Perspectives on Avian Influenza

1
Perspectives on Avian Influenza in Pakistan
Key Insights Qualitative Research among Poultry
Farmers, Contributors in the poultry industry,
Poultry Consumers and Opinion Leaders
2
Research Objectives
Cues for behavioral change communication
activities
Understanding awareness level of AI preventive
measures
Barriers to practice AI preventive measures
3
Target Audience, Methodology and Sample
Target Audience

• Opinion Leaders
• Local Government Officials
• Animal human health care providers
• Community influencers
• Media
• Associations

• Consumers
• Individuals
• Institutions

• Contributors
• Vendor Egg Poultry
• Vendor Feed Grain
• Dressing staffs/slaughterers
• Transporters
• Sweepers/sanitary workers

• Farmers
• Backyard
• Semi commercial
• Commercial

Sample

• 54 Depth interviews with poultry farmers
• 48 Depth interviews with opinion leaders
• 26 Depth interviews with consumers
• 32 Depth interviews with contributors

4
Centers
Capital Territory
1. Islamabad (rural)
North West Frontier Province
2. Peshawar (urban)
3. Abbottabad (rural)
4. Mansehra (semi-urban)
5
Flow of Presentation
Context

Slides 6-8
Farming, AI understanding, vulnerability
barriers Slides 9-17
Contributing, AI understanding, vulnerability
barriers Slides 18-24
Consumers, AI understanding, vulnerability
barriers Slides 25-30
Unearthing truth
Slide
31
Perceived causes symptoms of AI in human
Slide 32
Opinions leaders perspective barriers
Slide 33-34
Health Belief Model
Slide
36-44
Conclusion

Slide 45
6
The People Snapshots

• Occupation
• Dominance of small to medium scale business
• The other mentionable occupations found were
  Govt. service, daily labor, livestock business
  and agriculture

• Community
• Both local and migrants
• Multi lingual and cultural
• Rural areas are multi-tribal

• Mindset
• Conservative
• Religious
• Family centric
• Responsive to communal norms customs

• Family
• Wide prevalence of extended family with three or
  more kids

• Dreams Aspirations
• Performing Hajj/Staying pious
• Better education for kids
• Good marriage for children/siblings
• Financial solvency
• Countrys stability
• Better house, business expansion, business
  vehicle (Contributors)

7
Attitude towards Health

• Most of the target audience had an attempt to
  convey that they believe in prevention rather
  than cure through
• Maintenance of basic hygiene
• Drinking adequate pure water
• Taking balanced diet
• Avoidance of outside food
• The higher tendency to rely on prevention was
  found because of the following reasons
• Religious belief? cleanliness is the part of
  faith
• Prevalence of environmental pollution in Pakistan
• They were also found to skeptical about the
  medical facilities in Pakistan due to
• Wide availability of duplicate/poor quality
  medicines
• Perceived high charge despite lack of expertise
  of medical practitioners
• Least equipped hospital within reach
• The above points drive them to
• Self-induced drugs
• Home-made portions
• Consultations with local quacks/dispensers
• Moreover, fatalism? disease and cure both are in
  the hand of God makes them become careless about
  health care? wide out-home chicken consumption
• And like the other third world nations, poverty
  is eventually a big barrier against health care
  in Pakistan

8
The Poultry Industry Skimming through

• The poultry industry is on a constant boom from
  household yard to enormous farms due to huge
  demand of poultry and eggs in Pakistan
• The growing demand for poultry has caused
  numerous intermediaries and facilitators within
  the industry, creating employments in plenty
• In response to the growing demand, the
  restaurants and also fast food shops are serving
  chicken meals to expedite revenue inflow
• The overall depiction is widespread poultry
  culture and thus higher risk of AI emergence and
  outbreak in Pakistan

• Main Players
• Farmers
• Backyard
• Semi Commercial
• Commercial
• Contributors
• Vendors Egg Poultry, Feed Grains
• Processors Dressing Staff
• Transporter Drivers, Loaders, Porters
• Sanitary Workers
• Consumers
• Restaurants
• Fast Food Shops
• Individuals
• Opinion Leaders? Community, Govt., Media

