CHAPTER 5Technical standards for veterinary support

Veterinary support

Introduction

This chapter discusses the importance of veterinary support in emergency response. It presents the options for veterinary interventions and introduces tools to determine their appropriateness. The Standards, Key actions, and Guidance notes follow each option. Case studies are found at the end of the chapter. They are followed by appendices containing checklists for assessment and monitoring and evaluation. Key references are listed at the end.

Links to the LEGS livelihoods objectives

Providing veterinary support in an emergency helps achieve two LEGS livelihoods objectives:

to protect the key livestock assets of crisis-affected communities
to rebuild key livestock assets among crisis-affected communities.

The importance of veterinary support in emergency response

Emergencies can increase disease risk and animal vulnerability. Different kinds of emergency impact on animal health. For example:

Droughts, floods, and harsh winters reduce access to grazing, resulting in weaker animals with lower disease resistance.
Flooding displaces topsoil, creating favourable conditions for anthrax.
Disasters such as earthquakes can injure animals.
The risk of disease transmission increases when livestock are brought together from different areas.
Where people and livestock are displaced, animals are moved to places with diseases to which they may not be immune.
Risk of zoonotic disease transmission between animals and people increases in crowded camp conditions.

Veterinary support can protect and strengthen animals, thus protecting livestock assets. Through improved animal health, the supply of livestock products can be maintained during emergencies. In general, veterinary vaccines and medicines are inexpensive items relative to the value of livestock. Veterinary care, such as vaccination or early diagnosis and treatment, can help to prevent sudden, large-scale livestock losses resulting from infectious diseases that cause high mortality. LEGS does not cover the prevention and control of major, internationally recognized epidemic livestock diseases because specific guidelines are available from the World Organisation for Animal Health (OIE) and the Food and Agriculture Organization of the United Nations (FAO), as indicated in the Introduction.

Besides controlling epidemics, veterinary care can limit the impact of chronic diseases. This care can increase benefits derived from animals, whether from milk production, fertility, or use as pack animals. Where high livestock mortality has occurred, it can take years for communities to recover. Veterinary care can help rebuild valuable livestock assets, whether these consist of pastoralists’ herds, a single donkey, a pair of draught oxen, or just a few chickens.

As part of emergency response, veterinary support also contributes to one of the animal welfare ‘five freedoms’ described in the Introduction; namely, freedom from pain, injury, or disease. It does this in several ways, including:

preventing disease, for example, by vaccination
enabling rapid diagnosis and treatment
improving herd health by treatment for parasites or by providing vitamins and minerals to malnourished animals
enabling rapid response to disease as a consequence of enhanced surveillance and disease reporting.

➡ Options for veterinary support

The options for veterinary support in emergency response presented in this chapter are divided into two areas: clinical veterinary services and public sector veterinary functions. The options for veterinary support are not exclusive: more than one option or sub-option may be selected and implemented. Their selection depends on local conditions and follows on from appropriate assessment and planning (see Veterinary support standard 1).

Option 1: Clinical veterinary services

Clinical veterinary services, comprising treatments and vaccinations, are usually the priority during an emergency. Support to clinical work can be extended to beneficiaries either through the government or through a private veterinary system, with or without veterinary paraprofessional workers such as community- based animal health workers (CAHWs). In many developing countries, clinical veterinary services are in transition from public to private sector delivery. The growing private veterinary sector may therefore be the main source of quality veterinary care. However, most veterinary professionals are likely to be based in major urban centres or near the most developed farms. In remote areas, veterinary paraprofessionals may be the main service providers.

Community-based animal health-care (CBAH) approaches are often very appropriate during the response to emergencies. CAHWs can have important roles in both clinical and public sector veterinary support. Particularly in protracted crises, studies show that CBAH systems have resulted in reduced livestock mortality and improved service accessibility, availability, affordability, and acceptance. When designed using participatory approaches, and when they include both male and female veterinary paraprofessionals, these systems respond well to livestock keepers’ priority animal health problems. In some countries, however, CAHWs have no legal basis to work, and other animal health service delivery mechanisms are more appropriate.

