2007

This 15-page Avian Influenza: Communication Strategy and Workplan for Egypt is developed by Egypt’s Ministry of Health and Population (MOHP), in coordination with the United Nations Children's Fund (UNICEF), State Information Services (SIS), and Communication for Healthy Living (CHL) of the United States Agency for International Development (USAID) as an extension of the 2006 draft communication plan. The original document aimed to present a comprehensive communication strategy and implementation plan to prepare for a possible outbreak of avian influenza (also known as bird flu). Since that time, community intervention programmes, including a national radio campaign, have been implemented in accordance with that draft and with the national Strategic Preparedness Plan for avian flu. As follow-up, both a UNICEF-sponsored qualitative study to assess the outcome of the community interventions and a national baseline survey were completed, both in late 2006. These have resulted in evidence from which this document derived its strategic planning.

In short, the document summarises the UNICEF interventions, gives a list of current objectives, and discusses strategies and activities in the categories of:

• Community interventions
• Media capacity building and targeted campaign
• Research
• Pandemic preparedness

It includes sections on documentation, monitoring, and evaluation; limitations and challenges; joint programming possibilities with sister UN organisations; spreadsheets for management of activities; and a timeline.

Some guiding conclusions resulted from the UNICEF and MOHP community intervention and the mass media campaign undertaken by CHL and SIS. The community intervention trained 2,500 Raidat (community health workers) to focus on a door-to-door educational mobilisation in the 7 high-risk districts to bring key prevention and behavioural messages to communities to change poultry handling practices. Schoolchildren were also a focus of education for disease protection. The UNICEF-sponsored media campaign included celebrity drama, mini drama, educational spots, children's songs, and Q and A talk shows and echoed the same messages disseminated at the community level. Conclusions from the assessment studies were:

• The liaison role with the media (especially highly viewed programmes and channels) is a key to ensure the impact of the community message.
• There is need for a tight system for monitoring and supervising the community activities.
• A strong social marketing and awareness campaign in the areas of intervention will increase and support the community intervention programme.
• Intensive social mobilisation campaigning to support the community education is indispensable.
• School programmes should be followed up from central and governorate level.
• Stronger linkages should be made with Ministry of Agriculture (MOA) extension workers at the village level.

Specific communication objectives for 2007-2008 to control the spread of the H5N1 virus, a subtype of the Influenza A virus; minimise human exposure to infected poultry; prepare for a possible pandemic; and ensure early detection of avian flu infection include:

1. Improve knowledge of certain practices, such as the risk of children playing with / handling poultry and hygienic means to dispose poultry wastes.
2. Increase the percent of the public who believe that they could be infected by AI and / or who think that their children could be at serious risk if they handle poultry (i.e. perception of possible risk).
3. Decrease the percent of children playing / handling poultry in the areas of intervention.
4. Decrease the percent of the public who purchase chicken from un-safe sources (i.e. lay merchants).
5. Contribute to the preparation of behavioural messages for home care and hygiene in the case of a pandemic outbreak.

Specific strategies and activities derived from them that seek to reach the objectives are listed by category. Community Interventions are intended to be focused in high and medium risk areas as detailed in the document, though high population urban areas like Cairo and Alexandria will not receive intervention, as stated here, due to a lack of human capacity. Support for this MOHP outreach programme includes the training of trainers of Radiats, using condensed and less technical materials, modified based on research results, modified influenza education communication messages and a new reporting system. Subsequently, 1,500 new and 9,500 experienced Radiats will receive training.

House-to-house education to address behavioural change will again be carried out by radiats refiat (RR), whose work, according to study results, needs to be sustained over time to ensure ongoing behaviour change. Reworking of the reporting and monitoring system of the RR by the MOHP will be concurrent. Because the recognised role of influential leaders, including religious and educational leaders, in hierarchical communities, governorate level meetings will be held to ensure continuous dialogue and support in prioritising the issue of avian influenza. Simultaneous media campaigns placing key messages on billboards in markets, bus stations, clinics, post offices, and schools will use branding messages to convey information, education, and communication (IEC) messaging. Other social marketing techniques will be developed for remote areas. School intervention plans include morning announcements, posters, stickers in restrooms, and distribution of simple stories carrying key messages. This will be a nationwide effort in cooperation with the Ministry of Education. A materials review will assess what to re-use, what to redesign, and what to add, based on new audience feedback and the completed research available.

Media as a Change Agent has two main activities: partnership/capacity building and a targeted media campaign. Activities to ensure media preparedness with a strong understanding of the issue as a platform for pandemic awareness and preparedness include:

• Media roundtable: A core group of interested editors and senior journalists will be invited for a roundtable discussion on this subject, including shared materials and possible planning for a training workshop, as well as the formation of an on-going volunteer consultant/resource group.
• Media workshop: This activity will aim at presenting avian influenza information in a mixed package with practical tools for better journalistic standards.
• Media materials: Research studies completed as well as other important information on the web will be transformed in a media friendly package and will be communicated frequently and effectively to media professionals.
• Media follow-up: Continuous support with information as well as other rounds of “brown bag”
  seminars would be convened on regular basis to keep the link with the group.
• Media analysis: Print and broadcast materials will be filed and analysed for a final content analysis done by the third quarter of 2008.

The targeted media campaign will focus on the medium of television (TV), using strategies learned from polio campaigns. Attention needs to be given to the media habits of Egyptians, including the use of satellite channels. Fifteen-second educational messages, "key practice" reminders, news programming, and interviews with the public are recognised strategies, as well as the analysis of frequently viewed content. Radio is also an important medium with already identified popular channels.


The document continues with recommendations for research systematisation begun with the baseline survey process convened by UNICEF, recognising the roles of the agencies which took part and who can extend that research further through:

1. A refined KAP (Knowledge, Attitude, Practice)
2. A composite index for behavioural indicators
3. A data bank supported by the UNICEF Monitoring and Evaluation Unit
4. An outcome assessment on communication intervention

The Strategy section concludes with a discussion of pandemic preparedness communication materials involving UNICEF. First, UNICEF will collaborate with partners like the MOHP on a qualitative study of public reactions and possible panic issues in order to develop predictions and messaging guidance, including home care practices and community needs and readiness, among other issues. It will explore a liaison with UNICEF headquarters on a possible meeting co-organised with the World Health Organization (WHO) to review risk preparedness in the region.

UNICEF, Egypt Office website. [7]