9
Nature of Poultry Farms

• SEMI COMMERCIAL FARMS
• Chickens kept in larger area fenced with
  net/multistoried pen/separate room in a house
• Feed/water given inside
• Level of bio-security Low

• BACKYARD FARMS
• Brick/wood/net built
• During day chickens roam freely at night kept in
  the house
• Level of bio-security Very low

• COMMERCIAL FARMS
• Entry and exit are highly restricted
• Separate utensils used for feed and water
• Punctual medication
• Controlled temperature
• Level of bio security Moderate-High

10
Farmers at a Glance

• Majority of the farmers lacks high aspiration
• The backyard and commercial farmers hardly desire
  for anything ? they are happy with their current
  belongings and their dreams are limited to basic
  needs
• The semi commercial farmers are running the
  poultry farms as secondary source of income and
  aspire for bigger farms ? need for greater status

Abraham Maslows hierarchy of needs
Backyard farmers
Commercial farmers
Semi-commercial farmers
11
Role of Poultry Farm in Life Farmers
Backyard poultry farmers
Commercial poultry farmers
Semi Commercial poultry farmers

• Backyard poultry farms perceived to be a source
  of indulgence in food basket i.e. having eggs in
  the breakfast, serving chicken to relatives

• Only source of income for survival for most of
  the farmers ? hence poultry farm play a vital
  role in their life

• Poultry farms perceived to be an extra source of
  income ? contributes more in disposable income
  hence betterment of lifestyle

12
Poultry Care AI Measures Current Scenario
Catalysts of Poultry Care Adopting AI
Preventive Measure
Investment
Across
Involvement
High Investment
Commercial Farmers
Primary Income Source
Catalysts of Reluctance in Poultry Care
Adopting AI Preventive Measure
Low Financial Risk
Backyard Many Semi- Commercial Farmers
Low Involvement
13
Perception about AI Farmers

• Majority of the farmers are aware of the term
  Bird Flu and its epidemic nature in poultry
  although some farmers perceive that it is just a
  simple flu
• Most of them believe that it is a rumor even
  though the publicity was huge during its outbreak
  in Pakistan
• Some farmers know that it can also transmit to
  human but others do not believe it as there was
  no human case witnessed
• No difference by types of farmers noticed
  However, regional differences were prevalent?
  Only in Islamabad farmers admitted about the
  outbreak of Bird Flu in their region
• Farmers perceive Bird Flu to be a past incident ?
  no present or future threat perceived

Attitude Towards Practicing AI Preventive Measures

• Consumption of sick poultry by self not
  perceived to be risky at all ? widely practiced
  high confidence on high temperature boiling
• Majority of the farmers are unaware of AI
  contraction through direct contact ? leading to
  not using any precautions while handling poultry
• AI vaccinations perceived to be irrelevant due to
  the belief of nonexistence of AI in Pakistan

14
Actual Level of AI Vulnerability
Backyard poultry farmers
Small chicks moving around with adult chicken
High vulnerability of contracting AI
Roaming around freely
Sitting on bed that is used for human
Open pen ? not restricted
15
Actual Level of AI Vulnerability
Semi-commercial poultry farmers
High vulnerability of contracting AI in poultry
humans
Bowl not removed and cleaned after usage
Different birds are living together
Moving around freely
16
Actual Level of AI Vulnerability
Commercial poultry farmers
Moderate to low vulnerability Commercial poultry
farmers are not ensuring proper care as well
Lack of space ? too congested
Hole ? not properly caged ? easy access
Unclean and dirty utensils used for feeds
17
Barriers to Practicing AI Preventive Measures
Farmers
What to do

• No outbreak? non-existent in Pakistan
• High temperature kills all germs
• Fatalism? disease cure are divine
• Applicable for larger farms? high volume of
  poultry, high risk associated (backyard semi
  commercial)
• Domestic poultry perceived to grow naturally ?
  perceived to have more resistant power (backyard
  semi commercial)

Belief
Present evidences with scientific explanation
including images Focus business growth if poultry
properly taken care of Appoint Imams to convince
people of the divine law of securing selves any
how
Ensure proper participation of media and
Facilitate local bodies/organizations with
information

