Field epidemiologists hone communication skills needed during an outbreak

AI.COMM identified an important gap in the training of field epidemiologists in the area of basic, applied communication skills, which require that field epidemiologists speak with communities and media, as well as policy makers, especially during and after outbreaks. To meet this need, USAID asked AI.COMM to design curricula on applied communication skills for field epidemiology training professionals. A pretest workshop was held in Bangkok in September 2009, moderated by a professional researcher who conducted feedback sessions following each of the three sessions, and offered an overall evaluation at the end of the day. Participants included 16 students in the Thai FETP program, the world’s longest running FETP program, as well as members of the Ministry of Public Health and U.S. Centers of Disease Control and Prevention who serve as advisors to the program.

Following the Thai pretest training, AI.COMM staff, in coordination with AFENET (the African Field Epidemiology Network), conducted a training for field epidemiologists in Kampala, Uganda, with 12 participants drawn from government ministries and academic institutions from several countries in East Africa, including Uganda, Kenya, and Tanzania. The training consists of three lessons that provide field staff with key practical communication skills they will need, especially when conducting and reporting on outbreak investigations, and employed discussions, hands-on learning activities and feedback sessions, as well as on-camera interview role plays to hone skills in listening and asking questions, developing talking points and key messages, and message delivery. All participants acknowledged that communication is very important for their fieldwork, and most of them felt that they do not have adequate communication skills and were interested in improving these skills. Participants felt that the Applied Communication Skills Curriculum gave them an opportunity to gain practice in important communication skills such as asking questions, listening, crafting message points, making recommendations and speaking with different audiences, such as communities, media and policy makers. Field Epidemiology Training Program: Applied Communication Skills (PDF).

Using an integrated social marketing approach to battle avian and pandemic influenza outbreaks

Across the globe, the AI.COMM project has used an integrated communication approach that employed a variety of methods and channels to drive home information and promote protective behaviors. Hearing the same messages from trusted sources and demonstrating basic but feasible healthy practices – sanitation and hygiene, separation and isolation of poultry, and reporting outbreaks immediately – can make a dangerous virus manageable and less threatening. AI.COMM used a spectrum of strategies to deliver information on good practices and behaviors based on qualitative and quantitative research: A combination of mass media, social mobilization, advocacy, community-based communication, interpersonal communication, public relations and social media were tailored to a country or a situation and used to demonstrate correct public health practices. In many cases, AI.COMM tapped into the power of existing social networks and mobilizing them to help educate and effect positive behavior change. In Bangladesh, for example, the project spearheaded an effort to establish a social network that would bring together most stakeholders to pool their resources and ensure that messages going out to the public were consistent. The network – consisting of NGO workers, rural backyard poultry farmers, smallholder commercial farmers, consumers of poultry, poultry-related business officials, religious leaders and health and veterinary staff.—worked to establish an AI resource center to provide updated information and materials to NGOs and other stakeholders. A network orientation for over 100 NGOs was held to develop a common understanding and to help coordinate efforts. The network also provided trainer on interpersonal communication (IPC) skills in four high-risk districts and nurtured over 500 field resource staff on creating AI awareness at the grassroots level. In Nigeria an emphasis was placed on advocacy and IPC to engage stakeholders including religious leaders and community elders that were central to the success of implementing any type of communication activity. Their approval and endorsement paved the way for the implementation of the other strategies – social mobilization, mass media, and IPC targeted to at risk audiences.

Hands-on training sessions help to educate first responders on how to protect themselves during avian and pandemic outbreaks

Only a few months into the AI.COMM project – a three year program funded by USAID to help prevent and control avian and pandemic influenzas using behavior change and communication approaches – it became clear that many of the people who were first one the scene during avian flu outbreaks did not know how to protect themselves from the virus. Moreover, most did not fully grasp the myriad ways they could be unintentionally spreading the virus and contaminating other individuals and objects. As a result, AI.COMM developed a set of training modules on the correct use of personal protective equipment (PPE); decontamination supplies; and viral sample testing and packaging processes – all of which were commodities sent by USAID to countries experiencing outbreaks. In addition to personal protective equipment, the modules underscored the importance of following proper disinfection procedures following outbreaks to ensure there is no reoccurrence, as well as how to correctly sample, test and package virus from sick or dead animals so that they are viable for use at confirmatory laboratories. Once the training modules were completed, AI.COMM training staff were then quickly dispatched to countries including Mali, Niger, Cote d’Ivoire, Jordan and Bangladesh to implement these hands-on, three-day instructional sessions with both animal and human health workers. The format of the modules served as a foundation for several subsequent training curricula, including a series of trainings for government officials in Bangladesh. Copies of these modules, as well as other training curricula, can be found at www.avianflu.aed.org/training.htm.

