**7. Communication**

Communication is a crucial aspect of disease management. It includes all forms of communication from daily media surveillance to the distribution of printed materials aimed at raising awareness of Avian Influenza control measures (e.g. hygiene, cleaning/washing, and waste disposal).

Disease Management of

required to adequately address the problem of AI.

can avert significant morbidity and mortality.

resources on stopping outbreaks before they occur.

about avian influenza. Retrieved from http://www.cdc.gov/flu/avian/gen-info/facts.htm

about avian influenza. Retrieved from http://www.cdc.gov/flu/avian/gen-info/facts.htm

managing H5N1 in live birds.

approach for managing AI.

**9. References** 

Avian Influenza H5N1 in Bangladesh - A Focus on Maintaining Healthy Live Birds 269

Coordination among donors and agencies is critical and an area that needs to be further strengthened. In addition, prudent communications has the potential to reduce the risk of market collapse due to infection of AI and prevent more cases in both humans and animals. While many lessons have been learned, there are still many gaps that need to be addressed to the problem of AI in Bangladesh. There needs to be a clear understanding of the epidemiology of the H5N1 virus. Research on the development of cheap and easily available quick diagnostic techniques needs to be expanded. In addition, more manpower is needed to improve the logistics of the Veterinary Service to carry out surveillance and respond to outbreaks of AI. Finally, improved coordination between stakeholders and donors is

The need for clinical management of AI H5N1 may be decreased and possibly eliminated by

To achieve this goal, there are further steps that need to be taken. First a coordination, information, and cooperation model should be developed focused on increasing common understanding to prevent the threat of emerging and re-emerging zoonotic diseases of economic importance in the region. In addition, more emphasis should be placed on "risk" oriented communication rather than "fear" oriented communication. A cost-effective method for diagnosis and response should be developed, as well as increased capacity building. In spite of the challenges, with hard work, transparence, strong coordination, and willingness, focusing efforts on improving and sustaining animal health is a feasible

The current public health approach to avian influenza focuses on control and management after an outbreak has already occurred. However it would be possible to utilize resources more strategically by adopting a prevention-centered approach. By preventing an outbreak before it occurs, resources can be directed toward broader improvements in sanitation and hygiene practices that will positively affect not only avian influenza control efforts, but those of many other communicable diseases. In addition, focusing resources on prevention

Efforts to support a prevention-centered approach to pandemic avian influenza can be used to strengthen the nation's public health infrastructure, more broadly, which will ultimately result in greater public health and security gains than any reactionary response could possibly hope to. While the necessity has previously been to control and mitigate outbreaks once they have occurred, we are in a strategic position to move towards a more sustainable focus on prevention. It is time to seize the opportunity to get ahead of the threat and to focus

Centers for Disease Control and Prevention. (2007. May 07) Avian Influenza (flu): Key facts

Centers for Disease Control and Prevention. (2008. May 28) Avian Influenza (flu): Key facts

World Health Organization. (2006a, February). Avian Influenza ("bird flu"). Retrieved from http://www.who.int/mediacentre/factsheets/avian\_influenza/en/

The majority of the communication messages have focused on five target audiences: slaughter at home, restaurants, consumers, truckers, and vendors at live bird markets. Additionally, there have been regular press briefings issued, as well training and orientation sessions for the media personal reporting on Avian Influenza issues. As a result of improved communication, people have better access to accurate information on prevention and treatment of H5N1. People are also better informed on basic bio-security and hygienic preventive measures, where to receive services in the case of an outbreak, and the government policy on H5N1 as it relates to the compensation, bio-security, and rehabilitation plans (USAID/Bangladesh 2010).

In an attempt to improve communication and information access for the public, current communications efforts are looking to establish and implement web-based SMS communications plans. This technology has the potential to be used to update the relevant stakeholders at all levels with information regarding Avian Influenza. This includes everything from the current market price of birds to outbreak alerts to best practices (USAID/Bangladesh 2010).

One example of disease management from a communication-based approach is illustrated through the piloting of an intervention to reduce the risk of transmission of Avian Influenza to humans in rural Bangladesh. This intervention involved developing, modifying and disseminating a set of culturally appropriate messages on slaughtering and handling practices for sick and dead poultry. Once the original communications materials were developed, their acceptability and feasibility in the community was explored and the message was disseminated at five courtyard meetings. Using observation, informal conversation, in-depth interviews, and group discussions to collect data, researchers found that villagers verbally expressed willingness to follow the messages if their poultry have "bird flu." However, in practice, they were unwilling to avoid slaughtering or selling sick poultry as they would lose household income(USAID/Bangladesh 2010).

Research has shown that barriers to practicing AI preventative measures fall into two categories. The largest barrier that prevents the practice of AI preventive measures is the attitudes of the population. While people may express a willingness to follow the practices, in practice, the perceived risk of AI infection in humans is too low to outweigh the immediate cost of losing income from the poultry. In addition, there is little value given to the prevention of AI. In general, the cost of prevention for any poultry farmer in greater in the short term and the benefits are reaped over the long term. This leads to negligence and carelessness towards the practice of AI preventive measures. The second barrier that prevents the practice of AI preventive measures is a lack of awareness. The lack of awareness begins with a failure to initially identify the disease in backyard and semicommercial farms. Populations also lack awareness about high-risk behaviors that can lead to the contraction of the disease in humans and the prevention measures for the points of contraction. Finally, there is a lack of awareness about AI vaccination for poultry (USAID/Bangladesh 2010).
