)
Technical Working Meeting on Avian Influenza Communication Page - 25 07 April 2006, Summit Parkview Hotel, Yangon
Brief Introduction to CREATE!
The philosophy of CREATE! is that all tools should have:
� High impact (e.g. strong visuals)
� Simple, clear, ‘action’ orientated messages
� Participatory development and testing with intended beneficiaries
� Actively avoid creating stigma
• CREATE! materials have been shared with MOH, CHEB, and other ministries, UN agencies and INGOs.
Thank you.