In humanitarian crises, preventive and curative clinical veterinary interventions fall into two broad categories that can be implemented simultaneously through stationary or mobile services. These are:

1.1
examination and treatment of individual animals or herds
1.2
mass vaccination or medication programmes.

1.1 Examination and treatment of individual animals or herds. This option allows for animals or herds to receive treatment specific to the diseases present at the time of the treatment. The option assumes that animals in different households or herds may have different diseases, and therefore allows for flexibility in the clinical care provided. In some countries, this approach is increasingly supported by veterinary voucher systems that are developed jointly by community, private sector, and government partners (see Case studies 5.1 and 5.2 at the end of this chapter). Similarly, responses that provide cash, directly or indirectly, to households can enable people to pay for veterinary care from private workers. In addition to providing case-by-case clinical care, these approaches aim to avoid situations in which the free provision of medicines undermines existing private veterinary services.

1.2 Mass vaccination or medication programmes. These programmes are widely used with the aim of preventing diseases in livestock populations during emergencies. Most commonly, emergency mass medication or vaccination programmes are one-off events and are implemented at no cost to livestock keepers. Care must be taken to ensure that the financial viability of existing veterinary services is not undermined.

Mass medication programmes often use anti-parasite medicines, especially for worms and ectoparasite infestations such as ticks or lice. Practitioners and beneficiaries of these widely used programmes have reported positive impacts. However, because some systematic reviews have indicated limited impact or cost-effectiveness (see Case study 5.4 on mass deworming during drought), LEGS does not yet include a standard on mass medication. Should agencies choose the mass medication option, LEGS recommends proper evaluation (see Core standard 6: Monitoring, evaluation, and livelihoods impact) to better document the impacts of mass medication and understand when and how it should be used. It is recognized that a particular challenge with evaluating mass deworming programmes is that some impacts may only be observed after the emergency, so this is something that needs to be factored into the timing and design of evaluations.
Mass vaccination programmes usually cover infectious diseases such as anthrax, clostridial diseases, forms of pasteurellosis, and Newcastle disease. Although widely used, evidence of the livelihoods impact of mass vaccination during rapid-onset and slow-onset emergencies is very limited (see Case study 5.3). Therefore, LEGS does not include a standard on mass vaccination. If agencies choose to support mass vaccination, LEGS recommends proper evaluation (see Core standard 6: Monitoring, evaluation, and livelihoods impact).

Option 2: Public sector veterinary functions

Support to public sector veterinary functions is most applicable during protracted emergencies or the recovery phase of either rapid- or slow-onset emergencies. Support may supplement weakened government capacity, or intervene where no officially recognized government authority is present. It includes two key areas:

2.1
veterinary public health
2.2
livestock disease surveillance systems.

2.1 Veterinary public health. Veterinary public health, defined by the World Health Organization (WHO), FAO, and OIE as ‘the contributions to the physical, mental and social well-being of humans through an understanding and application of veterinary science’, relates to the understanding, prevention, and control of zoonotic diseases as well as to food safety issues. It plays an important role in the protection of consumers against zoonotic diseases, particularly those that can be transmitted through food products like meat and milk. Veterinary public health involves not only veterinary surgeons in the public and private sectors but also other health and agriculture professionals, communication specialists, and paraprofessionals.

Zoonotic diseases are transmissible to humans either through animal- derived food, such as meat or milk, or by contact with animals. Control of these diseases is a key public sector function. Zoonotic diseases include anthrax, salmonellosis, tuberculosis, brucellosis, rabies, mange, Rift Valley fever, and highly pathogenic avian influenza (‘bird flu’). Specific guidelines for prevention and control of these diseases are available from FAO and OIE (including animal welfare considerations), as mentioned in the Introduction.