• Least awareness about prospective human
  contraction of AI through direct contact
• No awareness of specific AI symptoms

Lack of Awareness

• Unwilling to give extra effort as they have low
  investment and involvement in poultry business
  (backyard semi commercial)

Lethargy
Educate them about potential family health
hazard
Subsidize or introduce cheap alternatives of
hygiene materials
Poverty

• Lack of resources for hygiene maintenance
  (backyard semi commercial)

Make them realize the likely hazards through
visual explanation
Conformity? to wide practice within community

• Eating sick birds is widely practiced and people
  feel part of a bigger community

18
Nature of Services Contributors

• FEED/GRAIN VENDING
• Feed/grain (made of poultry garbage) purchased in
  lot and usually sold in loose packs bulk sales
  for larger vendors
• Vendors store their commodities in dedicated
  protected silo larger sellers store them in
  ware-house
• In addition, medicine, crushed rice, wheat, corn
  for backyard poultry sold
• Level of bio-security Low? goods dealt with
  bare hand perceived no direct contact as
  pre-packed

• POULTRY/EGG VENDING PROCESSING
• Chickens stored for a short period of time in
  cage (smaller)/separate room (larger)
• Vendors usually process chicken themselves
• Processing done after purchase is made in the
  presence of purchaser
• Eggs put in crates not refrigerated except
  summer kept there if not sold out
• Level of bio-security Low? no protection used

19
Nature of Services Contributors

• SWEEPING/SANITATION
• Sanitary workers appointed by municipality/market
  association/vendor and also free lancers
• Hand cart/paddle van used to collect garbage from
  shops to dump in a particular place
• Level of bio-security
• Low? rural sweepers cleaning with bare hand
• Low-Moderate? mostly market association appointed
  sweepers are facilitated with gloves/masks/apron
  in urban area

• TRANSPORTATION
• Poultry/eggs collected from different areas
  mainly Punjab, Rawalpindi and Peshawar
• Mostly pick-ups multi-layered cages built on
  top metal cage with shelves for egg trays
• Generally drivers do the loading/unloading
  staffs used in larger farms
• Poor maintenance of vehicle? cleaned when visibly
  dirty only
• Level of bio-security Low? un/least protected
  handling

20
Contributors at a Glance

• Vendors being relatively financially well off are
  intending to be in the social need zone while
  transporters and processors are mostly in safety
  need zone
• Sanitary workers are mainly struggling to earn
  livelihood

Vendors
Transporter, Processor
Abraham Maslows hierarchy of needs
Sanitary workers
21
Perception about AI Contributors

• The contributors had different level of
  perception regarding AI
• Human cant be infected birds disease
• Disastrous for poultry huge downturn in business
• Even infected bird can be eaten through proper
  boiling
• Past incident
• Other areas are infected not respective
  areas(Mostly poultry/egg vendors)
• Human contraction also opined (Mostly feed/grain
  vendor)
• Recklessness? have been being involved in the
  industry without protection like gloves masks for
  long and nothing happened (Mostly sanitary
  workers)
• Generally identified as yellow journalism?
  intentional propaganda to sell out vaccination

22
Attitude Towards Practicing AI Preventive
Measures Contributors

• Fatalism resulted into rigidity and belief of
  rumor resulted into recklessness ? have become
  the focal points of concern in adopting measures
• Mindsets, bolstered by inter-generation
  belief/practice/ritual may turn into a stout
  impediment against preventive initiatives
• Despite feed/grain vendors deal with commodities
  made of poultry garbage, they perceive
  themselves to be at least risk for contraction
  since no perceived direct contact
• Poultry/egg vendors are intensifying the risk of
  contraction more for themselves as well as
  processors through processing sick chickens on
  the basis of the belief that proper boiling kills
  all the germs that undermines direct contact
  issue
• Sanitary workers although are wiling to embrace
  preventive measures, very few of them mostly in
  urban/semi-urban areas get facilitated with
  protections like gloves, masks, apron others are
  victim of bare hand sweeping practice

