Analyzing Social Media and Public Health

The provided assignment details a comprehensive analysis of social media's role in public health. It includes references to research papers, articles, and online resources that demonstrate the importance of social media in healthcare. The assignment requires students to apply theoretical knowledge to real-world scenarios, making it an engaging and challenging task for those interested in public health and digital media.

Running head: INFECTIOUS DISEASE
Infectious disease
Name of the Student
Name of the University
Author note

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Introduction
Hepatitis-C is the major public health concern in Egypt. It the viral liver infection
transmitted via unsterilized medical equipment, sharing needles and blood transfusion. Chronic
infection may lead to cancer as there is no effective vaccine or medication (1). As mentioned in
scientific reports of 2017, the prevalence of the infection is high across all population. In general
population, the prevalence is 11.9%, and that in high-risk population is 55.6%, and those at
intermediate risk is 14.3% and 56.0% among those with the liver conditions (1). There is
increasing prevalence due to transmission mainly from healthcare. Chronicity is high among
antibody-positive Egyptians making screening a priority (1)
Figure 1: Trends in percentage of the population age 15-59 with active Hepatitis-C,
Egypt 2008 and 2015 Z-5170763 Public Summary

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Task 1
Ministry of Health has established the National Committee for Control of Viral Hepatitis
(NCCVH) for improving the preventive strategies for hepatitis C in Egypt. The activities of
NCCVH include introducing direct-acting anti-viral (DAAs) agents. It is considered to be the
most effective treatment among others that are existing (2). The proven efficiency of the DAAs
are SVR> 90% (survival rate) (2). It has been found with the minimal adverse effects. NCCVH
lunched the DAA program (using Sofosbuvir- NS5B polymerase inhibitor) for HCV treatment in
2014, gave positive results, high cure rates, with minimum side effects like rashes. Number of
patients on DAAs since 2014 is 129.249 (2). However, there was a barrier including resistance
cases, low rate of follow up, and lack of knowledge of long-term impacts (2). NCCVH is yet to
introduce new action plan that covers all the aspects of prevention and control as well as
establish the specialized treatment centers as per the population size in each area. There is a need
for ambitious screening programs in addition to the other control strategies like educational or
awareness campaigns in support of global partners like World Health Organisation (2).
Another control practice of Egypt is to eliminate HCV, as per 10-15 year prevention and
control plan in 2006. It includes offering of safe blood, injections and health services, increases
access to diagnosis, treatment by more than 90% and achieve more than 90% cure rate. However,
main challenges are generics such as quality assurance, IPR, proven efficiency (3).

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Figure 2: HCV prevention and control plan, Wto.org. 2015
Egypt has launched the National Infection Control Program in collaboration with the
Ministry of Health and Population to promote safe health in hospitals. Required guidelines were
developed in 2003 and were launched in 450 facilities. After the implementation with adequate
training, monitoring and supervision there was an increase in compliance of the healthcare
workers to precautions such as hand hygiene and personal protective equipment. There was a
decrease in the annual incidence of HCV infection from 28% to 3% among previously uninfected
recipients of renal dialysis (2,4). The result was obtained in 60 facilities with dialysis units.
These guidelines were found to be useful by World Health Organization and were revised and
adopted in 2008 (2,4). After the international Health Regulation assessment, it was found that the
National Infection Control Program was successful in decreasing the iatrogenic transmission of
HCV (4). Also, the Egyptian's "viral hepatitis care and treatment program" has successfully
provided the subsidized care and treatment services to 190,000 people in Egypt having the

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chronic hepatitis-C infection (4). It is considered the most significant national programs in the
world. It has been successful in a small number of facilities, but the high cost of treatment and
the increasing population with the chronic infection is causing the challenges (4). There is still a
need for establishing the viral hepatitis surveillance system for implementing the preventive
interventions.
NCCVH has set the national control strategy that outlines the best practices for delivering
the patient care after 2006 (2, 5). It highlights the set of service principles. In addition one of the
most effective and successful programs in the Egypt, national viral hepatitis treatment
programmes (5). Using this programme more than 850 000 received treatment, and more than
one million were evaluated since 2006 (5). The nationwide network of “digitally connected viral
hepatitis-specialized” treatment programme was established. Before 2011, prevention of
infection was limited to the awareness and education campaigns for undergraduates and
postgraduates in universities along with vaccination campaigns (5). This was helpful in serving
people up to 6 million. It helped create access to the all HCV-infected individuals (5).
For national eradication of viral hepatitis, “Plan of Action for the Prevention, Care &
Treatment of Viral Hepatitis, Egypt” has been finalized for 2014-2018. After 2011, this plan
focuses on seven components including “surveillance, infection control, blood safety, hepatitis B
virus (HBV) vaccination, care & treatment, communication, and research.” This plan includes
robust and dynamic steps to prevent viral hepatitis. Policy-related support and the system
changes are critical to success. However, the main limitations are the reduced focus on funding
and reduction of indirect costs (6). A similar plan is proposed for controlling the hepatitis C (3)
in Egypt. The expected outcomes by 2030 are depicted in the figure below-

