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Global Program on Avian and Pandemic InfluenzaAvian influenza (AI) or “bird flu” could be the next great global health threat. About 300 people have been infected and 169 have died since 2003 by contracting the virus through close contact with infected birds. But public health experts fear it is only a matter of time before the virus mutates into a form that passes easily among people, triggering a pandemic. Millions could die and economies would be crippled for months. Models developed at the Johns Hopkins Bloomberg School of Public Health show that it may be possible to detect an outbreak at its earliest stage and deploy resources to stop it. The School’s Center for Communication Programs (CCP) can provide expertise on strategic health communication, which will play a crucial role in responding successfully to an outbreak. CCP is already working in countries to help develop avian flu communication strategies. Programs can be designed for key audiences such as the general public, policymakers, the media, health professionals, the poultry industry, and households with direct contact with live poultry. Strategies include hand washing promotion, hygiene improvement, and safe handling of poultry. The Avian and Pandemic Influenza brochure provides a description of the various approaches CCP undertakes for A&PI preparedness and response, including advocacy, capacity building, and community mobilization. It also illustrates the use of health communication in A&PI preparedness through examples from the ongoing AI projects that CCP conducts worldwide. For more information contact: Please consider making a gift to CCP to support our avian flu work. NEWS
Muppets, Pharmacists and Media Aid Avian Flu PreventionCCP is working closely with partners in over 30 countries to promote behaviors and practices that could help prevent the spread of avian influenza (H5N1). The behavior change campaigns they have developed, which include everything from printed flyers to children’s television programs, are tailored to the specific cultural needs of each country. Avian and Pandemic Flu Strategic Communication Action Planner (ASAP)
The overall goal of the toolkit is to provide an easy-to-use, interactive and dynamic resource with an evidence-based strategic framework for developing country-specific initiatives catered to different phases of the epidemic. If a country reaches WHO's Phase 6 for example, the tool will offer streamlined planning variables aligned with crisis mode. Scenario planning for each phase of the epidemic is integrated into the tool, as are strategies for managing public relations, media planning, message development and monitoring and evaluation. The tool assembles resources from all over the world and provides access to essential websites, documents, research studies and emergency-preparedness models for developing A&PI communication programs and products. Outstanding global examples of A&PI communication programs will also be highlighted. Strategic communication models and approaches of the different organizations such as CDCynergy, P-Process, COMBI, CREATE! and ACADA will all inform the development of this toolkit. The partners are collaboratively developing the toolkit through on-line forums and plan to engage field officers and health professionals from all over the world in the pilot-testing of the prototype. Egypt’s Sesame Street Focuses on Hand Washing to Help Prevent Avian Flu Spread
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The Communication for Healthy Living project, part of the Health Communication Partnership based at CCP is providing technical assistance to Egypt’s Ministry of Health and Ministry of Information in their implementation of an avian flu communication response. The communication strategy provides a comprehensive approach to the implementation and appropriate phasing of all communication interventions. The communication response addresses health, agricultural, and environmental sectors and has identified nine audiences that will drive specific interventions and determine messages and communication channels: the general public; policy makers; media personnel; health professionals; poultry industry (mid-large farms, markets and shops, and food service industry); households with direct contract to live poultry; households without direct contact; travelers; and the airline industry. The campaign provides reliable, timely, and authoritative information in a rapidly changing environment. The unified strategic approach will help ensure that all campaign interventions are easily identified, have consistent messages or a clear relationship if coming from multiple sectors, and are credible for each stage of the epidemic.
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In the aftermath of the Avian Influenza (AI) outbreaks throughout the Near East region since February 2006, the Government of Jordan asked CCP's Jordan Health Communication Partnership (JHCP) to help establish a National Communication Committee to process scientific findings, gain important insight from national experts, and increase the awareness of AI risks, means of transmission, and basic prevention measures. From that point forward, CCP worked with a range of national and international stakeholders to develop the “Prepare Now – Share How” national communication strategy to provide comprehensive advocacy and behavior change support to the relevant parties in Jordan.
Once completed, CCP was asked by UNICEF-Jordan to implement the first wave of their national communication campaign via the following intervention components:
COMPONENT 1. CHILDHOOD PROTECTION: Increase proper preventive behaviors to reduce the threat to school-aged children, and their families.
COMPONENT 2. ‘SAFE POULTRY’ FOR POULTRY REARERS: Increase knowledge and proper practices for safe poultry rearing, trading, slaughter, and preparation. Increase knowledge of specific regulations governing poultry rearing (caging, species segregation, signs of infection, etc.), selling, in addition to proper slaughter and disposal practices.
COMPONENT 3. CAPACITY BUILDING FOR COMMUNITY ADVOCATES: Increase knowledge and capacity of civic leaders and advocates (community leaders, religious leaders, teachers, journalists, and healthcare workers) to recognize the basic AI prevention measures and educate individual communities on locally-appropriate preparedness actions.
COMPONENT 4. MEDIA EDUCATION: Increase capacity of media personnel and journalists to report consistent AI information that originates under a unified campaign to ensure a sole source of trusted messages.