23
Actual Level of AI Vulnerability Contributors
Sell processed chicken? chances of selling sick/
dead chicken
Direct contact with the feed/grains made of
poultry garbage
No use of mask and gloves? direct contact with
blood unclean environment
Transportation of bulk purchase? vulnerable to be
affected? incident of dead/sick prevalent
Processing utensil full of germs, intensified by
flies
Cleaning with no protection
24
Barriers to Practicing AI Preventive Measures
Contributors
What to do
Belief

• Ablution before payers perceived enough to
  maintain general hygiene

Educate Imams with scientific explanations and
appoint them to advocate
Mindset

• Proper boiling kills germs of all kinds?
  strengthens the tendency of selling sick chickens
• No contraction from direct contact
• Dirt not visible is non-existent
• Goods already packed? no direct contact
  (Feed/grain vendor)
• Wearing gloves may arouse suspicion in customers
  minds? cues inferiority of chickens (few
  processors)
• Stink is of greater importance than germs threat

Educate with scientific explanations with
visuals Also communicate empirical evidences
highlighting dangerous aftermath of these
mindsets Use volunteers from the same profession
Make them understand about the family health
hazards and likely financial loss out of illness
Lethargy/ Recklessness

• Unwilling to do extra work ( across)/never
  happened wont happen (sanitary worker)

• Scarcity of resources to buy gloves/masks/extra
  clothes

Subsidize or make the things available at cheap
rate
Poverty
25
Consumers at a Glance

• The institutional consumers wish for a evolved
  lifestyle along with name recognition and greater
  status
• The individual consumers crave for a serene
  family life together with role recognition
• Safety is a common phenomenon aspired by both the
  parties

Abraham Maslows hierarchy of needs
Individual
Institution
26
Role of Poultry in Life/Business Consumers
Individuals
Institutions

• Role of chicken is occasion specific for poor
  people when it is of a daily matter for upper
  class

• Business? high demand for chicken dishes amongst
  consumers

27
Perception about AI Consumers

• Individual consumers seemingly highly aware
  without any conviction with belief of
  rumor/chicken specific nature of the disease
• Institutions are aware of the contagious nature
  of AI however seem to be intentionally
  down-playing the effect to cater own interest
  and misconception? denial about AI outbreak in
  Pakistan and respective area
• Individual consumers seemingly in a precarious
  state in terms of AI contraction out of
• Lack of awareness? more likely to get infected
  being in direct contact of the bearer? eggs, meat
• Lack of resource? poverty very often compels them
  to eat ill bird/egg since price fall during
  outbreak
• Misconception about cleanliness, AI (conceptual,
  symptom, prevention)
• Institutional consumers susceptibility found to
  have an adverse co-relationship with the size of
  the organization

28
Actual Level of AI Vulnerability Individuals

• Ignorance
• Extreme fatalism? He takes the decision of
  disease and its cure/no escape when death comes
• Limited knowledge about actual source of
  contraction i.e. processing Vs consumption
• No harm in cooked dish? dressing time risk
  undermined
• Myths
• Villagers believe they have more immunity
  compared to urban people
• Ill chicken can be eaten before it becomes weak
• Proper boiling kills all kinds of germs
• Fresh and healthy chickens dont have bird flu?
  feel safe through not buying apparently ill
  chicken

• Conservatism
• Prejudice against media interaction? hindering
  information transmission
• Poverty
• A crucial impediment against avoiding ill chicken
  consumption during deflated price

Vulnerability has to be addressed at mindset level
29
Actual Level of AI Vulnerability Institutions
Storage Perception of washing chickens eggs
just before cooking and preserving directly in
freezer/refrigerator? high chance of contraction
while preserving and to other foods preserved in
the same place

• Large Restaurants
• Perceive to be vulnerable on both self and
  customer view point? avoidance of direct contact
  and spreading though consumption respectively
• No perceived vulnerability of others
• Dressing done at POP

Handling Institutions are used to handling
large number of chickens/eggs? higher chance of
contraction while dealing with bare hand? direct
contact Intention of making more profit? higher
selling during outbreak makes them more vulnerable
Cooking Method Aiming to enhance taste
restaurants do marinate meat before
cooking/preserving the result is applying less/
short-time heat during cooking? higher viability
of germs
Cutting chicken with bare-hand
Reckless manner of storing
30
Barriers to Practicing AI Preventive Measures
Consumers
What to do
Mindset

