Delivery Of Animal Health Services Research Articles

Challenges and options for animal and public health services in the next two decades

Trade in livestock and livestock products makes up approximately one sixth of global agriculture trade. This trade is demand driven, primarily by growing human populations, changing economies, and consumer preferences in developing countries. Different rates of population growth, economic growth, urbanisation, environmental sustainability, and technology transfer will determine which countries will reap the greatest benefits. Global trends in demand and supply for food, not terrorism, will drive the future of animal and public health service delivery. To benefit the greatest number of people and countries, animal and public health services should support policies that temper growing disparities among rich and poor countries, city and rural populations, and the sexes. Economic growth is critical to overcoming disparities between countries and best supported by integrated animal health, public health, labour, and foreign policies. Opportunities for job growth will be the greatest along the value added chain of food production and will require significant investments in science- (risk-) based education.

Performance of Community-based Animal Health Workers in the Delivery of Livestock Health Services

Since the liberalization of animal health services in Kenya in the early 1990s, community-based animal health workers (CBAHWs) have become an important alternative animal health delivery channel in the country's marginal areas. However, professional veterinary practitioners have questioned the effectiveness of CBAHW programmes in animal health service delivery in Kenya. This is partly due to lack of information about their performance and partly because CBAHW programmes were implemented before the necessary changes in the existing legal, policy and institutional frameworks had been made. This study was designed to provide such information. In this regard, the productivity of livestock herds among farmers who utilized the services of CBAHWs was compared to that of livestock belonging to farmers who utilized the services of professional veterinarians. The annual live births per mature female (birth ratio) and the proportion of young stock to mature females (breeding index) was computed over a period of 3 years in cattle and goat herds under care of CBAHWs and professional veterinarians. The birth ratios in cattle and goats under CBAHWs were not significantly different from those under the care of professional veterinarians (p > 0.05). Furthermore, the breeding index of cattle and goats under the two categories was not statistically different. Besides the CBAHWs providing clinical services, they also created positive externalities through participatory learning enjoyed by neighbouring livestock keepers, who later dispensed with their services. Policy attention is therefore needed to enhance the participation of CBAHWs in animal health service delivery and to appropriately integrate their activities into the existing formal animal health delivery system in Kenya. Interventions that improve the professional development of these workers, with emphasis on areas pertaining to care of young stock, would not only promote the sustainability of CBAHW programmes but would also improve livestock productivity in the country's marginal areas.

Synergies between veterinarians and para-professionals in the public and private sectors: organisational and institutional relationships that facilitate the process of privatising animal health services in developing countries.

The delivery of veterinary services in most developing countries was, until recently, considered to be the responsibility of the public sector. However, over the past four decades, economic constraints and the imposition of structural adjustment policies (SAPs) have led to a gradual decline in public sector investment in real terms and thus a reduction in the quality and quantity of services available to livestock keepers. Many governments acknowledged that they were no longer able to provide services that were essentially of a 'private good' nature and introduced radical policy changes which sought to introduce the concepts of a market orientated approach towards agriculture and livestock production in particular. The role of government, in the future, would be to provide a reduced range of essential 'public good' services and to create a favourable environment in which the private sector could become established as a provider of 'private good' services and at the same time act as a partner in carrying out certain public functions under contract or 'sanitary mandates'. In almost all developing countries, however, these policy changes were not accompanied by appropriate development strategies. The reasons for this are complex. Firstly, SAPs may be considered to have been foisted upon governments by donors and are thus perceived by many policy-makers as the cause of financial problems, rather than a solution to them. Secondly, most animal health senior policy-makers in the public sector have been trained as veterinarians and lack the required management skills to plan change effectively. Furthermore, as regards clinical veterinary service delivery, especially in rural or more remote areas, the solution fostered by donor investment, which involves deregulation and the deployment of privately operating para-professionals, is often perceived as a threat to the veterinary profession and might result in limiting access to international markets for the trade of livestock and livestock products. An informal delivery system has gained a foothold in many developing countries in the absence of a well-planned strategy for the privatisation of animal health services. Most governments would now acknowledge that this presents a greater risk than the deployment of well-regulated and effectively supervised para-professionals. This paper explores some of the principal challenges facing policy-makers in their efforts to bridge the transition from full state provision of animal health services to the formation of a partnership with the private sector. Governments and donors need to take active steps to facilitate the process of privatisation of animal health services, especially those targeting the poorer rural subsistence and pastoralist farming systems. This would entail an initial investment in developing the necessary management skills at all levels in the delivery system. Thereafter, further investment would be required to allow the changes to be managed using tools such as the strategic planning cycle. Should sufficient resources be made available to allow the full participation of all stakeholders in the delivery of animal health services, appropriate institutions and effective organisational relationships addressing all the more important issues will have to be identified. The paper then proceeds to describe how different livestock production systems determine the level of demand for animal health services. If these services are to be provided on a financially sustainable basis, they must be tailored to meet actual rather than perceived demand. Identifying an appropriate model for animal health service delivery thus requires careful analysis of the production system to be targeted. Governments and donors can play a useful role in providing resources for this type of study as well as for appropriate market studies, business planning, training and access to soft loans. Finally, as regards regulation, as the law stands today, many activities currently practised by para-professionals are classified as 'acts of veterinary medicine or surgery' and may only legally be performed by qualified and registered veterinarians. The concept of 'principal' and 'subsidiary' legislation provides the necessary flexibility in the regulation of the delivery of animal health services to accommodate the rapid changes taking place in this environment today. Deregulation involves the delegation of responsibility for the performance of a defined range of veterinary interventions to para-professionals under the 'supervision' or 'direction' of a registered veterinarian. The author illustrates how the experiences of a number of projects in Tanzania were used to propose a definition of 'supervision' in law. The definition offers an opportunity to overcome the fear of compromising standards of delivery of animal health services through the deployment of para-professionals. In addition, such functioning provides employment opportunities for private veterinarians in rural areas where access to formal primary animal health services would otherwise be denied and may contribute to the process of quality assurance of national veterinary services in developing countries.

