Indonesia FGD Pre-test 6

Avian Influenza 3Avian Influenza 3A Qualitative Research A Qualitative Research ReportReport

Prepared by Prepared by SynovateSynovateIndonesia for AED Indonesia for AED

This report was submitted by Synovate Indonesia and funded by USAID under the AED-managed AI-BCC Project

Background • Despite growing rates of diseases in poultry and mounting

human cases, bird flu information can help reduce risk –especially for the backyard farmers. The print media is yet to run material containing clear and actionable prevention messages.

• To address this, AED is preparing a rapid launch of prevention information through mass media and other channels.

• To make sure that the material created communicates the desired message and meets with message objectives, AED would like to commission a research to test the same.

Background• The material to be tested would be as follows

– Two version of handout brochure and poster which designed to promote steps in preventing AI from spreading.

– Three version of poster on AI prevention, directed to Kids, Females, and Males.

– Three different logos supporting the material.

• This document details our findings from this qualitative study

Research Objective

• The objective of the research would be to: – Understand residual perceptions and understanding of AI,

nomenclatures used to describe the condition – Evaluate communication material on paramaters such as

• Comprehension of elements & Message take-out• Memorability, urgency and readiness to act • Appeal of messages

Research Design• Qualitative research was conducted through Focus Group

Discussions in two cities, Medan (North Sumatra) & Bogor (West Java).

• Respondent profile:– Medan :

• Group I: Community Leaders, Males • Group II: Housewives

– Bogor :• Group I: Housewives• Group II: Community leaders, Males • Group III: Younger respondents, mixed gender.

Research Centre:– Medan– Bogor

11-Youngsters

211Housewives

532Total

21(All are staff from

local government)

1Community Leaders

Total Bogor Medan

Sample Spread

Brief snapshot of the respondents

A closer look at our respondents…

Medan • Male respondents, part of the

RT/RW committee, come from various work background. Some have their own business, work as an employee and farmers.

• Female respondents are housewives with no working activity. Mainly stay at home to raise kids or gather with other females.

Bogor • Male respondents are staffs of the local

government company, some serves as the community leader. Have interest in rearing chickens, ducks or birds. Poultry are considered as a hobby, not as a source of income. Shows a great awareness of AI.

• Female respondents are housewives which rear chickens and ducks at their house. Some has own home business such as warung or tailor service.

• The younger respondents are the young people who participate in a local youngster community. Some has own business or worked in a company, the others are recent high school graduates and seeking for employment.

Not AwareAware

Males in Bogor

Housewives in Bogor

Housewives in Medan

Males in MedanYoungsters

in Bogor

• Seen to have different level of awareness and attitudes towards AI, but mainly aware.

• Not all of the respondents rear chicken, but have experience in rearing and got exposed to sudden death cases in surroundings:“I have 22 chickens, I once had hundreds of chickens but many died because of the bird flu…it happened about 6 months ago”“Some of us have un-breed chickens, we call it ‘ayam kampung’… “I don’t rear chicken myself, but all my neighbor do.”“I have chickens in home, it is useful since I don’t like to throw away waste food, I just feed it to the chicken.”


Medan• It was observed that rearing chicken

is somewhat seen as a hobby, and also an additional source of income when needed.

“I sell my chicken in Lebaran day.”• All of the chicken owners have

chicken pens near their house, used by the chicken only in the night.

“It’s different with the farmer’s chickens. We don’t need to cage them, It’s just the way it is for the kampung people.”

Bogor• Respondents rear only Ayam

Kampung, not the breed chicken, thus feel no need of caging them.

• Respondent feels that having a cage is a must, but it is rarely used.

“I have a cage in the back yard.”“My chicken prefers to sleep on the tree.”“My chickens also prefer to sleep on the tree. I think they don’t like to be caged.”“Since they are still chicks, they don’t like to be caged.


No Differences among chicken rearing activities across centers

Awareness ofAvian Influenza

Awareness of AI - MedanMedan• Experienced some case of chicken sudden death and in great

numbers, but still uncertain about the disease causing it. “I once experienced that my chicken were suddenly ‘kejang-kejang’ and died afterwards.”“I once had my chicken died suddenly without knowing when it wassick.”

• Compare AI to the other disease called Aratan, (Cholera for Chickens) Temboro, however realize the differences in the symptoms.

“I think Flu Burung is the new name for the disease, before that we knew that as Aratan…it’s almost similar to cholera but it’s for chicken.”“However, the disease is even worse, after the chicken suffer the disease; it didn’t even take a day for it to die.”“I think Aratan is different from Flu Burung, because chickens can still be cured, meanwhile if it suffered from AI, it’s just going to die.”“In Aratan, the droppings is white in color, just like a chalk.”