Veterinary public health also includes the food safety of animal-derived foods like meat or milk. A specific concern is that some veterinary medicines leave residues in food, leading to possible consumption of these residues by people. In the context of humanitarian crises, the trade-offs between human food security and human food safety are not well understood. However, emergencies can occur in areas characterized by severe food insecurity where there are high levels of child malnutrition. In some cases, malnutrition levels exceed WHO cut- off for emergencies even in normal periods. For people in this situation, the risk of continuing or worsening food insecurity seems far to outweigh the risk of ill health due to the consumption of meat or milk that is contaminated with drug residues.¹

2.2 Livestock disease surveillance systems. These systems are concerned with searching, reporting, and mapping diseases. CAHWs may have a valuable role in reporting suspicious cases and outbreaks. In some regions, such as parts of the Horn of Africa, international trade in livestock or livestock products is very important to livestock keeper livelihoods. Trade is affected by international animal health standards, disease information, and the risk of exporting/importing livestock diseases. Government surveillance systems are one major source of information. All disease surveillance activities in emergencies therefore need to be designed in collaboration with government authorities, where these are able to function.

Examples of disease surveillance and investigation activities during humanitarian crises include:

raising public awareness in order to stimulate disease reporting
training veterinary paraprofessional workers to report disease outbreaks
supporting government surveillance systems by linking veterinary paraprofessional workers’ disease-reporting systems to official structures
facilitating timely disease outbreak investigation and response
providing regular feedback in the form of disease surveillance summaries to the workers who report.

The advantages and disadvantages of the veterinary support options and sub-options are summarized in Table 5.1.

Table 5.1

Advantages and disadvantages of veterinary support intervention options

➡ Option 1: Clinical veterinary services

Sub-option

Advantages

Disadvantages

1.1 Examination & treatment of individual animals/herds

Allows flexibility and veterinary care on a case-by-case basis
Can support existing private sector service providers, e.g. through voucher schemes
Wide coverage is possible, particularly when well-trained and supervised veterinary paraprofessional workers are used
Allows targeted or strategic prophylactic treatment or vaccination of individual animals or herds at risk
Some quantitative evidence of impact on animal mortality is available

If provided free, coverage and duration of service likely to be limited by the budget
If provided free, risks undermining existing private sector service providers
Quality of locally available medicines may be poor

1.2 Mass medication or vaccination programmes

Relatively easy to design and implement
Mass deworming does not require a cold chain
Cost per animal can be low
If done effectively, mass medication has the potential to enhance livestock survival and production
Mass medication has the potential to provide income for the veterinary sector; for example, through voucher schemes

There are weak laboratory facilities in many areas for confirming disease diagnosis before targeting specific diseases
Large-scale vaccination programmes difficult to design properly without basic epidemiological information
Coverage is often determined by budget rather than technical design criteria
Free treatment and vaccination can undermine the private sector.
For many vaccines, need to establish or support cold chains
Risk of poor immune response to vaccination in animals already weakened, e.g. due to lack of feed
Quality of locally available medicines may be poor

➡ Option 2: Support to public sector veterinary functions

Sub-option

Advantages

Disadvantages

2.1 Veterinary public health

Public awareness-raising is often inexpensive
Can foster collaboration between veterinary and human health sectors

May require specialized communication expertise to design and test educational materials in local languages
If not carefully managed and timed, can divert resources away from more direct livelihoods-based assistance

2.2 Livestock disease surveillance systems

Can complement all other veterinary interventions and assist impact assessment of these interventions
Fosters linkages between central veterinary authority and affected area
Can help to promote international livestock trade in some countries and regions

Needs to be based on clearly defined surveillance objectives
Can easily become a data-driven rather than an action-oriented process
If not carefully managed and timed, can divert resources away from more direct livelihoods-based assistance

Timing of interventions

Support to clinical veterinary services can be appropriate in both emergency and non-emergency situations. Support to public sector veterinary functions, however, may be most appropriate during the recovery phase, when immediate threats to livestock mortality and morbidity have passed (Table 5.2).

Links to other chapters

Veterinary support should be integrated with other livelihoods-based livestock interventions. Veterinary care alone does not guarantee livestock survival or productivity in emergency situations. Livestock require feed and water (Chapters 6, Ensuring feed supplies, and 7, Provision of water) and, in some areas, housing (Chapter 8, Livestock shelter and settlement).

