Could Avian Influenza be Contained in Rural Egypt through Community outreach behaviour change Program

Women and children in rural Egypt are generally the most affected by H5N1 spread. From economic, nutrition or livelihood sides it is a serious threat especially to the poorest. Since 2006, the Egyptian Ministry of Health and UNICEF initiated a widely spread community education interventions that cover most of the affected rural and peri urban areas through a network of 13,000 community health workers (CHW) reaching almost 5 million families. The objectives included improving critical knowledge and encouraging healthier breeding practices. A recent comprehensive evaluation concluded that UNICEF MOH interventions reached the intended strategic objectives. The 70% of families visited by (CHW) reported a higher level of gained and recalled knowledge of protective means. A statistical correlation (Pearson R= .011) exists between being visited by a CHW and the perception of self efficacy in protecting oneself especially when compared with non visited families in the same areas. Critical practices like hand washing with soap and water after handling poultry were also strongly correlated with the CHW visits (Pearson R= .000) and the caging of poultry away from the living areas as well as the decreased children participation in the poultry breeding (Pearson R= .000). However, some challenges remain. CHW system needs to be streamlined to include all the community health messages delivered and not only avian relevant and synergistic links with other community resources are crucial to amplify the interventions' impact.