Improving bio security in Lao PDR

An innovative pilot project has been completed in Lao PDR, under the USAID-funded avian influenza program, to help backyard farmers to improve their bio security and that of their village as a whole. AED in collaboration with FAO, worked in four villages in Vientiane and Champassack provinces to identify and implement feasible bio security measures to prevent poultry diseases from entering the village, and to mitigate impact, if an outbreak were to occur. The project uses participatory action research (PAR) to involve the community -- including village authorities, village veterinary workers (VVW’s), poultry raisers and other volunteers -- to assess the local situation, exchange ideas about poultry disease, identify problems and determine feasible interventions for prevention and response. The PAR was led by community members, themselves, and provided a forum for them to discuss their understanding and knowledge of the risks of poultry disease, and identify the measures they can implement village-wide to protect their poultry and families. After the eight-month pilot project, results showed that all four villages remained AI-free and that important behavioral changes had taken place such as an increase in reporting of sick and dead poultry; improvements in quarantine, isolation, separation, and night-time housing; importing fewer poultry into the village and providing clean feed & water for poultry. All these changes were decided on and acted on by the villagers themselves. Participatory Action Research (PAR) for the Development of a National Avian Influenza Communication Strategy: A Field Guide (PDF).

It takes a village: Village leaders bring their communities together to improve poultry raising practices and fend off avian influenza outbreaks

A USAID-funded project in Lao PDR tackled the difficult issue of getting backyard farmers to adopt new and safer poultry raising behaviors by developing a village-wide solution. Research showed that the habits of individual backyard farmers were difficult to change. As a result, USAID’s Avian Influenza Behavior Change Communication (AI-BCC) project, took a different approach. Rather than trying to convince individual farmers to change their behaviors, the project tapped into the traditional practice of village-level decision-making, and developed a comprehensive training program for village leaders, combined with a comprehensive AI Package to build the capacity of village heads and, in turn, their communities to mitigate the risks of an outbreak. This package provides a variety of resources - such as low literacy posters and booklets, video and audio CDs, and outbreak kits - that was created for village leaders to use when responding to and preventing outbreaks. AI-BCC assistance provided comprehensive training, along with complete AI outbreak packages for village leaders in over 300 villages in four districts in Vientiane, Savannakhet, Champassack, and Luang Prabang. In addition, this network of trainers and trainees has been used to strengthen pandemic preparedness skills as the country faces the 2009 influenza A H1N1 pandemic. “In the end, we have created a network of trained people across the district and village levels to deliver information”, noted Dr. Phoumy Bhoudisane of the Lao Government’s Center for Information and Education for Health (CIEH). “We discussed and exchanged information and planned together to implement activities based on consensus that we have not been able to get in the past.” Bringing these groups together in itself, he added, “is a great success.” AI-BCC in LAO PDR.

Unlikely “Superhero” emerges in fight against bird flu

Soon after the Avian Influenza outbreak hit the capital city of Lao PDR in mid-2006, a new superhero emerged to help fight the spread of avian influenza in Lao PDR. His name is "Superkai", or "Super Chicken", as he is known to English speakers. The National Human & Avian Influenza and Coordination Office (NAHICO), with support from the AED, introduced this unlikely spokesperson to Lao PDR just as he was most needed, and over the next 3 years he could be seen at various community activities promoting awareness of avian influenza prevention. First developed during an AED-sponsored communication workshop, this superhero spokes-chicken for AI prevention and control is a broad-breasted rooster with a familiar red cape and strong opinions about healthy behavior. Superkai made his first appearance in public awareness television ads and on posters and flyers, where he demonstrated how to prevent the spread of bird flu. Part chicken and part human, Superkai was developed in Laos through the work of Lao Television staff, using newly-acquired video animation software, at a workshop organized by the Lao Journalists Association, sponsored by the US Agency for International Development (USAID), and facilitated by AED. With a powerful commitment to the health of both poultry and people, combined with unstoppable energy, Superkai travels on foot, motorcycle or boat to help farmers and communities prevent avian flu outbreaks. He serves as a credible source of good behavior and best practice to stop the spread of the bird flu virus. "Our interviews with backyard farmers and their communities showed that there was both the need and the desire to have more information on specific steps to take to prevent outbreaks of bird flu," said Dr Bounlay Phamousack, Director of NAHICO in Lao PDR. "The Super Chicken fills that need in a fun yet educational way." In addition to posters and booklets, Superkai has appeared on television and on stage, doing question and answer sessions, songs, dances and drama performances at festivals. He continues to appear in materials and events in Vientiane and other provinces in Lao PDR. SuperChicken: Using an Icon in the Fight against Avian Influenza (PDF).