Clinical veterinary services and community-based animal health-care systems complement destocking (Chapter 4, Destocking) by helping to ensure the survival of the remaining stock. Veterinary public health inputs, such as pre- slaughter and post-mortem examinations, are important for slaughter destocking. Additional veterinary support is required during restocking (Chapter 9, Provision of livestock) to examine livestock before purchase and provide clinical services after livestock distribution.

Cross-cutting themes and other issues to consider

Gender and social equity

In emergencies, women are more vulnerable to food insecurity and other threats. Equitable and effective primary veterinary service delivery requires an understanding of the gender issues involved in livestock ownership and use. It is important that emergency interventions are based on understanding gender roles and responsibilities and the implications of planned activities. Women (and girls) may be responsible for small and/or young stock, including disease identification and treatment. Women should be involved in animal health interventions. Issues to consider include the following:

In many societies, livestock care and management tasks are divided along gender lines. Men and women may have very different roles.
In normal, non-emergency times, women tend to be overlooked by veterinary staff and by merchants who sell animal health products. Livestock extension workers and training programmes may target men. Training has lower impact when men are trained to perform women’s tasks.
In an emergency, animal health officials may prioritize protection of large species such as cattle. Women’s animals may be ignored.
It is important to identify sub-groups and consider their animals’ main health problems. Vulnerable groups, such as female-headed households, may exist. Some groups may own specific types of livestock – for example, poultry, small ruminants, or donkeys.
Women may use donkeys more than men, for example, to carry wood or water. Animal health professionals may be neither knowledgeable about nor interested in treating working equines.
Women sometimes become responsible for all types of livestock in an emergency.

For these reasons, it is necessary to make sure that information and animal health interventions reach women and specific vulnerable groups. Women may have significant ethno-veterinary knowledge that should be taken into account in planning. Where possible and appropriate, women should be involved through specific targeting of activities and by recruiting women CAHWs.

People living with HIV and AIDS (PLHIV)

Due to their reduced immunity, it is especially important to prevent zoonotic diseases affecting PLHIV. The risk of zoonoses increases where animal and human populations live near each other. These conditions may exist in urban/ peri-urban environments and in camps with displaced people and animals. Veterinary support interventions can reduce the vulnerability of PLHIV. In addition, livestock-derived food products, such as eggs, meat, and milk, can provide significant nutrition to PLHIV. Thus, increasing livestock productivity through animal health interventions can have positive impacts.

To reduce the risks, proper handling and preparation of food is required. Veterinary public health needs to integrate veterinary interventions with human health information/services. The Sphere Handbook contains minimum standards on hygiene and human health services. These should be considered together with veterinary response plans.

Protection

CAHWs carrying cash and/or high-value medicines may invite robbery or attack. Insecurity can also have animal health implications. Animals stolen from a neighbouring group or area can introduce disease into the herd. In camps, the risk of livestock assets and associated goods being stolen is high.

Environment and climate

Vulnerable livestock keepers are susceptible to emergencies caused by extreme weather events, such as drought, severe winter, cyclones, and floods. Certain weather events are associated with increased disease. Parasitic worms may become more problematic in moist, warm conditions. Insect-borne virus diseases, such as Rift Valley fever, may follow protracted rainfall that creates favourable conditions for the mosquito vectors. Protracted droughts or winters can lead to reduced grazing, resulting in poor body condition and increased susceptibility to infectious diseases and parasites. Thus, in climate-associated crises, veterinary interventions may become a relevant addition to responses that include, for example, providing feed.

Initiatives that help to protect livestock assets, such as providing feed, water, or veterinary support, reduce mortality and may help to sustain livestock populations that natural grazing resources cannot support. The potential impact on the environment needs to be considered, particularly in an emergency that severely impacts natural resources, such as drought. However, despite common misconceptions, veterinary support is unlikely to increase herd size to the extent that unsustainably large populations of livestock are maintained. Rather, it can help to maintain a sustainable population of healthier, more productive animals.

