Health Competence Workshop

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Communication influences outcomes across multiple
health issues simultaneously
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Introduction

• Egypt has shown the world that strategic
  communication can help to create the knowledge,
  attitudes, communication practices, and social
  norms that lead to positive health behaviors that
  are the foundation for a healthy future.

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Introduction

• Communication activities in Egypt create
  innovative and effective campaigns that address
  todays crucial family health issues, from family
  planning to avian influenza.

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Knowledge of Family Planning Methods
Virtually 100 know at least one method80
are ever users
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Reduced Child and Maternal Mortality
Sources EDHS (1992, 2000, 2005), CAPMAS (1993),
NMMS (1992, 2003)
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FP use more than doubled since 1980Average
lifetime births dropped from 5 to 3
Average number of lifetime births per woman
Percent of married women currently using any
contraceptive method
Percent
Number of births
Sources EFS (1980), EDHS (1992, 2000, 2005)
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Improvements in Female Schoolingand Access to
Safe Water
Source W. Robinson F. Zanaty (2006). The
Demographic Revolution in Modern Egypt. Oxford
Lexington Books.
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Communication as the Driving Force Sources of
Family Planning Information
Television
Poster/ Billboard
Newspaper/ Magazine
Community meeting
Radio
Source EDHS (1995, 2000, 2005)
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What is Health Competence?
Health competence means Acting appropriately
and consistently to the health challenges one
faces. Affected by a set of predisposing
factors that facilitate the achievement and
sustainability of desired health outcomes
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Health Competence Facilitators

• Basic health knowledge
• Involvement
• Access to resources
• Efficacy
• 15 dichotomized items, range0-15, mean 6.8
  (2004), 7.0 (2005)
• a .62 (2004), a .65 (2005)

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Multiple family health behaviors

• Health Competent Behavior Index (2005)
• Use of contraception after 1st child
• Antenatal care during most recent pregnancy
• Postpartum neonatal checkups after most recent
  pregnancy
• Medically assisted birth
• Postnatal care after most recent birth
• Initiation of breastfeeding within 24 hours of
  most recent birth
• Optimum hand washing (before eating after
  defecation)
• Smoke free zone in house
• Ensuring safe injection
• 9 dichotomized items, range 0-8, mean 3.0, a
  .63)

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Percent of women using FP at parity one by level
of health competence
SOURCE CHL Minya Village Health Survey 2003
(n2,240 married women 15-49), Chi-square(7)
159.45, pitems, all dichotomous, a.6782). Individual
level factors Positive attitudes toward spacing,
n of FP methods known, ever discussed spacing
with anyone, discussed FP with spouse past 6
months, discussed FP with HW past 6 months,
exposed to FP messages past 6 months, have
sufficient health information, contact with HW
past 6 months, above average health
self-efficacy Community level factors
comfortable discussing FP with others, have
access to health information, have local health
CDA, have had local meeting on health past 6
months, have access to Gold Star facility.
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Mean number of family health behaviors by level
of health competence
SOURCE CHL Minya Village Health Survey 2005
(n2116 currently married women with at least 1
child), Chi-square(4, 2111) 24.72,
pafter 1st child, Antenatal care, Postpartum
neonatal checkups, Medically assisted birth,
Postnatal care for infants, Early initiation of
breastfeeding, Optimum handwashing, Smoke free
zone in house, Ensuring safe injection
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Number of family health behaviors increases with
health competence and CHL exposure
Source CHL Minya Village Health Surveys 2004
2005 (n1964 CMWRA, ever gave birth)
OLS regression, beta coefficients All
coefficients significant at pnoted p 15
New Program InitiativesAvian Influenza 2006-2007

• Preparedness
• Draft of a preparedness communication strategy in
  2005 before the outbreak in February 2006
• Extensive integrated campaign materials ready to
  go
• Formation of national committee development of
  national communication strategy and action plan
• Response
• Same day launch of national campaign
• TV spots, print materials, clinic pharmacy
  distribution, community meetings for backyard
  poultry producers, hotline promotion, website
  support, press inserts, journalist briefing
  training, quarantine team training video, Alam
  Simsim handwashing spots

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Phase I Initial Outbreak (2006)Protective
behaviors reported by numberof campaign messages
recalled
Source MOH/SIS, CHL Egypt Health Communication
Survey 2006, n4052 Chi-square, p 17
Phase II Sustained effort

• Exposure to AI messages from
• TV advertisements 85
• TV Programs 38
• Radio advertisements 5
• Radio Program 2
• News paper/magazine 12
• Poster/flyer/billboards 6
• Community meetings 1

Source UNICEF AI Survey, February 2007 (n3500)
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Phase II Extended impact

• AI Protective Behaviors
• 62 of breeders reported Caging birds
• 61 reported not allowing children to help them
  with poultry raising tasks
• 64 of home breeders intend to vaccinate their
  birds and 14 have already vaccinated their
  birds
• 90 of home breeders reported washing hands with
  soap and water immediately after dealing with
  poultry 

Source UNICEF AI Survey, February 2007 (n3500)
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Thank you