Awareness of AI - BogorBogor• Very much aware about the bird flu issues. Mention Flu

Burung at spontaneous level. • Aware that the disease is different from the one they used to

have in the past (tetelo). “There was one disease called tetelo in the village, but the symptoms are quite different from bird flu.”“This is a new disease.”

• Some are afraid of rearing poultry because of the AI issues.“Before there is an issue about Flu Burung, I used to have birds. I like Dove, Perkutut, or Tekukur (singing birds). I used to have 30 of them. Now I sell them all.”“I heard so many stories about bird flu, that’s why I sold my chickens.”

Awareness of AI – Bogor(continued)

• Limited knowledge about bird flu, shows a lot of interest in getting more details about it. Feels that their village has never been infected by Flu Burung because none of the owner got sick or died because of it.

“There is no case of flu burung in our village. None of the people got sick or died because of the sick chicken.” “Bird flu is when the chicken died so suddenly. Sometimes they just fall out of the tree.”

Perceptions and attitudes to AI• Across groups we saw that the key source of information for

Bird Flu was Television

• All claimed to have a TV at home, but not all had a radio or read news papers

• Even though most had experienced chicken deaths in the past in their surroundings (or own chickens died), most felt that their area are not infected by Bird Flu as yet.

Perceptions and attitudes to AI (continued)

• A feeling that bird flu would be a relevant problem in their area only when the Government identifies the area as a bird flu infected area – or when there is a human death (due to bird flu)

• In addition an stigma associated with Bird Flu “Some people paranoid of Bird Flu because of the others blaming when bird flu occurs… this is because it has been exaggerated in the TV”

• Media images also do not help in addressing stigma “The patient has to be isolated and the dead body has to be wrapped in plastic. It scares people”

Symptoms of AI• Most seem to be aware of the symptoms of Bird Flu among

birds –Rapid death of the bird (within a few hours of being infected) “Sometimes they fall dead while sitting on trees itself “–Blood and flesh of the chicken in blue / black –Liquid discharge from mouth –Plume turns blue –Feathers are listless –Birds lose their appetite

• Some (in Bogor) confused that Bird flu occurs mainly in chickens and not other birds

“It should be called Chicken Flu and not Bird flu because it only infects chickens”

Symptoms of AI(continued)

• Very few aware that the disease spreads to all birds (not just chickens)

“I sold my pet Perkutut (singing birds) and doves when I got to hear about this.. I had about thirty of them”“The disease can also spread to ducks”

• Limited awareness of the symptoms of Bird Flu among humans – not sure how the symptoms differ from regular flu –Need to clarify

“Its just similar to a regular fever.. Cannot know that its bird flu before going to the doctor”“If I am not mistaken the patient has trouble breathing” “From what I saw on TV it could be like a regular fever but may be the incubation period is different”

How does it spread• Most not sure about how the disease would spread – several

hypothesis:– Air borne – Through contaminated food – eating sick chicken meat – Spread through contact with other poultry

• For most, prevention is not a key concern and felt to be rather impractical “It is difficult to take on preventive measures. The chickens run around freely.. They find their own food.. Who knows what they have been eating thought the day”

• Hence take no steps to prevent bird flu.• (Very few) Preventive measures adopted

– Few claim to get birds vaccinated – however most claim that vaccination should be done mainly for large poultry farmers and not necessary for themselves

– Few claim to medicate birds with medicines meant for flu among humans “I give them Bodrex with lamp oil”“Give them milk ….”

Motivators and Barriersto Caging

• A pen is considered a requirement in someone’s house. Usually located behind the house.

• However, the cage is not very often used by the chickens and ducks.

– The origin of their type of chicken is to let it loose.“My chicken is not the breed type like they have in the chicken farm. Mine is Ayam Kampung, it's not supposed to be caged.“Our chicken usually sleeps on the tree. They like that. And it’s easier for us in rearing it.”“The habit is to feed them in the morning, let them loose during the whole afternoon, and they’ll come back in the evening.”

– There is a belief that caging ducks will cause them getting sick.“If you caged your duck all the time, the ground will get wet, and it will get them sick.“Ducks don’t like to be caged, you will loose them if you do so.”

Motivators and Barriersto Caging (continued)

• Keeping the poultry in a cage felt to cost more than letting them loose.“To feed the caged chickens will cost us more than to rear the loosed

ones.”“Rearing chicken is just a hobby; I don’t want it to give me a lot of trouble.”