Local capacities

Interventions that provide support to clinical veterinary services are usually community-based approaches. These approaches must recognize local people’s significant capacities for primary animal health care. Livestock keepers can make important intellectual contributions to service design, assessment, and delivery. They often possess detailed indigenous knowledge about animal health problems, including disease signs, modes of disease transmission, and ways of preventing or controlling diseases. This knowledge is particularly well documented for pastoralist and agro-pastoralist communities. Training and supporting local people to become CAHWs can and should build on this knowledge. CBAH systems can also provide an effective way for veterinary support to reach the remotest rural communities and can contribute to veterinary public health and livestock disease surveillance systems.

Access

In remote areas with poor infrastructure and communications, veterinary service delivery is a challenge even in normal times. In camp-like settings, displaced livestock keepers may be beyond the reach of regular veterinary services, and access to communities may only be achieved on foot or by boat. The more remote communities tend to be more vulnerable during an emergency. In these situations, veterinary paraprofessionals are usually the most appropriate service providers because they are able to travel and function in these environments.

Although CAHWs are included as veterinary paraprofessionals in OIE international standards, they are sometimes resisted by the veterinary establishment. They may not be legally recognized owing to misconceptions about their capacity. They may also be perceived as a threat to monopolies of professional service provision (see Core standard 7: Policy and advocacy). Yet the potential for well-trained and supervised CAHWs should always be considered during emergencies as a form of accessible and affordable veterinary service provision.

Affordability and cost recovery

When providing veterinary support to communities, there are different approaches to cost recovery. Three options are discussed in Box 5.1.

Agencies responding to emergencies sometimes provide free veterinary support. This practice can threaten existing services based on cost recovery. It can confuse livestock keepers who receive services for a fee from some providers, then free from others. It can undermine the regular income of veterinary service providers, who find it difficult to charge for services that others provide free. Evidence that the provision of free clinical veterinary care either provides significant livelihood benefits to crisis-affected populations or is cost-effective or equitable is very limited. More evidence of livelihood benefits is available for veterinary paraprofessional systems based on some level of payment for services.

Increasingly, the privatization of veterinary services in developing regions has compounded issues around poorer livestock keepers’ willingness and ability to pay for care. Evidence shows that poor people do make use of private clinical services based on simple, low-cost, community-based approaches.

During emergencies, veterinary service affordability is a challenge for agencies that seek to provide rapid, equitable, and effective clinical veterinary care while supporting local private service providers who require an income. Cash transfers may be an appropriate tool to implement a veterinary support intervention during emergency response.

Box 5.1

Clinical veterinary service delivery in emergencies: Three options for cost recovery

1
Services delivered free of charge. Coverage usually depends on funding by external agencies. In many cases, only a small proportion of the disaster-affected population will be reached. If clinical services are delivered by aid agency staff, the likelihood of undermining local services, markets, and longer-term development processes is strong. Without supervision, there may be a risk that services will not be provided free at the point of delivery.
2
Existing or newly trained veterinary paraprofessional workers. Usually these workers are paid by their community at rates lower than for professional services. This approach helps to strengthen local capacity and support systems that can be improved over time and as the emergency wanes. It also improves accessibility and availability. On the other hand, the issue of affordability becomes important.
3
Gradual introduction of payment for services. In this option, services are provided free during the acute stage of an emergency, and payment is requested for services in later stages as livestock markets begin to function. The risks of this option are similar to those of the first approach. It may be difficult to persuade people that they need to pay if the service was previously provided free.

Use of cash transfers

During crises, veterinary professionals and paraprofessionals can be subcontracted to deliver veterinary support, and mechanisms such as voucher schemes can be used to provide their services. See Chapter 3, Initial assessment and identifying responses, for a summary of cash and voucher approaches in emergency response. Cash transfer approaches can help reach poorer and more vulnerable livestock users. They can also help to maintain private services during emergencies.

Cash and vouchers can be provided specifically for clinical veterinary services. Some public sector veterinary functions can be subsidized as a form of indirect grant. See Case studies 5.1 and 5.2 at the end of this chapter, and Case study 9.8 in Chapter 9, Provision of livestock.