Kenya: the development of private services and the role of the Kenya Veterinary Association.

Private veterinary practice has existed in Kenya for more than half a century. Between the early 1930s and the mid-1960s, provision of clinical and advisory services almost entirely involved servicing commercial ranches and dairy farms. The Department of Veterinary Services (VSD) was mainly responsible for providing regulatory services in these areas. Until the mid-1960s, public sector veterinary responsibilities were predominantly associated with the prevention of notifiable diseases outside the commercial farming areas. In a major agrarian reform programme initiated in 1954, Kenya initiated an aggressive campaign promoting the dairy industry in the wetter areas of the country among small-scale farmers. In an effort to encourage dairy development, the VSD decided to provide some services, mainly tick control and subsidised artificial insemination. This support had a great positive impact on the 'smallholder' dairy industry. After the end of the colonial administration in 1963, most private practitioners left the country. A decision was therefore taken to transfer the responsibility of providing services of a 'private goods' nature, such as clinical services, temporarily to the public sector through the VSD. This was accompanied by significant expansion of training and the deployment of both professional veterinarians and para-professionals. By 1988, personnel costs had escalated to over 80% of the recurrent budget, leaving little for operational costs. This necessitated a policy change, which led to decreased government involvement in the delivery of animal health services. The private sector, as expected, responded appropriately to the change in policy. The Kenya Veterinary Association (KVA) launched a privatisation scheme (the Kenya Veterinary Association Privatisation Scheme) in 1994 to provide members with credit to set up private practices. The first phase of the scheme (1994-1996) was rated a success, with 100% loan repayments. The second phase of the project (from 1997) was characterised by a low number of loan applications, which increased the cost of loan administration per unit. There was some defaulting in loan repayments during this phase. While private veterinary practice took root in the high rainfall, intensive farming areas, this was not the case in the arid and semi-arid lands (ASAL), where community-based animal health workers (CAHWs) played a prominent role in providing animal health services. The lack of uniformity in the training of these workers denied them recognition by the Kenya Veterinary Board (KVB). An agreement has now been reached between the KVB, the Director of Veterinary Services and the KVA to discontinue the training of CAHWs and to retain and retrain existing workers for disease surveillance and reporting in ASAL areas. In conclusion, private veterinary practice has been successful in areas of high agricultural potential. Expansion to more marginal areas, however, would require incentives or subsidies.

INTEGRATING COMMUNITY-BASED ANIMAL HEALTH WORKERS INTO THE FORMAL VETERINARY SERVICE DELIVERY SYSTEM IN KENYA

The community-based animal health workers (CBAHWs) model has been one of the ways utilised in delivery of animal health services following the veterinary service reforms. Government statutory bodies have opposed the establishment of these programs arguing that their approach to animal health delivery does not fit within the existing technical, legal and policy framework. This study gives an account of the nature, characteristics, and activities of CBAHWs and provides information that would guide policy debate regarding their integration into formal health service delivery. It indicates that these programs provide mainly curative health services but the issue of sustainability has continued to dodge most of them. It establishes that, for trainees to continue actively providing services, continued professional development obtained through regular refresher training and entrepreneurship exemplified by proper record keeping are important. It therefore recommends that policy review is needed to address the role of CBAHWs and appropriately integrate their activities within the formal animal health delivery system.

A conceptual framework for the economic analysis of factors influencing decision-making of small-scale farmers in animal health management.

