Abstract
Pastoralists in sub-Saharan Africa have limited access to public services due to their mobile lifestyle, economic and political marginalization, and the limited health infrastructure that is common to arid and semi-arid lands (ASALs) where they primarily reside. This often results in poor health outcomes, including increased rates of maternal, neonatal, and under-5 mortality. One Health approaches that integrate human and animal health service delivery can help to improve pastoralists’ health through increased vaccine coverage and improved access to services.Kenya has institutionalized One Health at the national level; however, progress at the subnational level has been limited due to sustainability concerns, competing priorities, and insufficient coordination platforms. To address this gap, this paper presents a One Health framework (OHF) to aid in the implementation of integrated human and animal health policies in Turkana County, which can act as a model for other ASALs. Utilizing a grounded theory design, we conducted semi-structured interviews and focus group discussions with human health, animal health, and pastoralist stakeholders. Inadequate engagement with the public sector was identified as a major limitation by community members. Factors that contributed to this include distance to health facilities and restricted department capacities such as availability of vehicles, personnel, and cold chain maintenance.Our proposed OHF harnesses the existing structure of service delivery in Turkana and establishes an official coordination mechanism to implement One Health activities, through the form of mobile “One Health Huduma Centres”, offering a range of public services. This innovative framework is supported by stakeholders in Turkana and can improve service delivery constraints thereby improving the health of Turkana pastoralists.
Highlights
Pastoralists, who primarily raise livestock in arid and semi-arid lands (ASALs) and rely on strategic mobility to access grazing and water resources, play an important socioeconomic role in sub-Saharan Africa
Livestock diseases that are prevalent in African pastoral regions, such as foot and mouth disease (FMD), Peste des petits ruminants (PPR), Rift Valley fever (RVF), and contagious caprine pleuropneumonia (CCPP), threaten their livelihoods (Zinsstag et al 2016)
In order to overcome these limitations, we developed an One Health framework (OHF) for integrated service delivery, which can act as an official coordination mechanism for One Health activities in Turkana County (Fig. 2)
Summary
Pastoralists, who primarily raise livestock in arid and semi-arid lands (ASALs) and rely on strategic mobility to access grazing and water resources, play an important socioeconomic role in sub-Saharan Africa. Pastoralists are politically and economically marginalized, often lacking access to the Pastoralists in East Africa are at higher risk of zoonotic diseases, such as echinococcosis, rabies, Griffith et al Pastoralism: Research, Policy and Practice (2020) 10:7 brucellosis, bovine tuberculosis, and Rift Valley fever (RVF) due to their livestock keeping practices, consumption of animal source foods (e.g. drinking raw blood or milk), inadequate access to treatment, and living in harsh environmental conditions (Mangesho et al 2017; Zinsstag et al 2016; Desta 2016) In addition to their own health, pastoralists are greatly affected by the health of their livestock, upon which their livelihoods depend. These areas are characterized by marked variability in rainfall both spatially and temporally within and between years (African Union 2013)
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