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

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


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


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.


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


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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A

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P

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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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SS

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A

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ES

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SED

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AN

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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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OF A

VIA

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ST

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T

AR

GET

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UD

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AV

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B

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AV

IOR

RE

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FO

R

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RR

EN

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AV

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BA

RR

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S T

O

CH

AN

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A

CT

IVIT

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/ M

ES

SA

GES

A

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OC

AT

ES

P

RO

PO

SED

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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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nical W

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IN A

PA

ND

EM

IC

S

TR

AT

EG

Y

TA

RG

ET

A

UD

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CE

D

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IRE

D B

EH

AV

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C

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RE

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B

EH

AV

IOR

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AS

ON

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R

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EN

T

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AV

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O

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AN

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A

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RO

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AN

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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

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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.


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


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


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


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.


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.


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.


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


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.


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.


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:


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


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.


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


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)


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.

ai comm meeting 07april draft - · pdf fileannex 2: attendance list.....14 annex 3: welcome...

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