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The multi-sector framework for health communication established
by the USAID-funded Communication for Healthy Living project
placed Egypt in a unique position to effectively meet the
challenges of outbreak communications.
In the immediate aftermath of the Avian Influenza (AI) outbreak
in Egypt in February 2006, the Government of Egypt was able to
quickly establish widespread awareness of AI risks, means of
transmission, and basic prevention measures. Within hours of the
confirmation of cases of the AI virus in Egypt on February 17th,
all the major state-owned television channels were broadcasting
the news to the public as well as airing an informative TV spot
showing families how to protect themselves from the deadly
virus. The TV spots reached 82%, or 34 million, within one day,
and research in May showed message recall of the AI TV spots at
68%.
Egypt was in a unique position to respond swiftly and
effectively to the crisis because of the partnership and
cooperative mechanisms established between the Ministry of
Health and Population and the Ministry of Information through
the Communication for Healthy Living (CHL) Project, implemented
by the Johns Hopkins University/Center for Communication
Programs (JHU/CCP) through the Health Communication Partnership
(HCP).
The partnership between the MOHP and MOI’s State Information
Services (SIS), established with the support of USAID over 25
years ago, builds on the comparative strengths of both
institutions – the service delivery capacity of the MOHP and the
communication expertise of the Ministry of Information. USAID’s
CHL project builds the capacity of both ministries to implement
joint programs across health areas, addressing family planning
and reproductive health, maternal and child health, reduction of
infectious disease (including AI and HIV/AIDS), and the
promotion of healthy lifestyles. CHL project partners
disseminate health messages nationally via the mass and
electronic media, through MOHP’s 5000+ clinics, through outreach
workers from the government and NGOs, and through a national
“Ask, Consult” network of 13,000 private pharmacists.
All of these partners and channels were mobilized according to a
practical AI communication strategy developed by CHL prior to
the outbreak under the auspices of the national AI committee,
chaired by the MOHP with representatives from all the concerned
national bodies (including the Ministry of Information and
Ministry of Agriculture) as well as international partners (such
as USAID/ NAMRU and WHO). The strategy reflects WHO guidelines
for effective outbreak control, and is guided by key principles
of outbreak communication: Credibility/Trust, Early
Announcement, Transparency, Respect for Public Concerns, and
Advance Planning.
The approach of the communication strategy includes the
following elements:
• A Unified Campaign. On the national level a unifying logo or
“brand” for credible AI information is used on all campaign
productions and materials. To build credibility, this logo
appears alongside those of international partners such as the
WHO, and UNICEF as well as those of collaborative ministries and
organizations.
• Multi-sectoral action. The communication strategy involves
partners from several ministries, sectors, and industries in
critical activities.
• Multi-level implementation. Activities are designed to be
implemented on the national, community, and interpersonal level.
• Sustainable. It is likely that the AI threat will remain
indefinitely, and Egypt must stay alert to pandemic potential.
Activities must be ongoing so as to avoid complacency and a
return to at-risk attitudes and behaviors.
• Dynamic. The level or phase of AI in Egypt is likely to change
over time. The communication plan must therefore be continually
refined and adapted to address identified threats and gaps.
 Addressing
AI in the Egyptian context required identifying specific
messages for specific audiences. The communication response was
organized to address health, agricultural, and environmental
sectors. For example, poultry is a very important source of
income for many families—especially rural—in Egypt. 29.4% of the
population own poultry in Egypt. On average, income from poultry
represents about 14% of the total monthly income for these
households. Approximately ¼ of the households owning poultry
fall into the Highest Vulnerable Population (the poorest
groups). Pre-testing of preliminary avian flu communication
materials showed that rural groups as well as the general public
wanted more information on signs of flu in poultry and its means
of control, necessitating a coordination of messages emanating
from the MOHP and SIS with those of the Agricultural Sector.
Egypt has a sophisticated communication environment, with access
to print, Internet, and broadcast technology, as well as
extensive networks of outreach workers in the government, NGO,
and private sector. These form both the main communication
channels and the responsible parties for implementing the
strategy. A unified strategic approach helps to 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 epidemic prevalence.
Among the wide range of interventions are TV, radio and press
announcements, GOE website support, hotline promotion, press
inserts, press briefings and journalist training, provider
fact-sheets, and consumer fliers, posters and other information
materials.
In addition to the initial TV spot with general information on
modes of transmission of AI and basic preventive measures, CHL
collaborated on the production of three other TV spots on AI
with more specific messages on modes of transmission, hygiene
and safe preparation of poultry for consumption, safe handling
of live poultry, keeping children safe, and promoting a national
AI hotline. The AI hotline received close to 300,000 calls in
the first three months. CHL also co-produced a public service
announcement (PSA) on AI as a joint activity with Alam Simsim as
part of CHL’s private sector pharmacy development program, with
special messages on keeping children safe from exposure. These
spots were aired regionally via satellite.
Fliers with messages on AI prevention and protection for
families with and without poultry were produced and in
distribution prior to the outbreak via channels such as the
MOHP’s 5000+ clinics, outreach workers from the government and
NGOs, and the national “Ask, Consult” network of 13,000 private
pharmacies. The materials are available to download on via the
SIS-IEC Center database on the CHL website (www.healthcom-egypt.info),
and are a valuable resource for other Arabic-speaking countries
facing Avian Influenza. Newspapers and magazines reprinted
hundreds of thousands more as inserts, and continue to cooperate
in efforts to spread public awareness on AI.
CHL’s community programs provided the framework to train and
mobilize volunteers to address the AI threat in their villages,
holding meetings in homes to disseminate AI health messages and
setting up committees to screen all the houses breeding domestic
birds and to close shops that sold live birds. Pharmacies, often
the front-line health service delivery venue for the majority of
Egyptians, have also proved to be a critical source of public
information on AI, and 30,000 informational posters were
delivered to Ask-Consult network pharmacies, to be posted on
storefronts. Hundreds of thousands of AI flyers for providers
and consumers were also distributed to Ask-Consult pharmacists.
Capacity building of communication professionals, emergency
crews, and service providers has been operating parallel to
public awareness activities. A workshop for journalists was held
in May 2006 aimed at raising and maintaining awareness of the
risks of AI among the public, and countering misinformation and
rumors. In collaboration with the MOHP, and CHL produced a
training video for the emergency crews the government has
mobilized to collect and properly dispose of infected and dead
birds from farms. The video covers safety procedures for
protecting the team members themselves, and for containing the
virus. A program of orientation workshops and trainings for
service providers throughout the country began in May, supported
by a booklet. In-clinic seminars on AI for the general public
were conducted immediately following these seminars at 3500 MOHP
health units. A Q&A booklet based on questions received via the
MOHP AI Hotline was distributed as insert in several popular
newspapers and magazines. A booklet for use in trainings and
orientations is also being produced.
 The
SIS chairman serves as the official spokesperson on AI in Egypt,
and is committed to transparency in outbreak communication. CHL
provided the SIS with content for their AI media center and
website (http://birdflu.sis.gov.eg/html/index.htm) to facilitate
timely access to official information. CHL will continue to work
with national and international partners in Egypt to meet the
challenges that lie ahead in communicating about the risks of
AI, reducing misinformation, providing prevention information
and promoting safe behaviors that will protect the health of
Egypt’s people.
For more information, see the
Avian Influenza page. |