Women lead the way: Lao Women's Union mobilizes communities to prevent avian influenza

In early 2007, following a massive mobilization effort which successfully brought a citywide outbreak of Avian Influenza under control, the Lao women's Union organized a mobilization march down the main avenue of Vientiane to celebrate their success and to strengthen the community’s resolve to prevent further outbreaks in their capital city. With the support of USAID's Avian Influenza - Behavior Change Communication project (AI-BCC), managed by AED, the Lao Women's Union brought together in the Vientiane capital, the provincial governor, the governors from 6 of the 7 districts that had experienced the outbreak, as well as its own members, and the community at large - in total over 3000 people - to demonstrate the power of women’s leadership in taking effective community action in bringing a deadly outbreak in a major urban area under control. The Lao Women's Union was one of the first organizations to mobilize when the Avian Influenza outbreak hit the Vientiane capital area in February of 2007. The outbreak ultimately affected 6 districts, 39 villages, in the capital city alone, and led to the culling of over 300,000 birds, and affected over 100,000 families. The march in the Vientiane capital culminated a great deal of work which had begun a year earlier. AED began its collaboration with the Lao Women's Union in early 20006, providing an orientation to their leadership which led to the initiation of a two-year project to prevent and control avian influenza. An extensive community mobilization effort cascaded from master trainers in the capital through the provinces to the district and community levels. The effort drew on the Women's Union extensive membership in four priority provinces of Lao PDR. The Women's Union has a membership of over 1 million highly motivated members and chapters at the provincial, district and village levels and has the ability to reach most communities in the country. By most measures, it is the strongest civil society organization in Lao PDR. Moreover many if not most, LWU members, in fact, were backyard poultry farmers themselves and understood the need to learn how to prevent future outbreaks and avert the resulting economic hardship. “We were very quick and effective,” noted Mme. Phewlavanh Luangvanna, Training Director of the Lao Women's Union. “That's what we are acknowledging here with this walk. We have worked hard to get to this point,” she explained, “and I feel good about what we did for our communities -- we educated over 40,000 women in the villages on prevention measures... and not just the women, but their families as well.” Nurturing a Social Network to Respond to Avian Influenza Outbreaks: AI-BCC and the Lao Women’s Union (PDF).

Provincial multi-media AHI campaign promotes “3 Good Things” in Vietnam

In 2009, the government of Vietnam intensified promotion of practices to prevent and control avian and human influenza as prescribed in the National Strategic Framework for Avian and Human Influenza Communications, 2008-2010. In late 2009, the Department of Animal Health (DAH) of the Ministry of Agriculture and Rural Development in collaboration with the Sub-DAH Offices of Ha Nam, Quang Tri and Kien Giang provinces, launched an integrated mass media and social mobilization campaign to promote three of the key prescribed practices among poultry farmers and those involved in the local poultry trade. Called “3 Good Things”, the campaign aimed to motivate people to : 1) buy and sell healthy poultry; 2) wash hands with soap and water before and after handling poultry; and, 3) immediately report sick or dead poultry to the vet or village head. These messages were communicated by three entertaining, educational audio spots aired in provincial radio stations and commune loudspeakers, 126 billboards installed in high-traffic areas, 400,000 comic flyers distributed to farmers and poultry trade workers as well as 30 market events and one roadshow held in market vicinities. This was the first time that mass media and face-to-face communication channels were used to single-mindedly promote three key messages in an integrated, attractive and compelling manner. The campaign was also groundbreaking since the provincial and district animal health officers of the three provinces were directly involved in its planning and implementation. The radio and loudspeaker spots were able to reach an estimated 3.3 million farmers and workers in the poultry trade. The market events and roadshow drew an audience of more than 1,700 poultry farmers, vendors, transporters, slaughterers, breeders and consumers who actively participated in games, demonstrations, Question and Answer sessions and songs. The “3 Good Things” campaign was supported by the United States Agency for International Development (USAID) with technical assistance from the Avian Influenza Behavior Change Communication (AIBCC) project managed by AED. AI-BCC in Vietnam.