Associationwith the words

BASMI & ATASI

Overall• Prior to exposing stimulus material (brochures and posters),

associations were elicited to the words BASMI and ANTASI• This was done without cueing a context with the intention of

understanding the key associations, current usage, and moods and tones associated with the words.

• The associations evoked were consistent across groups and cities.

• Of the two words, there was a higher interest and discussion around the word BASMI than with ANTASI

Reaction to the word BASMI BASMI

Basmi as a word evokes strong, forceful and active associations. In the genre of a command or an order rather than a request or suggestion. The word is straightforward, direct and simple

“It’s more like a powerful order.”“Well, the word itself is very straight to the point. Do that!”“It has a strong effect.”

It would mean to wipeout, eradicate ordestroy actively

“To destroy”“To massively kill something”

Bring something to an end conclusively“To clean or to vanquish something along with the roots”“To kill it all”

ATASIATASI on the other hand is gentler. More like a debatable suggestion than an order“ATASI is associated to take care of something in a soft manner.”“ATASI is polite.. It doesn’t stress that the activity needs to be done”“BASMI is stronger, ATASI is like compromise, but can still debate…”More in the genre of finding an amicable solution rather than a direct order. “ATASI is like a compromise”“ATASI is politer than BASMI”

• Does not have the associations of wiping out or eradicating from the core “ATASI means not killing it all.. There is still something left.. Its like finding a way out or a compromise to the situation”

BASMI felt to be a strong, active word associated with destroying or vanquishing something

Reaction to the word BASMIBASMI

Communicates a degree of urgency and urges to take action now. Implies that the problem is already ‘here’ and therefore needs to be addressed “It is more associated to something bad, like disease”“To kill germs”“To kill disease”

ATASIAs is still in the realm of prevention (of a negative occurrence), implies that the problem is not ‘here’ as yet“To prevent something from happening…”“Before the problem gets here, and effect us, we need to ATASI the problem…” Thus does not bring with it an urgent call to act now. “In our village, the Flu Burung is not there as yet, so it’s better to say that we are preventing, therefore ATASI is more suitable.”(Possibility to procrastinate recommended behavior)“ATASI is more polite and can be used in everyday conversation, but does not have the stress effect.”

Basmi brings with it a degree of urgency to act – raises alarm bells

BASMI Implies an addressing a ‘serious’ problem“Mainly used for something very serious”

• Could be used to eliminate an inanimate negative aspect / object but not a being with a soul“Could say this for Flu Burung but not for the chicken”

• At a spontaneous level, respondents felt that the word could be used to address something with negative consequences – such as a disease / germs. “It is more associated to something bad, like disease”“To kill germs” or “To kill disease”Could be used to eliminate an inanimate negative aspect / object but not to a being with a soul“Could say this for Flu Burung but not for the chicken”

ATASIImplies addressing a minor / not very serious issue “A small and light problem should be ATASI.”

Felt the word is not suitable for a disease “Not suitable if used in disease. In disease we need to vanish it, not only overcome it.”

BASMI appropriate in disease context

Reaction to the word BASMI

Reaction to the word BASMI When probed on the appropriateness of the usage of the term in a Bird Flu context, most felt that BASMI would be better suited than ATASI “If you want to use it for a virus then BASMI is more suitable”“BASMI is often used in disease”

Only the female group in Medan mentioned that ATASI may be preferred over BASMI as Flu Burung is not yet present in their village - also mentioned that BASMI could be altered to say MEMBASMI (the verb form of BASMI) “We prefer ATASI, it’s softer ““It happened only Brastagi or Karo but not in our village. So can say ATASI“

BASMI IS MORE APPROPRIATE FOR AVIAN INFLUENZA

Reactions to specificbehavioral messages

Bersihkan kandang seminggu sekali serta kandangkanayam dan bebek secara terpisahClean cage once a week also cage chickens and ducks separately

Message of cleaning cage easily recalled and evokes discussion.

Most felt that this would be a tedious task and didn’t think they would comply with the behavior

“I don’t think I would do this….washing once a week is too much for me… I only clean cage when it is very dirty”“I don’t even clean the house that often… ““Very much disagree with cleaning the cage with soap once a week” “I think sweeping is enough”

• In addition most questioned why they needed to use soap to clean the cage in the first place – seen to be inconvenient. Low self relevance for the activity – felt to be appropriate for large poultry farmers – definitely not for them “Why do I need to use soap?”“It is impossible to ask people to clean it with soap”“Rearing chickens is just a hobby .. I don’t want to give me lots of trouble….this could be done by big poultry farmers”


• Most said that their chicken pens had soil as the base and were not raised above the ground – hence cleaning with soap would be impossible to do – at best they could sweep it occasionally

Need to give an implication for complying with recommended behavior to get a buy in


Bersihkan kandang seminggu sekali serta kandangkan ayam dan bebek secara terpisahClean cage once a week also cage chickens and ducks separately

Caging birds separately is also felt to be a difficult activity, however not as sharply opposed as cleaning cage once a week with soap.

