Impact assessment of a community-based animal health project in Dollo Ado and Dollo Bay districts, southern Ethiopia

Management of diseases in a ruminant livestock production system: a participatory appraisal of the performance of veterinary services delivery, and utilization in Ghana

INTRODUCTION

Sustainable livestock production remains crucial for attainment of food security globally and for safeguarding the livelihoods of many households in low- and -middle income countries. However, the high prevalence of infectious livestock diseases, coupled with inadequate provision and adoption of effective control measures, leads to reduced livestock productivity, increased animal mortalities, and emergence of antimicrobial resistant pathogens. This study sought to assess the management strategies employed by farmers for priority diseases affecting their animals and the utilization and performance of veterinary services.

METHODS

We conducted the study in three districts, namely, Mion, Pru East, and Kwahu Afram Plains South Districts, which represent the main livestock production belts in Ghana. We used questionnaires in surveys, to collect pertinent data from 350 ruminant livestock farmers and 13 professional veterinary officers (VOs) in the study districts. Additionally, we conducted seven focus group discussions (FGDs) with 65 livestock farmers in the study districts. The survey data was analyzed, and we describe the distribution of the priority livestock diseases, the disease management strategies employed, and the performance of veterinary services in Ghana. We also analyzed the raw FGD transcript texts deductively based on the study objectives. To validate findings across the different datasets, we used triangulation.

RESULTS

Almost all the farmers (98%) reared small ruminants, with about 25% also rearing cattle. The main priority livestock diseases identified includes pestes-des-petits-ruminants and mange infection in sheep and goats, as well as contagious bovine pleuropneumonia and foot-and-mouth-disease in cattle. We found that majority (82%) of the farmers relied on treatment, while only 20% opted for vaccination services. Additionally, the veterinary system in Ghana did not adequately regulate the antimicrobial medications employed by farmers to manage diseases. Thus, in most of the cases, the medicines applied by farmers were not useful for the target diseases. Although our findings show the farmers perceived VOs to perform highly compared to informal providers on most of the attributes evaluated including medicine availability and quality, treatment effectiveness, advisory services, service affordability, and competence, only 33% utilized VOs services. The majority of the farmers (51%) used the services of informal providers, who were better in proximity and popularity with farmers.

CONCLUSIONS

The livestock sector in Ghana faces a substantial challenge due primarily to vaccine-preventable diseases. Even though VOs demonstrated superior performance on key veterinary service performance indicators, their services are underutilized by livestock farmers. Additionally, the absence of regulatory oversight by the veterinary system over antimicrobials utilized in animal production contributes to their misapplication by livestock farmers, posing a considerable risk to both public health and food security. It is thus imperative to introduce new initiatives that enhance the uptake of animal vaccines and better antimicrobial stewardship to ensure sustainable livestock production.

Relationship between animal health and livestock farmers' wellbeing in Ghana: beyond zoonoses

INTRODUCTION

Livestock production is a key livelihood source for many people in developing countries. Poor control of livestock diseases hamper livestock productivity, threatening farmers' wellbeing and food security. This study estimates the effect of livestock mortalities attributable to disease on the wellbeing of livestock farmers.

METHODS

Overall, 350 ruminant livestock farmers were randomly selected from three districts located in the north, middle and southern belts of Ghana. Mixed-effect linear regression models were used to estimate the relationship between animal health and farmer wellbeing. Farmer wellbeing was assessed using the WHOQOL-BREF tool, as the mean quality-of-life in four domains (physical, psychological, social, and environmental). Animal health was assessed as annual livestock mortalities to diseases adjusted for herd size, and standardized in tropical livestock units to account for different ruminant livestock species. We adjusted for the potential confounding effect of farmers' age, sex, educational attainment, farmland size, socio-economic status, perception of disease risk to herd, satisfaction with health, previous experience of disease outbreaks in herds, and social support availability by including these as fixed effects, and community as random effects, in a pre-specified model.