• Proper boiling kills germs of all kinds
• Dirt not visible is non-existent
• No contraction from direct contact
• Washing? pre-cooking wash for chicken felt
  sufficient hand wash? done after all cooking
  procedure? no feeling of being clean repeatedly
  (also happened due to lethargy)
• Dressing done at POP? perceived no direct contact
  (Individuals)

Ensure participation of media Communicate
possible disastrous consequence with empirical
evidences
Use Imams for presenting the necessity of
measures religiously

• What is lotted can not be blotted

Fatalism
Recklessness

• Never happened, wont happen

Make them understand personal thus family hazards
Poverty

• Indulgence? price fall due to outbreak offers
  scope of relishing chicken dishes amidst poverty

Reduce price of the substitute products
31
Unearthing Truth

• Earlier discussions reveal
• Buying/consuming dead chicken believed as taboo
• Agility of the chicken finds a forefront place in
  POP checklist
• Paradox
• Transporters testifies some processors cut the
  chicken that fall sick/dead and lose agility
• Presence of pre-cut chickens at a lower price
  even in the competitive market
• Necessity of chicken consumption avoidance during
  epidemics believed to be rumor to many ones

• The vicious cycle comprises all the parties
  participation in pre-cut consumption
• Restaurant
• Piece-specific purchase? obligation for buying
  pre-cut chickens
• Lower-priced lot purchase (dead or ill)? higher
  profitability
• Individuals
• Lower priced purchase? chicken delicacy amidst
  poverty
• Recklessness? no belief in abstaining from
  chicken high flame kills all germs
• Fatalism? what is lotted cant be blotted
• Vendors
• Sale of ill/dead chicken? double standard act?
  loss minimization
• Availability of customers? piece-specific
  buyers, poor class, unethical restaurants and
  fast food shops

Overall intensifies AI vulnerability
32
Perceived Causes Symptoms Human

• Causes
• Consuming infected poultry without cooking
  properly
• Direct contact with infected poultry (few)
• Pork consumption (few)

• Symptoms
• Majority of the interviewees have no idea of AI
  symptoms in human few farmers have mentioned the
  following symptoms
• Fever
• Breathing problem
• Watery eyes like usual fevers
• Head spinning (few)
• Bleeding from nose and mouth (very few)

Cure Only a few feed grain vendors could
confirm there are vaccines and drugs for AI since
they sell poultry vaccines medicines
33
Opinion Leaders Perspective of AI Prevention
HOW MINDSET IMPACTS ATTITUDE BEHAVIOR?
Rumor? Not happened in Pakistan
Majority of the opinion leaders do not believe
the existence of AI in Pakistan and possibility
of AI epidemic in humans ? do not realize the
importance to take initiative to prevent AI
Species specific disease? exclusively birds
Past incident ? currently no existence of AI
No germ viable at high flame? normally high flame
maintained in Pakistan
Spiritual belief ? human death is perceived to be
a natural thing
Not a big disease for human ? easily curable (few)
34
Hindrances against Role Performance of Opinion
Leaders

• Lack of expertise? lack of information and other
  resources (at all levels)
• Disbelief/recklessness? no importance given (at
  all levels)
• Mal-coordination among ministries? bureaucratic
  complications
• Honestly speaking, I cannot fight with the whole
  ministry on my own you have no idea about the
  bureaucracy here in this country (Human Doctor,
  Islamabad)
• We dont get any fund or support from
  government
• (Civil Society Leader, Peshawar)
• There is corruption in our country authorities
  have high level political interference if this
  authorities get independent then we can really
  progress (Teacher, Peshawar)
• Lack of patronization? resulted from above issues
  
• Lack of authority distribution? everybodys job
  is nobodys job

35

• Health Belief Model
• (Source http//www.tcw.utwente.nl/theorieenoverzi
  cht/Theory20clusters/Health20Communication/Healt
  h_Belief_Model.doc/ )

• The Health Belief Model (HBM) is a psychological
  model that attempts to explain and predict health
  behaviors. This is done by focusing on the
  attitudes and beliefs of individuals
• The HBM is based on the understanding that a
  person will take a health-related action if that
  person
• feels that a negative health condition can be
  avoided,
• has a positive expectation that by taking a
  recommended action, he/she will avoid a negative
  health condition and
• believes that he/she can successfully take a
  recommended health action