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Figure 3- Proposed hepatitis control strategy 2014-2030, Wto.org. 2015
Task 2
The preventions and control strategies that are used in Egypt are proper hand hygiene,
safe infection, effective sterilization of medical equipment, screening donated blood, education
of health professionals and population about preventive methods and lastly, early treatment,
education, counseling of infected patients (1). The Hepatitis C infection is likely to persist in
Egypt for several decades. Thus there is a need for changes in the existing strategies. Two of the
main current strategy that needs modifications are awareness of both health professionals and
infected patients through campaigns and, Prevention, Care & Treatment plan (blood safety, early
treatment based on surveillance, screening, and monitoring).

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Campaigns were although done but failed to include the allied healthcare professionals.
The campaigns shall be able to increase public access to all hepatitis vaccine as well as advocate
for vaccine access. Egypt should be able to support the evaluation of new hepatitis vaccines and
vaccinations approaches which is also one of the WHO strategies for Hepatitis infection 2016-
2021 (2, 7). The campaigns on safe blood, hand hygiene or use of protective equipment, for
healthcare workers, must be modified to contain the social media awareness elements. This
element must also be used to promote public awareness of hepatitis vaccination. In different
countries like Australia and US, health care is involved to participate in the social media
campaign to promote awareness of various chronic health conditions like childhood obesity or
diabetes (8). Social media is the way to reach a massive number of population in less span of
time. The strategy of DAAs has been found useful due to 90% efficacy against HCV genotype 4
(8). It has been able to provide excellent SVR results in the Egyptian context. To make this
strategy more successful, there is need to eliminate the poor awareness about the use of sterilized
equipment and medical instruments (8).
Lack of funds is the major barrier to the digitally connected “viral hepatitis-specialized"
treatment programme and Plan of Action for the Prevention, Care & Treatment of Viral
Hepatitis, Egypt” (9,10). There is a need for ring-fenced governmental funding to enforce the
policies and national treatment plan. Egypt must implement the ring-fenced governmental
funding to enhance the treatment facility. The specific treatment programme can finance for
sustainability like the strategic direction 4 of WHO. Egypt should establish the equitable
mechanisms for pooling funds across the health systems for ensuring adequate coverage for
continuum of hepatitis services. The country must offer financial risk protection by reducing
financial barriers. Thus, the prevention and control plan for curtailing the hepatitis C infection

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must be modified by aiming for financial sustainability. It will allow people to receive the
hepatitis services without any financial hardships. By raising the revenue, and financial risk
protection, Egypt can increase access to high quality screening, medication, and diagnostics for
hepatitis C infection. It will help manage the indirect costs by modifying the national control
and treatment plan 2014-2018 by improving the financial services (6,7, and9). Indirect costs can
be managed by offering transfer vouchers or decentralizing services. It will allow better service
uptake, improve early treatment adherence of infected patients and decrease the financial burden
on households. The surveillance, vaccination care and treatment and blood safety control
strategies must be aligned with the financial risk protection. It means there is a need for focus on
affordable vaccines and health commodities (6, 7, and 9). Appropriate funding is also required
to address the complication of hepatocellular carcinoma and decompensated cirrhosis. This is
the major burden of Egypt and can be addressed by adequate health care resource allocation (9,
10).
Task 3
One of the strategies chosen for development of action plan is the education of health
professionals and infected people about the infection prevention method. The health
professionals lack the skills required for risk reduction in at-risk people and awareness of
medical equipment sterilization, hand hygiene, safe blood transfusion. On the other hand, the
infected patients lack the awareness of preventive actions to prevent infection and reduce the
comorbidities.
The action plan aims to develop a social media campaign for improving awareness of
both health professionals and the public in Egypt. The goal will be to increase awareness among