RESULTS

Our results showed that farmers had a median score of 65.5 out of 100 (IQR: 56.6 to 73.2) on the wellbeing scale. The farmers' reported on average (median) 10% (IQR: 0 to 23) annual herd mortalities to diseases. There was a significantly negative relationship between increasing level of animal disease-induced mortality in herds and farmers' wellbeing. Specifically, our model predicted an expected difference in farmers' wellbeing score of 7.9 (95%CI 1.50 to 14.39) between a farmer without any herd mortalities to diseases compared to a (hypothetical) farmer with 100% of herd mortalities caused by diseases in a farming year. Thus, there is a reduction of approximately 0.8 wellbeing points of farmers, for the average of 10% disease-induced herd mortalities experienced.

CONCLUSIONS

Disease-induced livestock mortalities have a significant negative effect on farmers' wellbeing, particularly in the physical and psychological domains. This suggests that veterinary service policies addressing disease risks in livestock, could contribute to improving the wellbeing of livestock dependent populations, and public food security.

Effectiveness and profitability of preventive veterinary interventions in controlling infectious diseases of ruminant livestock in sub-Saharan Africa: a scoping review

Agriculture in general, and livestock production in particular, serve as a livelihood source for many people in sub-Saharan Africa (SSA). In many settings, lack of control of infectious diseases hampers livestock productivity, undermining the livelihood of rural populations. This scoping review sought to identify veterinary interventions previously evaluated as well as their relative effectiveness in controlling infectious livestock diseases. To be included, papers had to be written in English, German or French, and had to describe the effectiveness and/or profitability of preventive veterinary intervention(s) against anthrax, blackleg, bovine tuberculosis, brucellosis, contagious bovine pleuropneumonia, contagious caprine pleuropneumonia, foot-and-mouth disease, goat pox, lumpy skin disease, pasteurellosis, peste des petits ruminants, and/or sheep pox in any SSA country. Of the 2748 publications initially screened, 84 met our inclusion criteria and were analyzed. Most of the studies (n = 73, 87%) evaluated the effectiveness and/or profitability of vaccination, applied exclusively, applied jointly with, or compared to strategies like deworming, antimicrobial treatment, surveillance, feed supplementation, culling and dipping in reducing morbidity and/or mortality to livestock diseases. The effectiveness and/or profitability of antimicrobial treatment (n = 5), test and slaughter (n = 5), and use of lay animal health workers (n = 1) applied exclusively, were evaluated in the other studies. Vaccination was largely found to be both effective and with positive return on investment. Ineffective vaccination was mainly due to loss of vaccine potency under unfavorable field conditions like adverse weather events, cold chain failure, and mismatch of circulating pathogen strain and the vaccines in use.

In summary, vaccination is the most effective and profitable means of controlling infectious livestock diseases in SSA. However, to achieve effective control of these diseases, its implementation must integrate pathogen surveillance, and optimal vaccine delivery tools, to overcome the reported field challenges.

Contributions of village animal health workers to foot-and-mouth disease control in Cambodia

Local animal health services in rural communities in Cambodia are mainly provided by village animal health workers (VAHWs), although the participation and contribution of VAHWs to livestock disease prevention are uncertain. The participation of the VAHWs as identified by their 'dropout rate' was examined in a desktop review in December 2020 of the national data on VAHWs recorded between 2011 and 2020. The contribution and involvement of VAHWs in disease prevention programmes were examined in a survey conducted between February and March 2014, then analyzed in the context of other surveys of VAHW knowledge, attitudes and practices. The survey involved guided group discussion with VAHWs (n = 198) from the two Cambodian provinces of Kampong Cham and Pursat. This study identified that VAHWs generated less than 22% of their annual household incomes from animal health services. Less than one-third had vaccinated livestock against foot-and-mouth disease (FMD), with none having vaccinated cattle every 6 months during the study period, and nearly half of the VAHWs having never vaccinated their own cattle against FMD. As no privately provided FMD vaccination services occurred in these communities, with all vaccines delivered through the government-subsidized programme, the findings confirmed that VAHWs only vaccinated animals against FMD when vaccines were made available by the Government. The desktop review found that the number of VAHWs in 2020 declined by more than 24% since 2017, and the proportion of female VAHWs was consistently low, with a mean of 8.26 (±1.019). These findings confirm findings from previous studies that identified considerable weaknesses in the VAHW system in Cambodia, particularly in contributing to FMD control. Cambodian animal health authorities require more effective policies to strengthen the current VAHW system, improving their services delivery; their retention as 'active'; their development of more sustainable roles with lower 'dropout' rates and the prolonged gender inequity. With the limited availability of government-subsidized FMD vaccination currently, extension programmes that engage VAHWs and farmers in seeking privately funded and delivered FMD vaccination that incorporates appropriate multivalent FMD serotype vaccines of high quality, delivered in small dose vials from a robust cold chain, is suggested. This strategy would assist VAHWs to contribute to the provision of private livestock vaccination services that are likely essential for sustainable FMD prevention and control in Cambodia.

