Background
Methods
Study sites
Developing intervention recommendations and materials
Data collection before intervention
Topics | Before intervention | After intervention | ||
---|---|---|---|---|
Informal interviewsa | Observationsb | Informal interviewsa | Observationsb | |
Awareness on avian influenza | 42 | N/A | 36 | N/A |
Housing sick poultry | 27 | 3 | 33 | 2 |
Selling/buying sick poultry | 20 | 0 | 22 | 2 |
Disposing carcasses or offal/blood of sick poultry | 46 | 6 | 45 | 7 |
Slaughtering sick poultry | 42 | 6 | 49 | 8 |
Cleaning site/tools after slaughtering sick poultry | 8 | 3 | 13 | 4 |
Hand hygiene after slaughtering/handling sick/dead poultry | 9 | 6 | 16 | 9 |
Covering nose/mouth while slaughtering/handling sick/dead poultry | 0 | 6 | 14 | 9 |
Keeping children away from slaughtering site | 14 | 3 | 3 | 4 |
Observations
Informal interviews
Intervention
Data collection after intervention
Data analysis
Results
Demographic information
Change in awareness
Topics [Intervention messages] | Interviews before intervention (Na = 42) | Interviews after intervention (N* = 36) | ||||
---|---|---|---|---|---|---|
Responses | Number of interviews with responses | (%) | Responses | Number of interviews with responses | (%) | |
Heard/knew about bird flu disease [Bird flu is a poultry disease] | - A disease of broiler/farm poultry, not of backyard poultry - Many poultry died/killed by government - Conspiracy of foreign country - A disease of chickens, not ducks - A birds’ disease caused from flu/cold - A foreign disease/did not occur in our village/country | 12b | (29) | - A disease of poultry/chicken/backyard chicken, which can also infect humans - A hazardous infectious virus of chickens which can also infect humans | 35b | (97) |
Signs in poultry [Poultry die very quickly in this disease. They get drowsy, and the wattle and comb become blackish blue. Wattle, comb, head and body swells with water. They get blood spots in legs.] | - Sudden death - Fever - Gizzard melts and chickens die in 24 h | 3b | (7) | - Blue/blackish wattle/comb - Blood/black spots in leg - Drowsiness/sit quiet - Swollen body - Fever - Liquid defecation - Stop eating - Secret saliva - Cold/coughing | 24b | (67) |
Can transmit from poultry to poultry [Bird flu can spread from one poultry to another] | 6 | (14) | 19 | (53) | ||
Route of transmission from poultry to poultry [Keeping healthy and sick poultry in the same place; giving food in the same plate; pecking on feces of sick poultry; from saliva, feces, blood, offal, skin, feathers of sick or poultry died of disease] | - Migratory bird | 2b | (5) | - If kept in same place with sick poultry - Eating from same pot with sick poultry - Scavenging in the feces of sick poultry - Contact with saliva/feces/blood/offal/skin/feathers of sick/dead poultry - Through breathing or air | 18b | (50) |
Can transmit from poultry to humans [Bird flu can also spread from poultry to human] | 8 | (19) | 28 | (78) | ||
Route of transmission from poultry to humans [While carrying poultry to the market for selling; while feeding or giving medicine; while slaughtering; while defeathering; if people put their hands in their nose, mouth or eyes without washing after handling sick poultry or poultry that died from disease. The germ of this disease can go inside the windpipe and lungs with breathing through nose] | - Through consuming bird flu infected poultry/egg - Children’s touching chicken | 6b | (14) | - Through breathing or air - Through consuming sick poultry - While slaughtering/defeathering sick poultry - Touching own body or children after touching sick poultry - Touching feces of sick poultry | 25b | (69) |
Sign-symptoms in humans [People can get fever, cold, coughing, throat ache, and breathing difficulty and may even die if the condition worsens] | 0b | (0) | - Breathing difficulty - Fever - Coughing - Death - Cold - Damage lungs/kidney/liver | 13b | (36) |
Topics [Intervention messages] | Interviews before intervention (Na = 42) | Interviews after intervention (Na = 36) | ||||
---|---|---|---|---|---|---|
Responses | # of interviews with response | (%) | Responses | # of interviews with response | (%) | |
Prevention
[Sick poultry should be kept separate and away from healthy poultry or one’s self; sick poultry should not be bought or sold; poultry died from disease should be buried; nose and mouth should be covered well while handling sick and dead poultry and hands should be washed well after handling; sick poultry should not be slaughtered; if one has to slaughter sick poultry, one should: cover nose and mouth very well, stop children from coming near the slaughtering site, cover the blood-smeared slaughtering site with ash or dust and scrape off the soil from that place and bury, wash slaughtering tools well with soap or soda or ash and water; bury offal, skin, feathers, at the end, wash hands with soap or soda or ash and water by rubbing well]
| Any prevention response | 8 | (19) | Any prevention response | 29 | (81) |
- Burning/culling | 6 | (14) | - Covering nose and mouth while slaughtering sick poultry/burying carcass | 27 | (75) | |
- Not consuming sick poultry/egg | 4 | (10) | - Burying offal, blood, carcasses | 27 | (75) | |
- Cooking/boiling poultry meat/egg well | 4 | (10) | - Separating sick poultry from healthy poultry and/or humans | 25 | (69) | |
