School-based Approach to Avian Influenza Prevention and Pandemic Influenza Preparedness and Response in Thailand

This campaign is based on the premise that implementation of a curriculum/instructional package on AI and human influenza is an integral part (prevention/mitigation stage) of a comprehensive pandemic (emergency) preparedness and response plan for the education system. The curriculum is part of emergency preparedness/prevention and response planning in which school-level emergency and preparedness plans (including other possible emergencies such as - for example - floods, Tsunami, and armed conflicts) were developed. The project develops, tests, disseminates, and monitors curricular materials aligned with curriculum standards and an instructional package with lesson plans and materials for child-centred learning activities designed for both public and private school students (and their families) grouped into 5 grade interval levels (grades kindergarten; grades 1-3; grades 4-6; grades 7-9; and grades 10-12). This component aims to strengthen the capacity of Thai schools to use a life skills approach to develop health behaviours that reduce the risk of animal-to-animal and animal-to-human transmission of avian influenza, as well as that limit the spread of both normal (seasonal) and pandemic human influenza. According to organisers, the learning materials presented nationally "take into consideration local peculiarities and can be even further localised by additional learning inputs from the local MoE administration and communities. The child-to-child approach is incorporated as ...[a] learning methodology/strategy and [as] community outreach."

Specifically, the instructional package contains integrated thematic curriculum units, incorporating various active learning methods to encourage development of understanding of the threat posed by AI and to allow adaptation of the learning to the specific local situation related to poultry rearing and food preparation. Core messages for healthy behaviours are grouped into the following phases - pre-pandemic, pandemic, and post-pandemic - and focus on basic hygiene practices, risk-reduction strategies for those living/working closely with birds, minimisation of transmission risk, and psychosocial factors. Learning outcome include knowledge, attitudes, and practices for development of life skills for healthy behaviours in preventing and limiting the spread and impact of avian and human influenza. Particular components of the curriculum will include:

• Rationale for a school-based approach to AI and pandemic human influenza preparedness and response
• Essential information on AI and pandemic human influenza
• Theoretical foundations and implications of the life skills approach
• MOE Basic Education Curriculum of 2001 and conceptual framework for a local curriculum on AI and pandemic human influenza
• Learning standards, life skills, learning outcomes, and informational content by grade interval level
• Interactive teaching strategies and active learning methods
• Sample lesson plans and materials for learning activities by grade interval level
• Assessment of learning outcomes (pre- and post-)
• Information and learning resources on AI and pandemic human influenza
• Linkages for school and community participation

To develop the package, UNICEF, along with its implementing partner, KIAsia's life skills education team, drew on experiences and lessons learned from 5 years of implementation of its project entitled "A School-based Approach to Community Participatory Learning and Action Against Malaria" in 53 disadvantaged schools in provinces bordering Myanmar and Cambodia. The organisation then offered a "writeshop" to draft the prototype instructional package embodying the principles of learning reform as specified in the Education Act of 1999. It then organised an orientation workshop for testing the curriculum and instructional package to obtain feedback for improvement from 39 selected schools in 27 Education Service Area Office (ESAOs). These schools also provided the core participants/facilitators for developing the learning materials. Education supervisors, school principals, and one teacher from each grade interval from selected schools participated in this process. On-site follow-up monitoring visits were conducted at 26 of the schools participating in field-testing to obtain feedback from teachers and students on the package. Finally, KIAsia held 2 feedback workshops with participants from the 39 schools to seek suggestions for improvements in the package; a report summarising results of the workshops was submitted to UNICEF. The instructional package was disseminated nationwide in the 2006-07 school year (May through September).

The printed medium is one way of supporting this process: 2.98 million sets of 9 posters and pamphlets carrying AI awareness and prevention messages and 190,000 copies of teacher manuals were also distributed to all schools. In addition, as part of the campaign's hygiene promotion component, 300,000 bars of soap were provided to elementary schools across the country.

An additional campaign component aims to strengthen capacity of schools to formulate emergency preparedness and response plans and apply them with specific focus on limiting the impact of AI and pandemic human influenza on the provision of basic education services to children. Because of the key role that children play in spreading influenza, it is generally accepted that one of the early interventions should be the closure of schools to reduce the spread of the virus, with special focus on rural communities where the population has few sites where they frequently congregate outside of schools, temples, and markets. Campaign organisers believe that, prior to the closure of schools, there is an opportunity to raise awareness of communities through preparedness and emergency response planning involving children and community leaders.

Specifically, UNICEF, with KIAsia, has developed a prototype planning process and format based upon a review of methodologies for business continuity planning (BCP) and school emergency preparedness and response planning (EPRP), incorporating specific guidelines for and examples of pandemic influenza planning for education providers already adopted for use in other countries. Plans address the 4 stages of action, including: prevention/mitigation, preparedness, emergency response, and recovery. To cite only one example, steps were taken to prepare for the role of schools in the recovery phase, involving psychosocial support and counseling to cope with trauma and bereavement. KIAsia field tested the prototype EPR planning process and format, followed by a workshop for feedback and reflection on lessons learned to date. The package was launched through 4 regional orientation workshops for ESAOs which then provided oversight and support to schools in formulating and implementing their EPRPs.

Health, Children.

According to UNICEF, since 2003 the H5N1 virus is known to have infected more than 250 people in 10 countries worldwide, killing 148. In Thailand, 17 people - 11 of them children under the age of 18 - have died of AI since the first confirmed human H5N1 case was recorded there in early 2004; there have been 3 human fatalities so far in 2006. Bird flu outbreaks have occurred in domestic poultry in at least 30 provinces in Thailand, the world's fourth-largest poultry producer. Authorities have been forced to destroy millions of ducks and chickens to thwart the spread of the virus, resulting in severe economic losses for both large- and small-scale poultry farmers.