COMPONENT 5. PUBLIC AWARENESS: Achieve widespread public recognition and recall of infection risks.
The materials from this initial wave were as follows:
Material: Teacher Fact Sheet (A & B)
This AI fact sheet for teachers was in support of Jordan’s “Prepare Now – Share How” communication strategy and aimed to increase the perception that Avian Influenza remains an ongoing public health threat and that proper practical preventive behaviors can reduce the threat to humans, thus protecting Jordanian families.
Material: Student Activity Sheet (A & B)
CCP has worked closely with Sesame Workshop in a number of countries and has used the recently created Hikayat Simsim characters to spread useful, fun, and informative messages on prevention to children throughout Jordan. An important feature of Hikayat Simsim is that the educational outreach component of the project builds upon the momentum of the television series by featuring the Jordanian muppet characters, Tonton and Juljul in activity books and other educational tools for children, parents and teachers. Children are already used to seeing the muppets discussing health, hygiene, nutrition and safety issues, so the presence of these characters in the Student Activity Brochure is a natural extension of their role in the lives of Jordanian school children.
Avian Influenza Television Spot
This television spot was designed by the CCP, in coordination with the Jordanian National AI committee, to provide information to the general public that the dangers of Avian Influenza can be prevented through simple behavioral practices. It highlights the importance of hand washing and kitchen hygiene, as well as the safe purchase and the proper preparation of chicken.
Ten Tips Brochure
This two sided brochure was designed for the general audience and poultry farmers providing ten general tips regarding protection from Avian Influenza. Tips include hand washing, appropriate personal protective equipment (PPE), proper caging, and maintenance of cages. The brochure also highlights poultry vaccinations and provides information about the appropriate agencies to contact in the event that Avian Influenza is suspected.
Brochure for Chicken Farmers
This two sided brochure was specifically designed for poultry farmers regarding general safety and safe husbandry proceduresto protect against H5N1 within the flock. It includes methods of biosecurity such as using formalin and chlorine to sterilize equipment after every use. It also includes procedures that should be followed in case of Avian Influenza suspicion among backyard poultry, migrating birds, and other poultry in larger-scale farms. These messages also introduce the farmer to the symptoms of Avian Influenza of infected poultry, stress the importance of appropriate personal protective equipment, and provide information about the appropriate agencies to contact in the event of a suspected outbreak or situation of concern.
Four Basic Safety Tips for those who Handle Live Birds
This brochure discusses the basic information about Avian Influenza including its symptoms and methods of protection, as well as providing four Basic Safety Tips for those who handle live birds. Tips include 1) prevention through the avoidance of direct contact with poultry, and the appropriate personal protective methods including hand washing 2) recognition of potential Avian Influenza cases among poultry 3) control of the disease through specific personal hygiene procedures following the handling of sick or dead poultry, and 4) reporting any suspicion or cases seen among poultry or other wild birds.
Brochure for Health Care Providers
This brochure was specifically designed for health care service providers regarding the symptoms of Avian Influenza in humans and the proper precautions to follow. It stresses the safety measures for the patient and the health care providers such as the use of masks and gloves. It also highlights the procedures followed for H5N1 investigations including isolation of the patient, the reporting of the case to the appropriate agencies, and the methods followed if the case is confirmed.
Poster for Health Care Providers
This poster was designed for health care service providers highlighting the symptoms of Avian Influenza and the proper procedures that should be followed when dealing with possible human Avian Influenza cases. It emphasizes the importance of controlling the disease and reporting the cases to the appropriate agencies. If the case is confirmed at a facility with the appropriate expertise, health cares providers should follow proper methods including taking samples from the nasal swab or the nasopharyngeal wash, carrying out a Rapid test, sending the samples to a PCR lab, and treatment of the patient depending on the evaluation of the case.
CCP, as part of the Primary Health Care Strengthening Project in Azerbaijan, has provided technical assistance to the Government of Azerbaijan to develop communication materials and activities to inform the population about the threat of the avian influenza virus. Early 2006, the avian influenza virus was found in numerous wild birds along the coast of the Caspian Sea and was soon found in poultry. In early March the first human case was confirmed and by the end of March eight people had been diagnosed with the virus; five of the eight individuals died of AI-related complications. The Government of Azerbaijan with the assistance of WHO indentified areas that needed strengthening in surveillance, reporting and infection control.
CCP assisted with the development of materials, tools and trainings to inform the population about avian influenza and to promote behaviors and actions to prevent the spread of the virus. In addition to informing the general population, primary audiences were indentified: backyard poultry farmers and their family, health care providers and veterinary personnel. In addition, workshops were conducted for the press on responsible reporting during health emergencies.
AI hotline: providing first-line support and accurate information for the general population with a hotline operated by the Ministry of Health. The hotline offers free dial-in, accurate, up-to-date information on the virus and local referral information. Technical assistance was provided to develop appropriate hardware support (phone system and computer software), a hotline attendant manual, Q&A sheet and call tracking and evaluation procedures.