- Handwashing with soap | 2 | (5) | - Not consuming/slaughtering sick poultry | 22 | (61) | |
- Burying carcass | 2 | (5) | - Washing hand after slaughtering or handling sick/dead poultry/eggs | 22 | (61) | |
- Not slaughtering/processing poultry | 1 | (2) | - Keeping children away | 13 | (36) | |
- Using mask | 1 | (2) | - Cleaning slaughtering site | 12 | (33) | |
- Vaccination | 1 | (2) | - Not selling sick poultry | 9 | (25) | |
- Not touching carcass with bare hand or using polythene to touch carcass for burying | 1 | (2) | - Cleaning slaughtering tools | 8 | (22) | |
- Not letting children to touch chicken and wash their hands with soap after touching | 1 | (2) | - Using polythene/gloves/piece of cloth to touch carcass/slaughter sick poultry | 6 | (17) | |
- Cooking/boiling poultry meat well | 6 | (17) | ||||
Burning/culling | 2 | (6) |
Change in preventive practices
Reported preventive practices | Before intervention | After intervention | ||
---|---|---|---|---|
na/Nb | (%) | na/Nb | (%) | |
Separated sick poultry from healthy poultry/humans | 22/27 | (81) | 25/33 | (76) |
Did not sell/buy sick poultry | 10/20 | (50) | 9/22 | (41) |
Buried carcasses or offal/blood of sick poultry | 8/46 | (17) | 16/45 | (36) |
Did not consume/slaughter sick poultry | 2/42 | (5) | 7/49 | (14) |
Cleaned site/tools after slaughtering sick poultry | 5/8 | (62) | 8/13 | (62) |
Washed hand with soap after slaughtering/handling sick/dead poultry | 3/9 | (33) | 6/16 | (38) |
Covered nose/mouth while slaughtering/handling sick/dead poultry | 0 | (0) | 2/14 | (14) |
Kept children away | 0 | (0) | 0 | (0) |
5.30 pm: The woman came to our house and informed (the research team) that a chicken with a tumor in its throat died. I (the observer) went with her to her house and saw that she kept the carcass covered with a bamboo basket in the yard… She informed me that she would dump it in the open field at night after completing her household chores. She indicated that if a wildcat took it away it would not stink. She would not dig a pit to dispose of the chicken because it would take a lot of labor. Her husband was an aged person and her son was not at home. Her daughter refused doing the laborious digging. 8.25 pm: She tore a piece of banana leaf and held the carcass with the leaf because it was repulsive to her and to avoid getting a bad smell on her hand. She took the carcass away from her house and dumped it in an open field for the wildcats. She washed her hand with soap and water after going home because the carcass’s wings had come into contact with her hands, which repulsed her.
Rationale for ignoring recommended behaviors
Perception of risk and financial concern
“They (the intervention team) told us to bury our poultry only if they get bird flu. But this chicken had a tumor.”
“Why shouldn’t we consume sick poultry, when we have raised them for such a long time? We will consume (poultry). Poison becomes water in fire.”“They (intervention team) told us to dump the sick poultry. Nobody dumps. Everybody lies that they won’t eat (the sick poultry). They dump if the sick poultry die inside their poultry shed, otherwise they slaughter them. They won’t let you know.”
“If the poultry is mildly sick or the disease has just started, that poultry can be consumed… We are poor.”
Inconvenience and personal discomfort
“We know all these (recommendations), but we don’t follow them out of laziness. Who will dig the soil? We remain busy at work.”
“It takes a long time to process a chicken. They (intervention team) recommended covering the nose and mouth throughout the slaughtering, defeathering and cutting and washing meat. Won’t I feel suffocated?”
“Be it a gamchha (towel) or orna (women’s scarf), sick poultry will die by the time we find it (to cover nose and mouth). Can anyone cover on time? Aklima’s mother slaughtered one (sick poultry) that day. She did not even have time to bring the slaughtering tool from her room.”
Social pressure
“Why don’t you slaughter? It would have been a good curry. Why aren’t you more careful?”
“We never worked while covering our noses and mouths before. If I do it, and you do it and she does it, then it is not a problem. We three can tell five more people. But it cannot be done alone… If a person, who does not know about the recommendation, sees me doing it, that person will certainly laugh at me.”
“There was a custom of washing hands with soap after touching anything (dirt) in my home. But it is not practiced here (her in-law’s house). If I try to do it, my mother-in-law rebukes me and scornfully says, ‘I brought a soap-user daughter-in-law.”
While the women of the household were cutting meat, a girl came from the neighboring household and asked, “Will you bury the offal?” Then the woman replied, “Why? Is it a sick duck? We would have had to bury if it were a sick duck.”
“I asked (my mother) to cover her nose but mother dumped it (carcass) in the pond without covering her nose… A crow took it away.”
Skepticism about the necessity of the intervention
“Why do you teach the technique of slaughtering (sick poultry) without giving medicine?”“Talking about these (recommendations) won’t work. Bring medicine.”“Which doctor should we go to and how should we treat our sick poultry?”