Egypt Case Study Discussion: Read, Reflect, and Practice in Groups 1.

Research and compare other

case studies on avian flu communication, Identify key elements of the communication strategy and
discuss haw they compare to key activities and strategies tfrom the Egypt case study. 2. What other
kinds of communication interventions and strategies can youthinkof to protect high-risk groups such
as women and children from avian flu? Discuss pros and cons of each potential option and focus
primarily on interventions that mey effectively encourage community participation and mobilization.
3. Research and discuss the socioeconomic implications of avian flu in a country of your choice and
related comimunication strategies and programs. Make sure to conduct a few in-depth interviews
with organizations and stakeholders who work De this issue in the country you selected. What can
we learn from school-based health communication? Recall and discuss any 4. personal or
professional experience that included schools as a key communication setting for health-related
topics. Analyze key success factors and other components of the intervention that appealed tc you.

Canada "With many experts at the time expecting severe influenza pandemic" (Nacinovich and
MacDonald, 2012), the second case study in this section features "regional planning efforts (that]
were developed to anticipate and respond effectively" (Nacinovich and MacDonald, 2012) to
pandemic flu in the Calgary Health Region of Canada. When several experts and organizations
warned in 2005 about the potential imminence of a pandemic (see definition within the case study),
"Canada was one of the first countries to have a pandenic influenza plan in place" (Nacinovich and
MacDonald, 2012). The case study discussesthe benefits of communication preparedness as well as
key components of the plan and activities that were developed in the Calgary Health Region.

BOX 16.2. PREPARING FOR A NIGHTMARE IN THE CALGARY HEALTH REGION-PLANNING FOR
PANDEMIC INFLUENZA Need, Situation, Health Issues Underständing the nature of pandemic is an
important step in the adequate preparation and crisis scenario planning regarding accurate and
timely health care communications. A pandemic is a geographical widespread outbreak of an
infectious disease in which many people are infcted at the same time occurring throughout a region
or even throughout the world (Heymann and Rodier, 2001). In 2005, the World Health Organization
(WHO) and the Public Health Agency of Canada warned that an influenza (flu) pandemic" is both
"inevitable" and "imminent" (World Health Organization, 2005d) Canada was one of the first
countries to have a pandemic influenza plan in place with the development of Its Canadian Pandemic
Infiuenza Plan at the national fevel (Public Health Agency of Canada, 2012). With many experts at
the time expecting a severe influenza pandemic, regional planning efforts were developed to
anticipate and respond effectively (Harper, Fukuda, Uyeki, Cox, & Bridges, 2005). These efforts were
advanced to assist in the "proper understanding of the nature of the threat, its likeiy impact on
Calgary, and to reassure people that Calgary Health Region is ready to respond" (Calgary Health
Region, 2005).

Goal and Objectives po) The Calgary Health Regian needed to focus on communicating with its
stakeholders by developing and implementing a detailed communication plan as part of its
contingency plan. Objectives • Develop and implement an overall pandemic response
communication plan. • Provide empioyers, health professionals, and the community with a better
understanding of pandemic influenza and its impact. Approach This case includes some of the
planning highlights and communication activities to develop in coordination at the health region
level. With each region responsible for developing contingency plans to reduce the impact of an
influenza pandemic, Calgary Health Region, Alberta Health and Wellness, and local municipalities
during this. frame in Canada came together to set out specific measures and actions. stakeholders
within

Sample Communication Strategies and Activities • Communication planning workshop for

representatives of all business units in the Calgary Health Region (ie. HR, emergency services,
operations, medical, etc.i to work through audiences, messages, and priorities • Overall
communications plan and development of the Calgary Health Region's main operational plan,
Pandemic Response Plan (Volume 1 was 185+ pages, Volume 2 was 473 pages) First public
document, Explaining Pandemic Intluenra, in April 2005 and its revised second release in December
2005 • Quick facts booklets for three separates audiences-community, employees, and physicians •
Creative communication elements focused on promoting best practices in general hygiene included
prevention posters and various educational tools • Pandemic micro-site strategies are integrated
into the Calgary Health Region's existing website • Pandemic intranet sites for employees •
Presentations at the Calgary Chamber of Commerce to reach the lo cal business community and
increase awareness with regard to pandemic preparedness and its importance to businesses.

