Abstract
Background: Endemic zoonoses have important impacts for livestock-dependent households in East Africa. In these communities, people's health and livelihoods are severely affected by livestock disease losses. Understanding how livestock keepers undertake remedial actions for livestock illness has the potential for widespread benefits such as improving health interventions. Yet, studies about livestock and human health behaviours in the global south tend to focus on individual health choices. In reality, health behaviours are complex, and not solely about individualised health experiences. Rather, they are mediated by a range of “upstream” factors (such as unequal provision of services), which are beyond the control of the individual.Methods: This paper presents qualitative research conducted from 2014 to 2019 for a study focused on the Social, Economic, and Environmental Drivers of Zoonoses in Tanzania (SEEDZ). Qualitative data were collected via focus group discussions, community meetings, informal interviews, formal in-depth interviews, observations and surveys that addressed issues of health, disease, zoonotic disease risks, and routes for treatment across 21 villages. Thematic analysis was carried out on in-depth interviews and focus group discussions. Conceptual analyses and observations were made through application of social science theories of health.Findings: Livestock keepers undertake a range of health seeking strategies loosely categorised around self and formal treatment. Two key themes emerged that are central to why people make the decisions they do: access to resources and trust in health care providers. These two issues affect individual sense of agency which impacts their ability to act to improve livestock health outcomes. We suggest that individual choice and agency in veterinary health seeking decisions are only beneficial if health systems can offer adequate care and health equity is addressed.Significance: This study demonstrates the value of in-depth qualitative research which reveals the nuance and complexity of people's decisions around livestock health. Most importantly, it explains why “better” knowledge does not always translate into “better” practise. The paper suggests that acknowledging and addressing these aspects of veterinary health seeking will lead to more effective provision.
Highlights
AND BACKGROUNDAcross Africa, over 70% of people rely on livestock for their livelihoods [1]
The idea commonly promoted through health interventions is often that one’s sense of agency will change merely with good advice or the right information, i.e., through increased “knowledge” and health interventions can be directed towards these gaps in knowledge [56, 57], disease risks can be mitigated [as for zoonoses, see Zhang et al [58]
How can health services be better addressed, more evenly distributed to communities who need it, and yet who may be resistant to increased attention due to histories of poor trust? We argue for seeing and addressing both the structural inequity of health at global, national, and local scales as well as for more provider engagement with the communities they serve in order to improve health services provision and access and which will contribute to improved trust and empowerment, for veterinary based Health seeking behaviour” (HSB)
Summary
AND BACKGROUNDAcross Africa, over 70% of people rely on livestock for their livelihoods [1]. Livestock face numerous health challenges including, but not limited to endemic zoonoses such as brucellosis, Q-fever, Rift Valley fever, and anthrax. These diseases can threaten livestockbased livelihoods by directly affecting human and animal health [4, 5] and indirectly through livestock production losses [6]. Endemic zoonoses have important impacts for livestock-dependent households in East Africa. In these communities, people’s health and livelihoods are severely affected by livestock disease losses. Health behaviours are complex, and not solely about individualised health experiences Rather, they are mediated by a range of “upstream” factors (such as unequal provision of services), which are beyond the control of the individual
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