• Although most have pens – feel that caging is impractical“All people here have cages, but the chickens sleep in the trees”

• Have mainly Ayam Kampung – and caging is mainly for high breed chickens

• Chickens mainly as a hobby & self consumption and not as a core business – hence don’t want to spend much time and attention towards such activities


Need to explain how caging can reduce risk

• Usual practice is to let chickens run free – Chickens fend for themselves and feed themselves thus not being a burden to the family “I feed them only occasionally… ”“To feed the caged chickens will cost us more than to feed the loose ones”

• Usual practice is to let chickens run free– Chickens fend for themselves and feed themselves thus not being a burden to the family

• Usual practice is to let chickens run free. In addition an added fear that caged birds are more susceptible to disease than those that run free.“There is a belief that caged ducks are easier to get sick than loose ones”

Awasi kesehatan unggas dengan teratur memberi vaksin, laporkan jika ada yang sakit dan kuburkan jika ada yang matiMonitor health of poultry by regularly vaccinating, report if any are sick and bury if any die


• As a message, vaccinating is felt to be a positive aspect but difficult to put into practice.• Feel it is appropriate / relevant for large poultry farms with high breed

chickens “We have only Ayam Kampung”


• Access to vaccines are difficult “The Dinas Peternakan is quite far from here.. I don’t want to pay

the cost only for the sake of my chicken”• Previous experiences in village of birds dying post vaccinating also is

discouraging “My friend got his chicken vaccinated but they died anyway”

• In addition wouldn’t want to pay for the vaccines – but if free and brought to their door step would consider it

“Vaccines are expensive…”• (Few Bogor) In addition fear of stigma as would getting chickens vaccinated implies that chickens are sick

“People tend to get suspicious, if we vaccinate our chickens. People will think that our chickens are sick and will infect theirs”

A vaccinating drive by the relevant authorities could help


Awasi kesehatan unggas dengan teratur memberi vaksin, laporkan jika ada yang sakit dan kuburkan jika ada yang matiMonitor health of poultry by regularly vaccinating, report if any are sick and bury if any die• Most expressed a resistance to report their sick birds to relevant

authorities • Primarily felt that the exercise would be pointless

“Do the think the Pak RT can do anything to cure sick chickens?”• The same is felt by community leaders too – as no action is taken

post reporting“Someone can to report to me that their chickens died.. I reported it to my boss, nothing happened. We just made a note of it… (no follow up action from the authorities or don’t even know what action to take)” (Bogor)

• Feel that reporting sick chickens would just result in hassles for the owner“To report this does not give us any benefit. The owner will only get into trouble”

• Additionally brochure does not give any information on who they can report to at a local level – need to provide information for their village / area“This address is in Jakarta.. Its too far”“This number is for all of Indonesia… it would take a long time before our problem is handled”

• Seem a lot more open to the message of disposing dead birds by burying them“We don’t just throw it away.. It produces a bad smell when the birds are rotting… ”

Provide local information to report – Need to follow up with action


Selalu cuci tangan dengan sabun setelah kontak dengan unggasAlways wash hands with soap after contact with poultry• Currently don’t wash their hands post handling chickens

“The advice is good but we don’t do that”“I think people are not very concerned about this”

•• Feel that washing hands is appropriate only if chickens are dirty – don’t understand that that they are susceptible to risk by not washing hands “Why should I wash my hands.. My chickens are clean…”“May be I could wash my hands with water but I don’t think I need to use soap”

Need to explain that soap not to clean hands from dirt but to disinfect


Ingat, begitu terasa demam segera bawa ke dokterRemember, when you have a fever quickly go to a doctor• Feel that this is an appropriate message – but doesn’t communicate a sense

of urgency • Doesn’t really get them to reevaluate behavior

“I think its normal to go to the doctor two to three days after have a fever”“We take medicine like Bodrex or Panadol and if the fever doesn’t go down then go to a doctor”

Need to clearly highlight the symptoms for which they need to go to a doctor


• On most behavioral messages does not motivate to act as does not address existing barriers.

• Doesn’t really get them to reevaluate behavior.“This is good.. I think the advice is needed by our people…. But some of it is exaggerated… like washing the cage with soap”

Thus does it motivate to act

Need to enhance self relevance Need to give implications to undertaking a particular behavioral activity

Need to address existing barriers in terms of attitudes and access