AI communication materials finally reach their intended audiences in Vietnam villages

One constraint faced by animal health workers in communicating avian and human influenza prevention and control has been the lack of visual aids and materials. Even if these materials are available, they often do not reach their intended audiences because of poor distribution. The Avian Influenza Behavior Change Communication (AI BCC) project in Vietnam decided to remedy this situation. It supported the government of Vietnam’s Avian and Human Influenza Program by developing and producing simple, highly visual materials which trained animal health workers can use in their information-giving activities to poultry farmers at the village level. In close collaboration with the Department of Animal Health (DAH) of the Ministry of Agriculture and Rural Development, the project developed an AI prevention leaflet with the Vietnam Women’s Union and an AI Outbreak leaflet with the Vietnam Poultry Association. These materials were reviewed by experts of the Food and Agricultural Organization, pretested among poultry farmers and finalized based on pretest results. To ensure that the materials reached the intended users, the project provided support for their transportation up to the commune levels. Monitoring activities showed that the materials did reach their intended users. Trained women’s union staff and farmer leaders were able to use the AI prevention and outbreak leaflets as guides for individual and group discussions on AI at the village level. A survey conducted in Ha Nam, Quang Tri and Kien Giang provinces in 2009 by an independent research agency revealed that 76% of animal health workers reported using communication materials in their work. Of these, the majority identified AIBCC-produced materials with many able to show these materials to the interviewers. The AIBCC project was funded by the United States Agency for International Development (USAID) and managed by AED. AI-BCC in Vietnam.

Provincial TV and radio campaign informs on mass poultry vaccination changes in Vietnam

In 2009, the government of Vietnam launched a pilot program to test various strategies to withdraw subsidies for its mass avian influenza poultry vaccination campaign in the five provinces of Nam Dinh, Ninh Binh, Quang Binh, Hau Giang and Soc Trang. In order to educate poultry farmers of the changes in the vaccination program, the Department of Animal Health (DAH) of the Ministry of Agriculture and Rural Development and the Food and Agriculture Organization launched a public awareness campaign called “A New Stage”. Aside from informing poultry farmers of these changes that would affect their poultry, the campaign encouraged farmers to seek specific information on these changes from the chief commune animal health worker. These messages were communicated through two entertaining yet informative TV spots shown in provincial TV stations and four audio spots aired in provincial radio stations and commune loudspeakers.of the five provinces.. Television was the main channel used to communicate the messages because research studies consistently showed that farmers consider TV as the main and most reliable source of information about avian and human influenza. Aside from provincial mass media, the provincial and district DAH offices distributed 500,000 flyers which carried the same messages as the TV spots. The mass media campaign was estimated to have reached nearly four million poultry farmers in these five provinces. “A New Stage” campaign was funded by the United States Agency for International Development (USAID) with technical assistance from the Avian Influenza Behavior Change Communication (AIBCC) project managed by AED. AI-BCC in Vietnam.

Cadre of trained AHI communicators reaches wide audience with AHI messages in Vietnam

At the peak of avian and human influenza (AHI) outbreaks in 2005, the government of Vietnam needed to quickly communicate AHI prevention and control measures to as wide an audience as possible. To respond to this need, a mass training program of village-level communicators was launched in late 2005. From 2006 to 2009, more than 30,000 animal and human health workers, agricultural extension workers, poultry farmer leaders, women leaders, commune officials and other community influentials were trained to effectively communicate avian and human influenza (AHI) messages in 36 of 63 provinces in Vietnam. These trained cadre of AHI communicators were the result of successful partnerships between the Department of Animal Health of the Ministry of Agriculture and Rural Development and mass organizations and local NGOs like the Vietnam Women’s Union, Farmers Union, Poultry Association, Feed Association, Veterinary Association, Agronomes et Veterinaires sans Frontieres and CARE Vietnam as well as the Ministry of Health’s Center for Health Education. Using participatory approaches, these mass organizations and NGOs trained their local networks to incorporate AHI messages in their existing communication activities. After training, these AHI communicators, wearing AHI caps or bags and armed with AHI leaflets, flyers and posters, were able to conduct extensive interpersonal communication activities in their villages. For example, in 2007, trained women’s union staff in 24 provinces conducted nearly 10,000 group discussions, club meetings, short plays and song competitions in 24 provinces which reached nearly 400,000 women backyard poultry farmers. Commune workers trained by CARE organized group discussions, school competitions, quiz shows and short plays on AHI attended by nearly 60,000 people in four provinces. A follow-up survey undertaken by an independent research agency in 2008 among those trained in 2007 revealed that a big majority of these AHI communicators continued to conduct AHI communication activities on their own even one year after training. The training activities were funded by the United States Agency for International Development (USAID) with technical assistance from the Avian Influenza Behavior Change Communication (AIBCC) project managed by AED. AI-BCC in Vietnam.