Television spots aired nationally during primetime shows, popular daytime shows and sporting events:
View synopsis of the four TV spots (English)
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Family protection against bird flu: two television spots were aired to inform the entire family on how the virus is spread, proper prevention measures including disposal of dead or sick birds and how to safely handle and prepare eggs and poultry. |
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Importance of containing back yard poultry: two television spots were aired to inform back yard poultry farmers on the importance of caging, proper handling of poultry, and disposal methods of and reporting procedures (with local health authorities) concerning dead poultry. |
Avian Influenza TV Spot Reaches Broad Azerbaijani Audience (USAID press)
Key preventive messages and referral process poster distributed to all district hospitals and clinics.
View/download poster
Personal protective equipment (PPE) brochure on proper use of protective equipment disseminated to all district veterinarians and agriculture workers. The brochure was distributed at the same time that the government delivered protective equipment to district centers. View/download brochure
Saglam Ol! (Be Healthy!): CCP collaborated with a locally produced health television show to dedicate one show to avian influenza. Segments showed easy construction of a backyard poultry cage, an interview with an AI survivor; and interviews with health and veterinary officials on how to avoid possible contamination when slaughtering and dressing birds (wild or domestic). Photo: building an easy-to-assemble backyard cage is demonstrated.
Workshops for journalists: two workshops addressed reporting techniques and responsibilities of the media during national health emergencies including avian influenza outbreaks. In addition to educating journalists about modes of transmission and prevention, the workshops highlighted how to strengthen community- and self-efficacy to prevent transmission in light of the very real threats posed by AI to human and animal health.
Regional South Caucasus Conference on Avian Influenza attended by health officials from Azerbaijan, Georgia and Armenia to discuss key actions and lessons learned.
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CCP is assisting USAID-Ukraine, UNICEF-Ukraine, and their contractors in designing, implementing, and evaluating high quality, effective communication strategies for avian influenza.
CCP assistance is two-fold:
Specific AI activities provided by CCP are as follows:
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Afflicted by the world’s largest number of H5N1 avian influenza (AI) human cases and human deaths, Indonesia has recognized the need to strengthen its surveillance and response. Led by DAI and with CCP heading up the strategic communication components of the project, the CBAIC project focuses on three interrelated elements:
In 2007, CCP orchestrated a national level message harmonization workshop which led to the first ever message harmonization booklet for AI control in Indonesia. In addition, CCP and partners developed and reproduced a set of AI materials to be used at the national, district and community levels for AI prevention and response. CCP oversaw the production and airing of an AI radio program in 2007 as well, and is about to launch a national level AI campaign.
National AI Prevention and Response Campaign
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CCP recently completed the core TV and Radio spots for CBAIC’s upcoming avian influenza campaign in Indonesia. The key messages in the spots are “Burn and Bury” dead carcasses, and “Report” any dead chickens. The underlying focus of both spots raises the threat level of AI to motivate greater responsiveness. KOMNAS, the government body coordinating all avian influenza activities is already airing the spots with their own funding, and CCP will launch the official campaign late January. The campaign will include a wide range of mass and community based media (TV, radio, print, billboards, talk shows, and community based activities) and will last for 3+ months. The spots are available for viewing now. Kudos to Tami and Dian, CCP’s CBAIC campaign team, in Jakarta for closely overseeing this work.
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CCP worked with the Government of Indonesia to develop a hand-washing campaign to improve personal hygiene to better prepare the community to face the imminent health challenges of a flu outbreak and aid in reducing transmission of the virus that causes avian flu. CCP built on its previous hand washing campaigns in Indonesia that focused on infectious diseases including diarrhea and acute respiratory infections. The recent campaign ran television spots December 2005 through February 2006 to create awareness of the potential hazards of handling chickens, handling raw chicken meat, food preparation, and cleaning eggs. The campaign urged the public to wash their hands properly, with soap, at critical times as an effective measure of preventing illness. It included:
With funding from USAID/Indonesia, CCP’s interest in averting new cases of avian flu has generated interest from one of Indonesia’s largest soap manufactures, Unilever. By promoting hand washing with soap to prevent avian flu, CCP was able to leverage nearly USD$150,000 from Unilever’s soap subsidiary, Lifebuoy, to support additional air time for nationally aired television spots developed with USAID funding. CCP’s partnership with Unilever demonstrates how, globally, the Center works to develop private-public partnerships to improve health.
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CCP has been given the role of developing a global Avian and Pandemic Influenza (A&PI) toolkit that will guide strategic communication initiatives worldwide. The toolkit is a product of an initiative spearheaded by a partnership of leading international organizations including UNICEF, FAO, WHO, CDC, and World Bank in the response to A&PI, and is funded by the Government of Japan.
TV spots and materials focusing on handwashing and hygiene produced under USAID-supported Communication for Healthy Living project implemented by the Health Communication Partnership in collaboration with Sesame Workshop’s “Alam Simsim.”
© 2005 The Johns Hopkins University. All rights reserved.