Use of lay vaccinators in animal vaccination programmes: A scoping review

Background

The human resource gap in veterinary sectors, particularly in low-income countries, imposes limitations on the delivery of animal healthcare in hard-to-reach populations. Lay animal health workers have been deployed in these settings to fill the gap though there are mixed views about the benefits of doing this and whether they can deliver services safely. We mapped evidence on the nature and extent of roles assigned to lay animal vaccinators, and identified lessons useful for their future deployment.

Methodology/Principal findings

Following the PRISMA Extension for Scoping Reviews guidelines, we searched seven bibliographic databases for articles published between 1980 and 2021, with the search terms lay OR community-based OR volunteer AND "animal health worker" OR vaccinator*, and applied an a priori exclusion criteria to select studies. From 30 identified studies, lay vaccinators were used by non-government developmental (n = 12, 40%), research (n = 10, 33%) and government (n = 5, 17%) programmes to vaccinate domestic animals. The main reason for using lay vaccinators was to provide access to animal vaccination in the absence of professional veterinarians (n = 12, 40%). Reported positive outcomes of programmes included increased flock and herd sizes and farmer knowledge of best practice (n = 13, 43%); decreased disease transmission, outbreaks and mortality (n = 11, 37%); higher vaccination coverage (10, 33%); non-inferior seroconversion and birth rates among vaccinated herds (n = 3, 10%). The most frequently reported facilitating factor of lay vaccinator programmes was community participation (n = 14, 47%), whilst opposition from professional veterinarians (n = 8, 27%), stakeholders seeking financial gains to detriment of programmes goals (n = 8, 27%) and programming issues (n = 8, 27%) were the most frequently reported barriers. No study reported on cost-effectiveness and we found no record from a low and middle-income country of lay vaccinator programmes being integrated into national veterinary services.

Conclusion

Although the majority of included studies reported more benefits and positive perceptions of lay vaccinator programmes than problems and challenges, regularization will ensure the programmes can be designed and implemented to meet the needs of all stakeholders.

In the absence of professional animal healthcare workers in hard-to-reach settings, lay persons, with limited, non-formal training, have been used to provide animal healthcare services, including vaccination. In spite of the perceived crucial roles lay persons play in the animal health sector, their services are largely unrecognized within official animal healthcare systems. We compiled evidence on how lay persons have been used in animal vaccination programmes and make recommendations regarding how they can be used in more effective ways. We found they were used by both government and non-government institutions to vaccinate different domestic animals and provide regular animal healthcare services. They were mainly used where professional animal healthcare workers are not available or are limited in number. The programmes were more successful where they had the support of the public and institutions, and their outcomes were largely similar to those delivered by professionals. We also found that community participation was an important facilitating factor, whilst the main challenges they faced were opposition from professional veterinarians, financial interests of stakeholders and planning issues. We concluded that lay animal vaccinator programmes could be more beneficial if better regulated.

Welfare Impact of Community-Based Veterinary and Breeding Services on Small Ruminant Keepers

Improved breeding practices and participatory health services have been designed and implemented by a partnership between national and international institutions in various parts of Ethiopia since 2014. Based on a panel data of two waves, we have estimated the impact of these interventions on small ruminant fertility, offtake, return per head of animal, and gross income per adult equivalent. Different specifications of the difference-in-differences model revealed that access to small ruminant health services has increased offtake, return per head of sheep/goat, and gross income per adult equivalent. Participants in community-based small ruminant breeding have also higher offtake and gross income per capita than those who are not taking part. The findings of this study are expected to help understand the economic benefits that accrue to rural areas when livestock development interventions are made based on the right diagnosis. The results of this study will also be useful in informing the ongoing discussion in Ethiopia on the transformation of the livestock sector.

