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CARE INTERNATIONAL IN VIETNAM

AVIAN INFLUENZA LOCAL RISK REDUCTION PROJECT

BASELINE KAP STUDY

August 2006

Disclaimer: The views expressed herein are those of CARE Viet Nam and do not necessarily reflect the official position of the Australian Government, the Australian Agency for International Development (AusAID) or any other Party.

Table of ContentsCARE INTERNATIONAL IN vIETNAM.................................................................0 Disclaimer: The views expressed herein are those of CARE Viet Nam and do not necessarily reflect the official position of the Australian Government, the Australian Agency for International Development (AusAID) or any other Party.Table of Contents....................................................................................0 Table of Contents .............................................................................................1 Introduction.......................................................................................................2 Avian influenza in Vietnam .............................................................................2 CAREs STOP AI program .............................................................................2 Aim..................................................................................................................3 Methods ............................................................................................................3 1. Study population.........................................................................................3 2. Data collection ............................................................................................4 3. Statistical analysis ......................................................................................4 Results..............................................................................................................4 1. Part 1: General information ........................................................................4 Attitudes towards AI.........................................................................................5 2.1. Part 2A: Knowledge of AI transmission and symptoms in poultry ..........6 21.1.1 Question 10: Transmission routes among poultry..........................6 2.1.2 Question 11: Symptoms of AI in chickens .........................................7 2.1.3 Question 12: Symptoms of AI in ducks...............................................7 2.2 Part 2B: Knowledge of AI transmission and symptoms in humans .........7 2.2.1 Question 13: Transmission of AI in humans......................................7 2.2.2 Question 14: Symptoms of AI in humans...........................................8 3. Part 3: Knowledge of AI practices ..............................................................8 3. Part 3: Knowledge of AI practices ..............................................................9 3.1 Question 14: Prevention methods against AI for family ......................9 3.2 Question 15: Protection methods for AI when slaughtering poultry ..9 3.3 Question 16: Protection methods for AI when cooking poultry ........10 3.4 Question 17: Prevention methods against AI for poultry ..................11 3.5 Question 18: What do you do when you suspect AI in your poultry? ..........................................................................................................................11 3.6 Question 19 and 20: Reporting suspect AI .........................................12 3.7 Question 21: Vaccination of poultry......................................................13 4. Part 4: Direct Observation ........................................................................13 Conclusion......................................................................................................14 Annexes..........................................................................................................16 Annex1. Study Protocol for KAP ..................................................................17 Methods ...............................................................................................................17 Study population.................................................................................................17 Data collection ....................................................................................................17 Statistical analysis..............................................................................................18 Timeline ...............................................................................................................18 Annex 2. KAP Tools .....................................................................................20

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IntroductionAvian influenza in Vietnam The H5N1 avian influenza virus (AI) is a particularly virulent poultry disease that has caused billions of dollars of livestock losses in Asia and is now considered endemic in Vietnam. It is a zoonotic disease that has already caused deaths in humans, and threatens to mutate into a human infection with potential consequences larger than the scale of the 1918 influenza pandemic. Direct losses from the 2003-2004 outbreaks in Vietnam resulted in 44 million birds either dying or being destroyed. Vietnam has been ground zero for human cases of avian influenza, reporting the highest number of human AI infections in any country by a substantial margin until just recently. Vietnam has experienced 93 cases resulting in 42 deaths as of 11 August 2006. Almost all the human cases to date have had presumed contact with infected birds. The most important exposures have been from handling sick or dead birds, although limited human-to-human transmission through close contact with infected relatives has recently been confirmed in Indonesia. The nature of the threat to humans persists so long as birds and other animals continue to be infected with highly pathogenic AI. The effective management and control of AI is critical not only for the livelihoods and food security of the rural poor in Vietnam, but because of the potential of the virus to mutate and become capable of human-to-human transmission. CAREs STOP AI program CARE in Vietnam has been working with communities since 2004 to address the major gap in AI awareness, prevention, and outreach support and, based on considerable experience, has developed a successful AI model to be replicated and expanded to the most vulnerable communities. CARE couples Behaviour Change Communication (BCC) with creative new approaches to develop the IEC messaging through both formal and informal community structures. CAREs model encourages partnership and a multi-sectoral approach to community mobilization for understanding of and response to AI. CARE initially conducted a Knowledge, Attitude and Practice survey in December 2004- January 2005 in Long An, An Giang, Binh Dinh and Son La provinces to obtain an in-depth understanding of mainly small-scale rural farmers knowledge, attitude and practices (KAP) on poultry rearing in order to inform health education in regards to AI. Using the results from this report, CARE developed the STOP-AI program (Strengthening Training, Outreach and Prevention services for the ongoing Avian Influenza response), which was funded by NZAID and implemented in four districts in Binh Dinh and Long An Provinces, between May 2005 and February 2006. An independent evaluation of the STOP-AI project was favourable, and concluded that the project effectively contributed to raising the awareness of Avian Influenza for small-scale poultry producers in Binh Dinh and Long An provinces. Further funding from McDonalds in early 2006 allowed CARE to expand the program to four districts in Hai Phong, Bac Ninh, Dong Thap and An Giang provinces (STOP-AI2). This project has been conducted in 64 communes and is2

due for completion in September 2006. In June 2006 AusAID also provided funding to expand STOP-AI2 in four different districts in these same four provinces (referred to as Local Risk Reduction project (LRR) from now on). This phase will reach an additional 32 communes. One of the additional components of the STOP-AI2 program is to conduct a knowledge, attitude and practices (KAP) survey of households in all four provinces at the beginning and towards the end of the project cycle in order to evaluate the effectiveness of the program. Aim To conduct a baseline knowledge, attitude and practices (KAP) survey of households in Hai Phong, Dong Thap, Bac Ninh and An Giang before conducting CAREs Local Risk Reduction project in these provinces.

MethodsThe study design is a cross-sectional survey, administered at the beginning of the project cycle. The same survey will be administered towards the end of the project cycle and compared to the results of this baseline. This report includes the baseline survey results only. 1. Study population The baseline study was conducted in one commune in each of the four provinces of the LRR project Hai Phong, Bac Ninh, An Giang and Dong Thap. The participating communes were randomly selected from the eight communes in each province that will be involved in the LRR project. The total number of households to be interviewed in each commune was 100. For each of the selected communes, information was gathered about the structure of the commune and this was used to determine the selection method of households for that commune. In Bach Ninh, the selected commune was Tam Giang, which consists of five villages. Each of these villages had a different number of hamlets (streets), and these were divided to allow for twenty interviews from each village as follows: 1. Hamlet 1 5 interviews in all 4 sub villages 2. Hamlet 2 4 interviews in all 5 sub villages 3. Hamlet 3 10 interviews in all 2 sub villages 4. Hamlet 4 4 interviews in all 5 sub villages 5. Hamlet 5 5 interviews in all 4 sub

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