$2020/2/11 08:08 Key Results During the initial phase of the pandermic influenza preparedness,
Caigary Health Region was very successful in building awareness of the importance of pandemic
influenza preparedness among all audience groups including the local community, businesses, and
Calgary Health Region staff. The print and onlinematerials were well received and helped Calgary
Health Region become a recognized leader in the pandemic influenza preparedness process by
engaging its staff and ensuring the local community had access to necessary and useful
information. Future Directions During pandemic, it is far too late to be thinking about refining
crisis plans or putting a an in place to protect your respective interests. The mere concept of a
pandemic threat ould immediately motivate government officials and business leaders to begin
the complex eparations for how to maintain adequate continuity and how best to plan for the
breadth and pth of needs and chalienges associated with health care communications that will be
critical to each stakeholder group. With the choices between "wait and see" and "plan for the
worst ad hope for the best," developing the pandemic planning and communication infrastructure
ow dernonstrates innovative, forward thinking based on established best practices that will
Comately yield long-term benefits for all stakeholders. Ultimately, it is far easier to explain.

why you effectively planned ahead and invested in the development of a plan than to need to
explain during or following a pandemic why a plan was not put in place. References Calgary Health
Region. Explaining Pandemic Influenza: A Guide from the Medical Officer of Heaith. Calgary, AB:
Calgary Health Region, 2005. Harper, S. A, Fukuda, K, Uyeki, T. Cox, N. J, & Bridges, CB "Influenza
Prevention and Control-Recommendations of the Advisory Committee on Immunization Practices
(ACIP ). " MMWR, 2005, S4 (Early Release), 1-40. www.cdc gov / mmwr / previewlmmwrhtmi /
r54e / 13al htm. Heymann, D. L, and Rodier, G. R. "Hot Spots in a Wired World: WHO Surveillance of
Emerging and Re-emerging Infectious Diseases." Lancet, 2001, 1 (5), 345 353. Public Health Agency
of Canada. "The Canadian Pandermic Influenza Plan for the Health Sector." www.phar-aspc
gc.ca/cpip-pclcpi/index-eng.php. Retrieved Nov. 2012. World Health Organization. "Responding to
the Avian Influenza Pandermic Threat- Recommended Strategic Actions." 2005d.
www.who.int/esr/resources/publications/influenza WHO_CDS_CSR_GIP_05_8-EN.pdf.

Source: Nacinovich Jr., M. R. and MecDonald, M, "Preparing for a Nightmare in the Calgary Health
Region- Planning for Pandemic Influenza." Unpublished Case Study, 2012. Used by permission.
Canada Case Study Discussion: Read, Reflect, and Practice in Groups 1. Research and review lessons
learned from past pandemic flu or other epidemics and disease outbreaks as they relate to
communicating risk in an emergency setting as well as encouraging the adoption and sustainability
of lifesaving behaviors and relevant social measures. Draw commonalities and differences among
two or three case studies to identity key elements of effective communication in the preparedness,
readiness, and response. phases (see Chapter Six). 2. identify and discuss potential community- and
household-based communication inter ventions to integrate existing elements of the Calgary Health
Region communication preparedness plan as highlighted by the Canada case study. Reflect on how
you will une on existing strategies and activities discussed by the case study and how you can makse
community participation and citizen engagement in support of an effective response 3. Research the
role of local business and health care providers within a pandemic What kind of information and
training is it important for them to receive in order to respond to a potential pandemic (or also
during a disease outbreak) both effectively and safely? Oraw your observations from published
papers on this topic, personal experience, and availabie case studies or organizational resources 4.
Analyze nmedia coverage during a recent pandemic or disease outbreak in your country or region
and reflect on the rofes and responsibilities of the mass media during a publir heelth emergency.
Focus on issues of accuracy, clarity of recommended emergency behaviors, responsible reporting,
and ather features that are particularly important at times of uncertainty and crisis such as during a
pandemic, epidemic, or disease outbreak Also, what are the main messages and do you think
underserved, vulnerable, or low literacy populations would be able to act on them? If not, what else
would you do to make stire no ane is left behind?