Small Ruminant Production in Tanzania, Uganda, and Ethiopia: A Systematic Review of Constraints and Potential Solutions

Sheep and goats are an important commodity for smallholder farmers across East Africa, but severe limitations remain in small ruminant production. This review aimed to identify specific constraints to small ruminant production and identify practical and sustainable solutions. From 54 eligible articles, most were focused in Ethiopia (n = 44) with only 6 studies performed in Tanzania and 4 in Uganda. The most frequently identified constraint in Ethiopia and Tanzania was disease (n = 28 and n = 3, respectively), and in Uganda, it was the lack of access to veterinary services (n = 4). Additionally, access to good breeding stock, lack of animal records, and an established marketing chain were also mentioned in all the three countries. Ectoparasites, gastrointestinal parasites, orf, and sheep/goat pox were the most frequently mentioned disease challenges causing productivity losses. Many articles provided potential solutions as suggested by farmers, including improved access to veterinary services and medicines, improved record keeping, and access to good breeding stock. Farmers highlighted the value of community-based participatory development plans to increase education on disease control, land management, and husbandry. This review also highlighted knowledge gaps, the need for further research, particularly in Tanzania and Uganda, and the importance of addressing multiple challenges holistically due to the links between constraints.

Participatory assessment of paid vaccination campaigns for village chickens against Newcastle disease in Kongo Central province

In the Democratic Republic of Congo (DRC), where state-driven animal vaccination campaigns are organized only in response to epidemics, the organization of a permanent animal vaccination service is urgently needed. A non-governmental organization has set up an experimental paid vaccination service for village chickens against Newcastle Disease (ND) in the Kongo Central province. This mixed-method study presents a participatory assessment of this experiment, identifying socio-economic factors that influence the decision of chicken keepers to adopt vaccination. The study was conducted in four territories of the province. Qualitative and quantitative data were collected through 12 focus group discussions (FGDs) with professionals of animal health and chicken keepers and 160 semi-structured interviews with chicken keepers, sampled by snowball technique. This participatory process has resulted in the design of a grid for assessing animal vaccination service's performance. Here translating the narratives into a preliminary structured assessment, this grid is an output of the study, to be mobilized for future rapid assessments of the vaccination service in a quantitative prospect. The grid consisted of nine criteria, further composed by 16 items, translated into questions to be asked to chicken keepers and vaccinators. In our study area, fieldworkers enumerated four animal vaccination campaigns during a period of 21 years (except those subject to the present assessment). Around 13% of chicken keepers of our sample had participated in ND vaccination programs. Almost 96% of interviewed chicken keepers expressed their willingness to pay for ND vaccination, and 87% of chicken keepers that vaccinated their chickens perceived the vaccine as effective. Vaccinators estimated that 56% of the chicken keepers who were contacted had actually paid for the vaccination of their chickens. The assessment grid highlighted four points in favor of the sustainability of this service, i.e. the general interest of chickens keepers, vaccine efficacy, vaccine availability and ease of use of the vaccine. Two weak points were identified, viz. the poor access of chicken keepers to information and the weak motivation of vaccinators. The vaccine coverage was calculated within the sample at 13.1%. Paid vaccination campaign for village chicken in Kongo Central obtained a performance score of 62.8%, with the highest score in Kwilu-Ngongo (73.1%) and the lowest in Kasangulu (52.4%). Two factors of adoption of vaccination were identified as statistically significant, i.e. chicken housing and territory. Significant differences appeared between territories in access to information for chicken keepers and in vaccinators motivation. The priorities for the improvement of this service appear to be awareness raising among chicken keepers and increasing vaccinators' motivation.