The delivery of veterinary services in most of sub-Saharan Africa has undergone substantial changes, with the private sector gaining increasing recognition as an alternative to state provision. Given this policy shift, the authors argue that a better understanding of the behaviour and decision-making processes of small-scale farmers in animal health management is urgently required, to guide policy decisions regarding the delivery of animal health services. Whether the involvement of the private sector will improve overall efficiency in the delivery of veterinary services will depend greatly on the demand response of livestock producers who must make decisions about the health of livestock. The authors briefly review the decision-making process in small-scale farming systems, the economic nature of animal diseases and disease control and the models that have been used to guide resource allocation for disease control. To gain an improved understanding of the behaviour and decision-making processes of small-scale farmers, the authors propose a conceptual model including variables that relate to characteristics specific to small-scale farmers and farms, economic factors, institutional setting and biophysical factors. Two possible approaches are proposed for the economic analysis. Agricultural household modelling allows the derivation and testing of hypotheses regarding the demand elasticities for veterinary services, while qualitative choice models are better suited to the analysis of determinants behind the choices of farmers. The authors conclude that an urgent need exists for empirical research in this area.

The new institutional economics of privatising veterinary services in Africa.

The authors review a number of critical issues in the structural reform of animal health services for both small and non-commercial livestock producers in Africa and highlight several problems that others concerned with the privatisation of this service area have tended to neglect. Most notably, attention is called to the following: a) the need to retain a central role for paraprofessionals in the new delivery system b) the important and problematic relationship between the veterinary and paraveterinary professions c) the importance of developing state contracting procedures for assisting the private delivery of animal health services that will avoid the problems of local monopoly d) the central role that professionalism will have to play in this area, if collective goods and the public interest are to be served.

Perceived constraints to privatization of delivery of veterinary services in Ghana.

Ghana is on the verge of privatizing selected activities in the delivery of animal health services. However, various constraints are being encountered. The aim of this paper is to identify these constraints so as to help find and solutions to them. Questionnaires were administered to veterinarians in Ghana to elicit their responses on various issues concerning privatization. A significant proportion (61%) of government veterinarians, who formed 94% of the respondents, were unwilling to go into private practice. Among the reasons given were that private practice was too risky, that farmers were unwilling or unable to pay for services, that capital to start practices was lacking and that the societal value for animals was low. Also, low livestock densities in many areas and the absence of commercial livestock farming were perceived as deterrents to the sustainability of private practice. Furthermore, the poor macroeconomic environment of high inflation, high interest rates and unstable currency discouraged investment. If privatization of veterinary services is to succeed in Ghana, these perceptions have to be addressed and solutions found, since veterinarians are the targets of the privatization process.

Financing the delivery of public-sector animal health services in Jamaica: pre- and post-privatization.

Lack of adequate financing was a major reason for the privatization of veterinary services in Jamaica in 1992. The belief was that, with privatization, funding of animal health services delivery would improve, since staff numbers and clinical activities undertaken by the Veterinary Division were reduced. However, analyses of data revealed that, in most cases, privatization neither improved nor stemmed the declines, that had started before privatization, in the measures or indicators used. It was concluded that privatization of veterinary services did not result in any appreciable improvement in the financing of the delivery of public-sector animal health services in Jamaica in the short term.

Systems approach to animal health services delivery in sub-Saharan Africa : the case of privatisation

The theory of privatisation is first reviewed with respect to animal health care in sub-Saharan Africa. Then, using the systems approach advocated in an accompanying paper, the authors argue that the nature of animal production systems obtaining in any economy is of central importance in determining the type and mixture of animal health services delivery systems present. These are influenced, in turn, by the demand placed on the production system by consumers, the levels of consumer income and the policies enacted by governments. The authors compare the situation in sub-Saharan Africa with that in developed countries, especially the United States of America. Theory would predict that privatisation of veterinary services in sub-Saharan Africa will be evolutionary rather than revolutionary, even with deliberate policies to encourage privatisation. In regard to personnel, private services would be much easier to develop on the basis of auxiliaries and technicians, rather than self-employed veterinarians and their associates. Hasty or wholesale privatisation, involving the creation of a cadre of self-employed veterinarians will, in the face of market failure, result in a reduction in the services available to low input/low output production systems. The general level of animal health care provided to certain types of producers will thus be lower than currently available. These theoretical predictions are borne out in practice.

Systems approach to animal health services delivery in sub-Saharan Africa: concept development.

The current trend towards restructuring to improve the standards and efficiency of public services in sub-Saharan Africa, within the framework of economic structural adjustment programmes, has stimulated debates and proposals regarding veterinary services in the region. Such debates sometimes neglect the fact that a number of different animal production systems may coexist within a single economy. The authors review the concept of veterinary services delivery systems and examine this concept in the context of animal production systems, concluding that different delivery systems may be required to cater for different production systems. Planners and policy makers are urged to ensure that advocated changes are compatible with the existing animal production systems. This systems approach may be applied in considering various aspects of veterinary services, including animal health care delivery, animal health education and training, research, outreach work and financing.