India Because interpersonal communication is a key area of health communication, this case study
(India) reflects on the lessons learned from two diphtherent interventions (addressing a polio
upsurge and an avian flu outbreak, both in India) for which interpersonal communication was the
most prominent element of communication programming. These experiences associate the
effectiveness of interpersonal communication to "the personal credibility of community mobilizers
and influencers" (A.eeq, 2012), and aiso identify sample issues that may undermine such credibility.
BOX 16.3. INTERPERSONAL COMMUNICATION: LESSONS LEARNED IN INDIA Polio Eradication On
February 25, 2012, after more than sixteen years of polio immunization campaigns, WHO officially
announced India as nonpolio endemic and remuved it from the list of polio-endemic Countries polio
virus (VWPV) cases in 2002, with more than 1,600 reported WPV cases. This outbreak reflects that
the impact of WPV was disproportionately high in children belonging to Muslim communities in
most parts of India. However, a deeper analysis of the affected children's profiles revealed that
poverty and not religion were the primary common factor among them.

Barriers and Challenges Poor social and economic conditions, lack of access to basic services,
including health, nutrition, and sanitation; unhealthy behaviors, such as open defecation and low
usage of manitary toilets: unsafe and contaminated water sources and unhygienic food caused
serious theeats to the health of vulnerable sections and decreased thcir immunity. Therefore,
despite taking multiole oral polio vaccine (OPV) doses, some children contracted WPV infection.
Preventive health präctices, such as immunization, were hardly a priority for poor parents who were
busy working hard to support their farmilies. Other barniers included misconceptions, such as the
belief that pol o vaccine causes infertity, lack of trust in the government, tatigue due to repeated
polio imununication rounds, sensationalized media stories, and so on
Evidence-based BCC (Behavior Change Communication) Marry parents in various high-risk areas
(HRAS) of polia with predominantly poor Muslms were not participating in immunızation campaigns,
and their children were not takıng adequate numbers uf CPV doses. This situation demanded more
systematic and focused communication interventions in these HRAS, and these strategies led poor
parents to accept immunization for their children. However, a sizable number of children who
missed vaccination formed a cohort of sursceptible children who constituted a wide enough
immunity gap for the virus to circulate and infect others. Interpersonal Communication and Social
Mobilization UNICEF India Country Office supported the deplayment of more than six thousand local
community mobilization coordinators (CMCS) Mostly local women, they were trained in
interpersonal communication (IPC sk ls and deployed in HRAS arnd in nonendemic states. Each CMC
covered around three hundred families with children under the age of five, and pregnant and
lactating mothers. This unique community mobilization deplayment contacted over 1.5 Tmillion
families for IPCatleast four times during each polio immunization round and also during the routine
immunization sessions between polio rounds. Underserved Strategy In 2003, an underserved
strategy (USS) was deveioped to strengthen the ongoing social mobi lization activities. The initiative
was led by the government and supported by WHO, Rotaty UNICEF, and full fledge universities
founded to provide education to poor and undeipr leged segments of society such as Aligarh Muslim
University (AMU), Jamia Millia Islamia (UN. and Jamia Hamdard. The strategic influence of these
institutions was spread through oe networks and forums including many local schools and madrasah
By 2006 more than national, state, district , and community-level social, religious, spiritual, and
occupationa tutions and forums were involved in various social mobilization activities including
developig.