Livestock mortality and offtake in sheep and goat flocks of livestock owners making use of services offered by paravets in West Afghanistan

In the present study, we quantified the effect of livestock services provided through paravets (intermediate-level training in veterinary medicine) on mortality and offtake of small ruminants in Western Afghanistan for the years 2010, 2011 and 2013. We compared mortality in adult and in young stock, and offtake of young stock of 120 livestock owners that made use of the paravet services (Users) with 120 livestock owners who did not make use of these services (Non-users). Security issues in the districts under study influenced the choice of villages. Within villages, livestock owners were purposively selected based on their known use of the services, including the provision of biologicals such as anthelmintics and vaccines. In addition, we subdivided both categories into 'partial' and 'full' based on the intensity of use of biologicals. Paravets were not only trained on preventive and curative veterinary medicine, they were also trained in extension and trained on adhering to a cold-chain and applying quality biologicals. For Non-users there was the possibility to buy biologicals through a local market or bazaar. In Afghanistan, local markets have an extensive supply of vaccines, anthelmintics, and medicines from a variety of sources, often not handled appropriately and therefore of varying quality. The results indicated that livestock owners making partial or full use of the paravet services had statistically significant better animal health and production results. The mortalities in adult stock, expressed as Incidence Rate Ratios (IRRs), for the partial-Users and full-Users categories were estimated to be respectively 0.80 and 0.73 times the mortality observed in the partial Non-users', the reference category. A similar result was observed for young stock mortality with estimated IRRs of 0.81 and 0.77 for partial and full-Users category respectively. The offtake for partial- and full-Users category livestock owners were 1.24 and 1.21 times higher compared with the reference category. In conclusion, we demonstrated significant improvement of health and production parameters in small ruminants' flocks of owners making use of the services of the DCA-trained paravets, emphasizing the importance of this sustainable and effective system of private veterinary service delivery in Afghanistan.

Measuring the quality of clinical veterinary services for Cattle: an application of a role play experiment in rural Uganda

Background

The dominance of veterinary paraprofessionals in the animal health markets has been linked to the decline in quality of veterinary services. This study uses a role play experiment to analyze how the interaction of farmers and service providers influences the quality and the demand for clinical services for cattle. The quality of clinical services was measured by scoring the accuracy of the service provider prescribing the appropriate drug for selected cattle diseases.

Methods

The game was played in four rounds. Farmers were given “animal medical card” with the name of the disease written on it both in English and the local language in each round. Service providers were asked to write the clinical signs, and prescribe the drugs.

Results

The results show that the ability to identify the signs of different diseases and the accuracy of prescriptions by veterinarians is not significantly different from that of paraprofessionals trained in veterinary science. However, the ability of service providers who are not trained in veterinary medicine to perform these tasks is significantly lower than that of service providers trained in veterinary science. The continued interaction between paraprofessionals and veterinarians gradually leads to an improvement in the ability of paraprofessionals trained in general agriculture and social sciences to perform these tasks. This was not the case for paraprofessionals with no formal training or education. Farmers do not easily change their beliefs about paraprofessionals, even if they receive information on their inability to diagnose diseases correctly and prescribe the correct drugs. Belief updating depends not only on the outcome of the previous round, but also on the gender of the farmer and the livestock production system.

Conclusion

This paper argues that the slow pace in which farmers update their beliefs about paraprofessionals limits paraprofessionals’ willingness to learn or consult with veterinarians. However, the use of “animal health cards” (records of diagnoses and treatments) could induce paraprofessionals to provide services of better quality clinical services for cattle and enable farmers to measure the quality of these services.

Helping working Equidae and their owners in developing countries: monitoring and evaluation of evidence-based interventions

There are an estimated 112 million Equidae (horses, donkeys, mules) in the developing world, providing essential resources for their owners' livelihoods and well-being. The impoverished situation of their owners and the often harsh conditions in which they work mean that the animals' welfare is a cause for concern. A number of equine non-governmental organisations (NGOs) operate within working equid communities providing veterinary care, education and training programmes aimed at improving equine welfare. However, there is little published information available that describes monitoring and evaluation (M&E) of such interventions using objective outcome-based indicators and where baseline data are available. The aim of this paper is to summarise the peer-reviewed reports of M&E in this sector and identify the key issues which need to be addressed in ensuring that such evaluations provide useful information on the work of these organisations. A rigorous evidence base for designing future interventions will provide an opportunity for enhancing the effectiveness of working equid NGO operations. Increased availability of M&E reports in the peer-reviewed literature will enable NGOs to learn from one another and disseminate to a wider audience information on the role of working Equidae and the issues they face.