36
The Health Belief Model Commercial Farmers
MODIFYING FACTORS
INDIVIDUAL PERCEPTIONS
LIKELIHOOD PERCEPTIONS
Demographic, sociograhic structural variables
Cost benefit analysis
Higher the investment, higher the intention to
reduce the risk of contracting diseases ? likely
to take preventive measures
Male farmers, lower-middle class people Poultry
farm is the main source of earning
Perceived susceptibility/ seriousness of the
disease
Perceived threat of disease
Likelihood of behavioral change
MODERATE TO LOW Moderate for poultry ? AI
perceived to be a rumor or past incident Low AI
health risk perceptions in human
MODERATE Mass culling is perceived to be a
threat ? loss of entire business Perception of
rumor reduced the threat
MODERATE TO HIGH Conviction of seriousness of AI
may persuade them practice AI measures
Educate about AI symptoms and human contraction
through visuals
Cues to action
37
The Health Belief Model Backyard Semi
Commercial Farmers
MODIFYING FACTORS
INDIVIDUAL PERCEPTIONS
LIKELIHOOD PERCEPTIONS
Demographic, sociograhic structural variables
Cost benefit analysis
Low investment hence return on investment
perceived to be a bonus ? less likely to invest
on preventive measures
Mostly male farmers, low income class
people Poultry farm is the secondary source of
income
Perceived susceptibility/ seriousness of the
disease
Perceived threat of disease
Likelihood of behavioral change
LOW Unlikely to make extra investment Convictio
n of AI human contraction may convince them to
change behavior
LOW Minimum investment minimum loss Low AI
health risk perceptions in human
LOW Mass culling is not perceived to be a threat
? small number of chickens Risk can be reduced
by eating and selling sick chickens
Educate about AI symptoms and human contraction
through visuals
Cues to action
38
The Health Belief Model Vendors of Poultry Eggs
MODIFYING FACTORS
INDIVIDUAL PERCEPTIONS
LIKELIHOOD PERCEPTIONS
Demographic, sociograhic structural variables
Cost benefit analysis
Tendency of making higher profit without
investing extra
Male, poor people Selling poultry/eggs is the
main source of income
Perceived susceptibility/ seriousness of the
disease
Perceived threat of disease
Likelihood of behavioral change
LOW Unlikely to take preventive measures as long
as business is profitable
LOW Short periodic storage no hassle in selling
out sick poultry Low AI health risk perceptions
in human
MODERATE AI outbreak declines poultry
demand However, currently no threat as it was
perceived as rumor
Educate about human health risk perception
Cues to action
39
The Health Belief Model Poultry Processors
MODIFYING FACTORS
INDIVIDUAL PERCEPTIONS
LIKELIHOOD PERCEPTIONS
Demographic, sociograhic structural variables
Cost benefit analysis
Extra expenditure perceived to be a burden
Male, low class people Processing poultry is the
main job, sometimes processing done by vendors
Perceived susceptibility/ seriousness of the
disease
Perceived threat of disease
Likelihood of behavioral change
LOW TO MODERATE No witness of AI contraction to
human resulting from poultry processing
LOW Unaware of AI contraction through direct
contact Low AI health risk perceptions in human
LOW No direct impact of AI in poultry
processing is perceived
Build awareness about human contraction Facilitate
with logistics
Cues to action
40
The Health Belief Model Vendors/suppliers of
Feeds/Grains
MODIFYING FACTORS
INDIVIDUAL PERCEPTIONS
LIKELIHOOD PERCEPTIONS
Demographic, sociograhic structural variables
Cost benefit analysis
Spending for AI preventive measures have low
relevance
Male, lower-middle class people Involved in
selling/supplying poultry feeds and grains
Perceived susceptibility/ seriousness of the
disease
Perceived threat of disease
Likelihood of behavioral change
LOW No witness of AI contraction to human due to
handling poultry feeds
LOW No contact with poultry and eggs Low AI
health risk perceptions in human
LOW No impact on feed selling
Reminder about maintaining hygiene factors
Cues to action
41
The Health Belief Model Transporters
MODIFYING FACTORS
INDIVIDUAL PERCEPTIONS
LIKELIHOOD PERCEPTIONS
Demographic, sociograhic structural variables
Cost benefit analysis
Financial ability does not allow to spend on