Camps

Camps with displaced people and their animals create ideal conditions for the spread of disease. The risk of transmission is high where different herds and age groups mix around water troughs. Specific measures to reduce animal disease risk in camps should be taken into consideration. One way to do this is to establish quarantine areas where new arrivals are segregated from other animals for a period appropriate for the diseases of concern. Another is to provide water troughs at watering points to help reduce disease spread between animals.

In camp settings, veterinary public health activities may be particularly appropriate. Livestock keepers, for example, can be trained to recognize disease symptoms and to know to whom they should report these. They can also be trained to apply good practices to prevent disease.

The Standards

Before engaging in veterinary support, the affected populations’ needs and the existing service providers’ availability and capacity should be carefully considered, as highlighted in the decision-making tree (Figure 5.1).

Veterinary support standard 1: Assessment and planning

The crisis-affected population, including vulnerable groups, actively participates in veterinary needs assessment and prioritization.

Key actions

With the involvement of all relevant subgroups within the crisis-affected population and in partnership with local veterinary authorities and service providers, conduct rapid participatory veterinary needs assessment and prioritization (see Guidance note 1).
Within the affected area (or, for displaced communities, ‘host community area’), map and analyse all existing veterinary service providers in terms of current and potential capacity if assisted by aid agencies (see Guidance note 2).
Ensure the assessment includes analysis of service providers before the emergency with regard to payment for services (see Guidance note 2).
Ensure the assessment includes a rapid analysis of policy or legal factors that may hinder or enable specific implementation strategies (see Guidance note 3).

Guidance notes

Rapid participatory assessment should:
- be conducted using experienced veterinary workers trained in participatory inquiry
- include specific attention to the priorities of vulnerable groups
- involve consultation with local government and private sector veterinary personnel
- aim to identify and prioritize livestock health and welfare problems warranting immediate attention according to livestock type and vulnerable group
- be cross-checked against secondary data when these are available and of adequate quality.²
A checklist and methods for assessment are given in Appendix 5.1 (see also Appendix 3.2: Participatory methods in Chapter 3, Initial assessment and identifying responses). Formal livestock disease surveys involving questionnaires and laboratory diagnosis are rarely feasible in emergency contexts. The modest added value of the disease information obtained is rarely justified in relation to the additional time and cost required and the need for rapid action. During protracted crises, more systematic livestock disease surveys or studies may be necessary to refine disease control strategies. In these cases, participatory epidemiological approaches should be applied as well (Catley, 2005).
Mapping and analysis of veterinary service providers. A map of existing service providers (veterinary surgeons and all types of veterinary paraprofessional workers), their activities, and coverage is needed for agencies to define their strategy for service delivery, including planned geographical coverage and access to vulnerable groups. The pricing arrangements of the different service providers should be reviewed as part of this mapping and analysis.

Categories of veterinary paraprofessional workers vary between countries but include:
- veterinary assistants
- animal health auxiliaries/assistants
- animal health technicians
- CAHWs, as defined in national and international veterinary legislation and codes
- informal veterinary service providers, including traditional healers and local pharmacists.
In some (usually conflict-based) emergencies, it is possible that neither the government nor the private sector can provide adequate veterinary services. In such cases, it may be appropriate for external agencies to support a community-based service through training of CAHWs and/or livestock keepers. This should be based on plans for building government and/or private sector capacity as this becomes feasible as part of a clear exit strategy.
Policy and legal factors. The assessment should include a rapid review of government and agency policies, rules, and procedures that relate to implementation options. For example:
- In some countries, certain types of veterinary paraprofessional workers are not legally recognized or else are restricted to a limited range of veterinary activities.
- Some countries may have livestock disease control policies that need to be followed; if these are not followed, alternative control methods need to be justified.
- There may also be restrictions on using certain types of veterinary products, as defined by national drug registration bodies.
- The purchase of veterinary drugs is sometimes hindered by bureaucratic requirements from some donors that prevent rapid and appropriate procurement in emergency contexts.
- Organizational/donor policy may hinder cost-recovery plans.
Understanding the policy context is vital both for recognizing potential constraints and, as appropriate, laying the foundation for associated advocacy or policy action (see Chapter 2, Core standards common to all livestock interventions, Core standard 7: Policy and advocacy).