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the target population by 30% regarding vaccination within the two years. The goal is to reduce
the transmission of infection by health professionals (by 30%) and increase the public access to
early diagnosis and preventive strategies (up to 40%). A further goal is to ensure 50% safe
injections and 95% blood safety screened in the quality assured manner within five years.
For first year the plan is as follows-
Activities Duration
Partnership engagements
recruitment staff
June- July 2018
Planning project
media content
meeting security requirements,
August- September 2018
Development of surveys,
training of volunteers
protocols,
Oct- Nov 2018
Baseline data analysis
reporting and documenting
Nov- Dec 2018
Implementation Jan onwards
Evaluation June- July 2019
(Table 1-Rough plan)
The rationale for the social media campaign is because it is the evidence-based option for
health promotion (11). There is literature evidence of many health care professionals using the
social media for preventing chronic health conditions like Breast cancer awareness campaign on

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Facebook (11). The literature review also provided the efficacy of the social media campaign. On
one study, online anti-smoking campaign on Youtube was conducted followed by quantitative
and qualitative analysis of audience response (12). There was greater prevalence of the positive
response from the audience. There was more number of positive messages and ratings than
negative ones (12). In another study the social media campaign was used to increase the physical
activity. It was 13-week social media-based –exercise (13). The positive outcome of the
campaign was greater number of people enrolling in the exercise classes due to promotional
media content (13).
The platforms of social media that will be used are Facebook and Twitter. The rationale
includes more than one billions users of Facebook across world and 35,000,000 in Egypt(14).
Every day more than one million people tweet at Twitter (14). Therefore, it will be the best
platform to create HCV awareness among the patients and knowledge of sterilization/blood
safety/hand hygiene among health workers, most needed in Egypt.
Appropriate staffing will be recruited to post awareness creating content on social media.
It will improve communications between healthcare professionals and patients. The videos and
posts will emphasize the importance of hand hygiene and educate the patient on early treatment.
There will be constant online training and supervision of the healthcare workers. It will help even
those living in remote areas lacking training facilities (11). Similarly, the patients will be aware
of the risk factors and protective factors to fight the infection. The target population will receive
the updated information on evidenced-based options (15). Best practices mandated by CDC
(center for disease control and prevention) government on social media campaigns will be used
such as scale word of mouth, removal of controversial topics (16).

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The benefits of the campaign include, awareness among all sections of society has
infected people. Health care professionals would be able to prevent hospital-based transmission
by adhering to hand hygiene policy and sterilization of equipment. There may be greater
participation in screening services by patients and at-risk people. On the other hand, there may
be greater participation in screening of donating blood and safety precautions by care providers.
The social media campaign will be successful as it will be implemented in alignment with the
ongoing campaigns in different cities. It will also be easy for the policymakers to make decisions
(15).
The potential partnerships include Non- Governmental and governmental Organizations
for completing the campaign within one year. It will be a cost-effective campaign as there will be
less number of resources required when compared to real campaign on streets. Approximately
$300 would be invested for advertisements, use of analytics graphics, photos, and videos as well
as social media management.
Particulars Cost allocated in $
Advertisement 50
Graphics, Photos, and Videos 50
Analytics 100
Social media management 100
(Table- 2- Sample budget- approximate )
The success of the campaign can be evaluated through internal statistics of the programs,
a number of followers, visitors in hospitals for screening, and community feedback surveys. It
will help ensure that the target people are educated and have received proper counseling. Adobe

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SiteCatalyst will help count number of clicks on the Facebook page (17). Future implications
may include nurses acting as better advocate and educators of patients. Nurses may help
educate people on using social media and help create user accounts.
Task 4
It is recommended to implement this strategy of social media campaign while
simultaneously focusing on the safe and affordable care. It is recommended to develop the
strong strategic information system that will help people understand the epidemics of viral
hepatitis. It will better help focus on the response when the information is shared in the social
media (1, 2, 3). There must be a development of effective indicators to gauge the response of the
health care providers, the impact of the campaign and new strategies to monitor the
implementations. There is need to measure the progress in legal measures and policy
implementation for improving the hepatitis response (6, 7). In order to ensure the success of the
robust campaign measures, the governing bodies shall ensure transparency and accountability
mechanisms. Both the government and nongovernment bodies must coordinate for strong civil
society participation. It is essential as there is a need for a range of partners and stakeholders for
implementing campaign at broad scale. Through the social media campaign, it will be possible
to make strong leadership and governance, which is needed for setting clear targets while
engaging with all relevant stakeholders. There is a need for inclusive and transparent assessment
and reporting processes.
There is a need for greater collaboration between the researchers and the policymakers to
ensure that the evidence-based option is translated into practice to provide the desired impact. It
will help health care providers to understand better. The government of Egypt is recommended