Participatory epidemiology: approaches, methods, experiences

Participatory epidemiology (PE) is an evolving branch of veterinary epidemiology which uses a combination of practitioner communication skills and participatory methods to improve the involvement of animal keepers in the analysis of animal disease problems, and the design, implementation and evaluation of disease control programmes and policies. This review describes the origins of PE and how the application of PE requires attention to both a participatory approach and participatory methods, supported by triangulation of data with conventional veterinary diagnostic methods. The review summarizes the various adaptations and uses of PE, including the design of primary veterinary service delivery systems, veterinary research and disease surveillance. In contrast to conventional data collection methods, an integral aspect PE is the concept of applying and evaluating new disease control programmes or surveillance systems in partnership with animal owners. In the developing regions where PE has been most commonly used, this action-orientated approach raises important challenges for veterinary institutions with limited financial resources. Information derived from PE studies can also question longstanding disease control policies and norms, nationally and internationally.

Impact of drought-related vaccination on livestock mortality in pastoralist areas of Ethiopia

Under a national Livestock Policy Forum in Ethiopia the impact of livestock vaccination during drought was assessed in order to inform the development of a best-practice guideline. For each of the different types of vaccine used during drought years there was no significant difference in livestock mortality, for any species, in vaccinated compared with non-vaccinated herds. The limited impact of vaccination on livestock mortality was attributed to weaknesses in the design and implementation of vaccination programmes, including use of inappropriate vaccines, low vaccination coverage, problems with vaccine dosing, incorrect timing of vaccination and problems with vaccine storage. If these weaknesses could be overcome vaccination could be a useful means to protect livestock assets, with considerable benefit-cost ratios. Vaccination should be conducted as a standard preventive measure during normal years, and programme design should be informed by participatory epidemiological studies.

Impact of a commercial destocking relief intervention in Moyale district, southern Ethiopia

A commercial destocking intervention was piloted in southern Ethiopia during the drought of early 2006. The intervention led to the purchase of an estimated 20,000 cattle valued at USD 1.01 million. On average, destocked households received USD 186 from the sale of cattle--approximately 5,405 households were involved. In terms of aid investment, the approximate cost-benefit ratio was 41:1. During the drought, income from destocking accounted for 54.2 per cent of household income (n = 114 households), and was used to buy food, care for livestock, meet various domestic expenses, support relatives, and either pay off debts or augment savings. Seventy-nine per cent of the income derived from destocking was used to buy local goods or services. Expenditure on livestock care amounted to 36.5 per cent of local spending, and included the private transportation of livestock to better grazing areas. The buoyant livestock export trade was considered to be an important driver of commercial destocking, demonstrating a positive link between livestock and meat exports, and pastoral vulnerability during drought.

Community animal health services for improving household wealth and health status of low income farmers

BACKGROUND

Community animal health services in low-income countries aim to improve the health of animals and directly improve the wealth and health or livelihood of their owners. These services have been promoted by aid organizations since the 1970s.

OBJECTIVES

To summarize reliable research of community animal health services on indicators for household wealth and health.

SEARCH STRATEGY

We searched the Cochrane Infectious Diseases Group Specialized Register (July 2005), CENTRAL (The Cochrane Library 2005, Issue 2), MEDLINE (1966 to July 2002), AGRIS (1975 to July 2005), Science Citation Index (2000 to July 2005), STN SIGLE database (1976 to 2002), and AGRICOLA (19 July 2005). We contacted relevant researchers and organizations, and also checked the reference lists of articles.

SELECTION CRITERIA

Randomized controlled trials and controlled before-and-after studies comparing community animal health services with no community animal health services or with an alternative animal health service.

DATA COLLECTION AND ANALYSIS

We independently assessed studies for inclusion in the review.

MAIN RESULTS

No studies met the inclusion criteria.

AUTHORS' CONCLUSIONS

Well-designed randomized controlled trials or controlled before-and-after studies that use standard pragmatic outcomes are needed to evaluate the positive results reported by observational studies.