Clinical veterinary services standard 1: Service design

Veterinary support is designed appropriately for the local social, technical, security, and policy context with the active participation of crisis-affected communities.

Key actions

Ensure the service design process uses the information and analyses of the initial assessment, and is based on the active participation of the crisis- affected population, including vulnerable groups (see Guidance note 1).
Check that the service design includes specific elements to reach vulnerable groups and, in particular, addresses challenges of accessibility and affordability (see Guidance note 2).
Ensure that the service design considers disease outbreak early warning indicators linked to extreme weather events, where early warning systems are available (see Guidance note 3).
Ensure that the service design considers the need for rapid procurement and availability of relevant veterinary vaccines and medicines, as well as the need for appropriate quality of products and proper storage at field level (see Guidance note 4).
Check that the service design includes plans for rapid training of local service providers as necessary (see Guidance note 5).
Ensure that the service design is based on local social and cultural norms, particularly in relation to gender roles (see Guidance note 6).
Ensure that the service design maximizes the security of local people, veterinary service providers, and aid agency staff (see Guidance note 7).
Ensure that the service design incorporates payment for services, where possible (see Guidance note 8).
Ensure that the service design builds in professional supervision of veterinary paraprofessional workers (see Guidance note 9).

Guidance notes

Design based on assessment findings. Service design should aim to address the prioritized livestock health problems identified during the initial assessment. It is rarely feasible or appropriate for a primary-level veterinary service to address all livestock health problems. In most cases, a limited range of vaccines and medicines can prevent or treat the most important diseases in a given area.

The focus of the service on prioritized livestock diseases needs to be understood and agreed by all actors, including livestock keepers. Where the priority cannot be addressed (for instance, when necessary technical support such as a cold chain is unavailable), this should be agreed with all stakeholders, including the beneficiary communities. Similarly, the appropriate timing for interventions (particularly vaccination) should be discussed and agreed with all stakeholders. The affected population should be as actively involved in the design of the service as is possible.
Reaching vulnerable groups. Service design should consider the types of livestock that vulnerable groups own or use, and should address the health problems of these types of livestock. Special attention should be given to accessibility and affordability issues in order to promote equitable access. Access to remote areas with limited infrastructure may require expensive means of transport (by air, for example), which limits coverage. Alternatively, access can be achieved by using locally based veterinary paraprofessional workers, who can travel on foot, mules, bicycles, boats, or other local means of transport. In some cases, programmes may need to provide or support local modes of transport for veterinary workers.

