Partner Insights FAO Risk Communication Seminar


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Partner Insights FAO Risk Communication Seminar

  1. 1. Partner InsightsFAO Risk Communication SeminarSusan Mackay, Senior C4D Specialist (Health) UNICEF
  2. 2. “Business unusual”
  3. 3. AI - What was learned (or not!)• Multiple KAP studies conducted between 2006-2007 (Unicef research in at least 16 countries)• Different methodology and designs made it impossible to compare or generalize results• Interesting insights for designing communication strategies, and general planning• However insufficient qualitative or participatory research to help address the critical „WHY‟ question
  4. 4. What the KAPs showed• High awareness but low understanding – High media coverage likely to be a significant factor• Low level of knowledge about transmission (at best one or two modes of transmission) and many „incorrect‟ beliefs
  5. 5. Challenges• Rural and less educated populations less knowledgeable and less aware• Studies largely descriptive – Lacking plausible explanations for demographic variables or varying levels of knowledge about different forms of transmission – Lack of nuanced analysis unfortunate as would have been key to improving design
  6. 6. Impact• Communication campaigns did contribute to increased awareness• Knowledge (transmission, symptoms, methods of disposal, and prevention) increased after exposure or participation in communication interventions eg – Meetings and outreach activities increased perceptions of the seriousness of AI in Laos – Substantial knowledge increases recorded (transmission modes and prevention) between 2006 and 2007 in Thailand and Egypt
  7. 7. Significant knowledge-practice gap • Although awareness and knowledge of prevention and transmission behavioural change was much lower – Some actions (cooking and handwashing) easier to implement than others (biosecurity and reporting behaviours) – also linked to low perception of risk – Need for a much deeper understanding of social, economic and political barriers to change
  8. 8. Risk perception• Even though awareness and understanding increased, risk perception and sense of urgency generally remained low• However in urban areas sudden drops in consumption reported during outbreaks – Yet in rural areas consumption even increased suggesting low risk perception• AI “only has relative importance”, “people are used to it”• Lower risk perception than issues such as dengue, malaria, malnutrition, diarrheal diseases and limited access to sanitation
  9. 9. Challenges• Studies identified variations in risk perception but did not (or were not sensitive enough) to investigate highs and lows – a better understanding of the drivers and timings of changing attitudes and behaviours is needed – more „dynamic‟, innovative approaches needed to tracking changing perceptions of risk – need to explore relationship with media coverage (animal and human cases) and of economic drivers
  10. 10. “… tools are still neededto address thechallenges ofcommunicating in thesedifficult circumstances.These tools can bedeveloped by looking atalternative paradigms ofrisk that exist within thesocial sciences.”Abraham, T, Bull World Health Organ 2009;87:604–607
  11. 11. “Risk Society” Beck, Giddens etc Epidemic Psychology“Psychometric Strongparadigm”Slovic et al.; Covello andSandman Social Amplification of Culture, Risk and Risk Blame Douglas (See Murdoch et al.)
  12. 12. But how does this translate inlow resource settings?
  13. 13. Behaviours Reality check (1)Studies showed that the four behaviours arerarely practices in high risk communities in„real life‟But too much emphasis on „educating‟ ratherthan finding the „locks‟ and „keys‟ tobehaviour change – Lack of link with „programme‟ and community developed solutions
  14. 14. Reality check 2 Reality check (2)“The idea that one should have to protectoneself from one’s poultry is literally exotic”“birds and humans have mingled forgenerations without any negative impact as faras they could see ….”We must constantly work within peoples social,cultural, political and economic realities.
  15. 15. Reality check 1 Reality check (3)“AI prevention and control faces formidableobstacles, including disbelief in the existence ofthe disease, lack of economic means toimplement recommended practices, anddistrust of the authorities and health services.“It is important to distinguish between obstaclesthat can be addressed through communicationalone, and those that need different andcomplementary programme interventions””
  16. 16. If we were starting again …• Much more emphasis on addressing attitudes, such as low risk perception and stigma around reporting• Total integration with technical programming to reduce structural obstacles that discourage health practices (eg grant subsidies, economic aid to strengthen bio-security, as well as incentives to promote community surveillance and reporting)
  17. 17. Design shortcomings• Not enough adjustment of the four key behaviours to local settings and realities – need for dialogue and consensus• Initial outbreak responses were inevitably „general‟, but later interventions should have been more tightly focused and nuanced to address specific needs and concerns (or lack of!) in segmented high risk populations
  18. 18. Potential solutionsParticipatory approaches to build localperspectives into design of activities andsolutions
  19. 19. Lessons learned• Too much emphasis on promoting the actual behaviour but not enough on „selling‟ the benefits and / or risks eg – Local beliefs – Social attitudes eg stigmatization – Agreeing feasible, low cost solutions – Encouraging self and collective efficacy – Credibility - understanding the context of trust in local authorities
  20. 20. Social determinants• Interesting gender, religious and cultural insights, but in many cases the data was available only after the bulk of communication interventions had been designed or implemented eg – Women primary handlers of poultry and eggs spending more time with backyard poultry – Men involved in handling slaughter, and cock-fighting in particular countries – Particular ethnic and or religious practices
  21. 21. Some highlightsInnovative work with schools eg. Thailand,Indonesia, Turkey
  22. 22. What worked• High level advocacy with government officials and decision makers• Training of print and broadcast journalists at national and subnational levels• Training frontline workers and volunteers, rapid response teams and poultry farmers• Orientation and training of government spokespersons, school teachers and community influencers• Folk theatre and rural media• TV and radio campaigns featuring public service announcements
  23. 23. Limitations• Frantic pace of activities – Emergency response to outbreaks – Pressure from donors to implement quickly when more time was needed for participatory research, design and implementation – Lack of existing capacity at all levels We were aware of most (if not all) of the limitations at the time but limited capacity to change course!
  24. 24. Institutional context• Level of government commitment, ownership and capacity varied• Coordinating committees a problem in some areas• Working relationships within and between agencies varied – where it was good generally the quality of work and impact was higher – These relationships work best where they are built in advance• Participatory planning processes involving multiple stakeholders was greatly appreciated
  25. 25. Resource issues• Some programmes had much more than funding than they were used to, others had to work with very limited resources• Limited human resources within country offices and country teams – some had to be pulled from other teams, others had to be recruited quickly without the necessary experience or training
  26. 26. AI and Pandemic Influenza• Much of the AI surge capacity was no longer in place when the H1N1 pandemic emerged• Confusion about the differences between AI response and pandemic preparedness – should have been delinked!• Much longer term investment is required in building „C4D‟ capacity – best way to be ready for an emergency
  27. 27. Wish list (1)• Interagency vision and leadership required to make long term communication investments towards „One Health‟• Capacity for evidence based communication planning and implementation in all agencies – correct balance of quantitative and qualitative research (including PLA, rapid surveys), implementation, monitoring and evaluation
  28. 28. Wish list (2)• More emphasis on achieving change through analysis of „locks‟ and „keys‟ to change, as well as careful use of appropriate risk communication approaches for developing country settings• Stronger partnership between the agencies – understanding each others roles, responsibilities, strengths and weaknesses
  29. 29. Thankyou