According to the organisers of this communication campaign, poultry is a very important source of income for many families - especially rural families - in Egypt. Nearly one-third of the population own poultry in this country. Pre-testing of preliminary avian influenza (AI) communication materials showed that rural groups as well as the general public wanted more information on signs of bird flu in poultry and its means of control.

In this context, the Communication for Healthy Living (CHL) Project designed an integrated package of communication interventions in Egypt under the rubric of its "Your Health is Your Wealth" initiative. The Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs (CCP) implemented this communication strategy through the Health Communication Partnership (HCP), as part of a United States Agency for International Development (USAID)-supported partnership between the Ministry of Health and Population (MOHP) and the Ministry of Information/State Information Services (MOI-SIS).

Under the auspices of the national AI committee, a multi-tiered bird flu preparedness effort was developed, which featured the following: television, radio, and press announcements; Government of Egypt (GOE) website support; hotline promotion, press inserts, press briefings, and journalist training; provider fact-sheets; community mobilisation in partnership with non-governmental organisations (NGOs); and consumer fliers, posters, and other printed information materials, which were provided through health facilities and a national network of pharmacies.

CHL had already scheduled a national survey (the Egypt Health Communication Survey, or EHCS) for May 2006 to assess the reach and impact of its family health communication activities. The programme augmented the survey to assess the reach of the AI campaign and its impact on knowledge of transmission and symptoms, and initiation of protective practices. The survey used a nationally representative sample (n=4052) of 15- to 49-year-old adults in 21 governorates.

Eighty-six percent of the adult population - an estimated 38 million people - were able to recall messages from the campaign.

The national AI hotline received close to 300,000 calls in the first 3 months of the campaign.

Eighty to ninety percent of respondents reported that they had learned something from the campaign. Specifically, 84% reported having learned about modes of transmission, 90% said they learned about symptoms in humans, and 88% knew more about symptoms in birds of avian flu.

On the whole, 78% percent of those who could recall a campaign message, compared to 55% who could not, reported taking at least one protective action. Specifically, these actions included:

• Avoiding contact with birds - 52% of those who heard 2 or more campaign messages said they did so, as compared to 42% of those who had not heard any campaign messages.
• Keeping children and the elderly away from poultry - this was the case for 39% of those who had heard 2 campaign messages, as opposed to 29% of those who had heard none.
• Washing their hands (35% vs. 16%) and utensils (30% vs. 14%) more carefully after preparing poultry.