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to convene partners and promote and shape glob; research agenda. It must collaborate with the
WHO on the development of new vaccines, service delivery approaches and other commodities
(18). It must regularly, document the priorities for innovation and accelerating care (6, 9). To
ensure the success of the social media campaign, Egypt must devise the injection safety policy
aligning with the WHO guidelines. There is a need of innovating safety-engineered injection to
prevent reuse. The epidemics of the hepatitis C can be controlled by increasing access to the
sterile injecting equipment. Health care providers can be made aware using the comprehensive
package of There is a need for the development of effective hepatitis C vaccine. There is also
the need to collaborate with WHO for country health systems surveillance platform (7, 19).
To improve the rate of access to health care the government must work on the social
media campaign and target the health equity, engage communities, and leverage public and
private sectors. The social media campaign should share effective interventions that are tailored
to specific population and sections of society. The surveillance, vaccination care and treatment
and blood safety control strategies must be aligned with the financial risk protection. It is
because lack of funds has been found to be a measure barrier. It is suggested to develop equitable
mechanisms for pooling funds across the health systems. It will allow for adequate coverage for
continuum of hepatitis services. It needed because the coverage of prevention programmes is
limited. The same can be disseminated through the social media campaign. It is also suggested to
address the stigma and discrimination through the campaign to protect people with high risk of
infection (7, 19).

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References
1. Kouyoumjian, S. P., Chemaitelly, H., & Abu-Raddad, L. J. (2018). Characterizing
hepatitis C virus epidemiology in Egypt: systematic reviews, meta-analyses, and
meta-regression. Scientific reports, 8(1), 1661.
2. El Kassas, M., Elbaz, T., Elsharkawy, A., Omar, H., & Esmat, G. (2018). HCV in
Egypt, prevention, treatment and key barriers to elimination. Expert review of
anti-infective therapy, 16(4), 345-350.
3. Wto.org. (2015). Access to Innovation: Hepatitis C and the Egyptian National
Experience. Retrieved from
https://www.wto.org/english/tratop_e/trips_e/trilat_symp15_e/Manal_trilatsymp_
e.pdf
4. Centers for Disease Control and Prevention (CDC. (2012). Progress toward
prevention and control of hepatitis C virus infection--Egypt, 2001-2012. MMWR.
Morbidity and mortality weekly report, 61(29), 545.
5. El‐Akel, W., El‐Sayed, M. H., El Kassas, M., El‐Serafy, M., Khairy, M., Elsaeed,
K., ... & Shaker, M. K. (2017). National treatment programme of hepatitis C in
Egypt: Hepatitis C virus model of care. Journal of viral hepatitis, 24(4), 262-267.
6. www.emro.who.int. (2018). Plan of Action for the Prevention, Care & Treatment
of Viral Hepatitis, Egypt 2014-2018. Retrieved from
http://www.emro.who.int/images/stories/egypt/VH_Plan_of_Action_FINAL_PRI
NT1.pdf

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7. World Health Organization., (2018) Global health sector strategy on viral
hepatitis 2016-2021.Retrieved from: http://www.who.int/hepatitis/strategy2016-
2021/ghss-hep/en/
8. Grajales III, F. J., Sheps, S., Ho, K., Novak-Lauscher, H., & Eysenbach, G.
(2014). Social media: a review and tutorial of applications in medicine and health
care. Journal of medical Internet research, 16(2), pp. 5-7.
9. Elgharably, A., Gomaa, A. I., Crossey, M. M., Norsworthy, P. J., Waked, I., &
Taylor-Robinson, S. D. (2017). Hepatitis C in Egypt–past, present, and
future. International journal of general medicine, 10, 1-6.
10. Estes, C., Abdel‐Kareem, M., Abdel‐Razek, W., Abdel‐Sameea, E., Abuzeid, M.,
Gomaa, A., ... & Waked, I. (2015). Economic burden of hepatitis C in Egypt: the
future impact of highly effective therapies. Alimentary pharmacology &
therapeutics, 42(6), 696-706.
11. Jabbour, S., & Yamout, R. (Eds.). (2012). Public health in the Arab World.
Cambridge University Press. Retrieved from: https://books.google.co.in/books?
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bsC&oi=fnd&pg=PR7&dq=Public+Health+in+the+Arab+World&ots=c03sEahr7
h&sig=RUPx9AeqvnkdeudDu9Xfr8srCpI#v=onepage&q=Public%20Health
%20in%20the%20Arab%20World&f=false
12. Chung, J. E. (2015). Antismoking campaign videos on YouTube and audience
response: Application of social media assessment metrics. Computers in Human
Behavior, 51, 114-121.DOI: https://doi.org/10.1016/j.chb.2015.04.061