preventive measures
Male, low class people Transporting chickens and
eggs is the main source of income
Perceived susceptibility/ seriousness of the
disease
Perceived threat of disease
Likelihood of behavioral change
MODERATE Intend to follow preventive measures
if instructed and support provided by the
owner/authority
LOW Short term interaction Low AI health risk
perceptions in human
MODERATE During AI outbreak, demand for poultry
declines resulting in decrease in transport
frequency
Build awareness about human contraction Ensure
active role of authority in logistic facilitation
Cues to action
42
The Health Belief Model Sanitary Workers
MODIFYING FACTORS
INDIVIDUAL PERCEPTIONS
LIKELIHOOD PERCEPTIONS
Demographic, sociograhic structural variables
Cost benefit analysis
Unable to afford extra beyond basic needs
Mostly male, very poor Sanitation is the income
source for bread and butter
Perceived susceptibility/ seriousness of the
disease
Perceived threat of disease
Likelihood of behavioral change
MODERATE TO HIGH Need to deal with various
wastes as well as germs ? perceived to be
vulnerable
MODERATE Long-term interaction high risk of
germination Low AI health risk perceptions in
human
MODERATE May get ill ? would hamper day to day
activity
Build awareness about human contraction Facilitate
with logistics
Cues to action
43
The Health Belief Model Consumers (Individual)
MODIFYING FACTORS
INDIVIDUAL PERCEPTIONS
LIKELIHOOD PERCEPTIONS
Demographic, sociograhic structural variables
Cost benefit analysis
Benefit gt cost for upper class people Cost gt
benefit for lower class people
Male female, all class people Chicken and egg
are regular food items for upper class people
poor people have them as indulgence
Perceived susceptibility/ seriousness of the
disease
Perceived threat of disease
Likelihood of behavioral change
Moderate for upper income class Low for lower
income class
LOW Adequate boiling perceived to kill all
germs practice of purchasing dressed poultry (
mostly) reduces susceptibility Low AI health
risk perceptions in human
Moderate to low for upper class people ? stop
having chickens and eggs temporarily Low for
poor people ? perceived to be an opportunity to
have better food
Educate about human health risk perception
Cues to action
44
The Health Belief Model Consumers (Institution)
MODIFYING FACTORS
INDIVIDUAL PERCEPTIONS
LIKELIHOOD PERCEPTIONS
Demographic, sociograhic structural variables
Cost benefit analysis
Investment is not an issue for larger
institutions if profit accelerated as a result
of better image created Profit through low
investment is the motive for smaller institutions
Male, low to middle class people Both main
source of income and secondary source of income
Perceived susceptibility/ seriousness of the
disease
Perceived threat of disease
Likelihood of behavioral change
Moderate to high for larger institutions ?
willing to change behavior while there is a
threat of demand decline Moderate to low for
smaller institutions
LOW No impact in making chicken dishes Low AI
health risk perceptions in human
Moderate high for larger institutions ? fear of
losing demand Low for smaller institution?
target consumers are more sensitive to price ?
leading higher demand during lower price scenario
Inform, remind and monitor constantly through
proper authority
Cues to action
45
Conclusion
Most farmers and contributors do not pay heed to
the existence of AI currently? no outbreak in
Pakistan/past incident/not own vicinity
phenomenon some of them are concerned about
securing their own interests? deny the outbreak
in respective areas
All the people involved are care free about
avoidance of chicken consumption during outbreak
due to cultural practice, fatalism, reckless
attitude, unawareness (in cases) and poverty (who
are applicable)
Opinion leaders instigate chicken consumption at
mass level through opining AI as rumor publicly
Awareness building as well as subsidizing in
collaboration is imperative to fetch behavioral
change with a prerequisite of making the opinion
leaders understand the significance of the
hazard use of religious leaders would be
critical in communicating the preventive measures
which would cater to the national tendency of
fatalism