In rapid-onset emergencies, transport might be provided free of charge, whereas in more protracted crises, cost-share arrangements are often feasible. The payment-for-services strategy needs to take account of the need for rapid and equitable delivery while also supporting private sector veterinary workers where possible. For more vulnerable groups, private veterinary workers can be subcontracted by agencies to deliver a service for a specified short period of time. Voucher schemes may be used (see Case studies 5.1 and 5.2). In areas where the private veterinary sector is active or where the government charges for clinical veterinary care, normal pricing policies should be followed, with possible exemptions for targeted vulnerable groups. To avoid confusion, community participation and the agreement of community representatives on these issues will be needed, as well as clear communication with all stakeholders.
Preparedness for weather-related disease outbreaks. Many livestock diseases are associated with variations in climate, especially with the onset of rains or with heavier than usual rainfall. For example, Rift Valley fever in East Africa has been linked to high rainfall and flooding caused by El Niño events. Emergency veterinary support interventions should take account of the developing knowledge of linkages between weather events and animal disease outbreaks in order to increase preparedness (see the section on Links to other standards and guidelines in the Introduction for links to information sources on transboundary diseases).
Rapid procurement and storage. Agencies with limited experience of veterinary drug procurement should seek expert advice. The quality of veterinary drugs and vaccines varies considerably between suppliers, whether sourced locally or internationally. Suppliers vary in their capacity to supply medicines in large volumes with appropriate expiry dates within agreed delivery times. Procurement can be further complicated by the wide range of products available. Because some veterinary vaccines require isolation of local field strains of disease pathogens, the vaccine’s exact composition needs verification. Local importers, often located in capital cities, can supply readily available drugs in reasonable quantities. However, the quality, expiry dates, and drug storage conditions should be checked. At field level, many veterinary vaccines and some drugs require cold storage. They should not be purchased or used unless adequate cold- storage facilities are in place and a cold chain for transporting them can be ensured. Storage in camp-like settings may present particular challenges because of the lack of cold-chain maintenance and storage. Cold-storage facilities for human health services can sometimes be shared. However, human health professionals are sometimes unwilling to store veterinary products in human health cold chains. High-level agreement needs to be reached beforehand in order to take full advantage of expensive cold-chain facilities.
Training plans. Where some veterinary workers are already present and rapid delivery of services is required, training should be limited to short refresher courses. These should focus on 1) clinical diagnosis of the prioritized diseases, and 2) correct use of veterinary vaccines or drugs. Depending on the existing capacity of local personnel, this refresher training is not always needed. Where veterinary paraprofessional workers such as CAHWs need to be selected and trained from scratch, guidelines are available for CAHW systems in development rather than emergency programmes (see References and Catley et al., 2002). To enable rapid response in emergency situations, it may be necessary to streamline some best-practice principles relating to CAHW selection and training. However, as emergencies become protracted or come to an end, further training is recommended to enhance CAHW knowledge and skills. In some countries, national technical intervention standards and guidelines for CAHW systems are available, as well as training manuals for short, practical, participatory CAHW training courses.
Social and cultural norms. The design of veterinary support needs to take into account local social and cultural norms, particularly those relating to the roles of men and women as service providers. In some communities, it is difficult for women to move freely or travel alone to more remote areas where livestock might be present. However, even in very conservative cultures, it is often possible for women to be selected and trained by women as CAHWs in order to provide a service for women. Women livestock keepers are among the most vulnerable groups.
Protection. Where livestock are very important to local economies and livelihoods, veterinary drugs are highly prized. These small-volume, high- value items are easy to steal and resell. Service design should consider the risk to veterinary personnel of violence, abduction, or theft. Livestock are often grazed away from more secure settlements. Sometimes they are moved long distances to grazing areas and water points. Veterinary workers travelling to such areas may be at risk, especially in conflict situations. Local veterinary paraprofessional workers may be appropriate in these situations because they know the area and may be familiar enough with armed groups or security forces to be able to negotiate access.
Payment for service. Based on documented evidence, service design should, where possible, incorporate payment for services. Voucher schemes should be used for the most vulnerable livestock keepers. For others, full payment for services should be rapidly resumed. Governments may consider all vaccination as a ‘public good’ rather than a ‘private good’.3 However, prevention of diseases not easily transmitted between animals, such as clostridial diseases, may be considered as a private good. Theoretically, the private sector is best equipped to deliver private goods.
Professional supervision of veterinary paraprofessional workers. Even where paraprofessionals such as CAHWs are working in remote areas, they should be under the overall supervision of a veterinary professional. Professional supervision enables monitoring of the correct use of veterinary products, disease reporting from the field up the chain to the authorities, and integration of CAHWs in existing private or state veterinary services.

Clinical veterinary services standard 2: Examination and treatment

Examination and treatment are conducted appropriately with the active participation of the affected communities.

Key actions

Clearly document the roles and responsibilities of all actors. Where appropriate and necessary, make written agreements (see Guidance note 1).
Euthanize incurable sick or injured animals humanely and safely (see Guidance note 2).

Guidance notes

Roles and responsibilities. During emergency clinical veterinary service provision, problems may occur due to lack of stakeholder coordination. For example, problems can arise from a misunderstanding of the roles and responsibilities of different actors, from false expectations about the service’s aims and coverage, or from confusion over pricing arrangements or beneficiary selection. Many of these problems can be avoided through stakeholder consultation, a commitment to community participation, and, where possible, close collaboration with local authorities and private sector actors. Roles and responsibilities should be documented in memoranda of understanding or similar agreements. These can provide useful points of reference in subsequent disputes.
Euthanasia. Animal euthanasia should follow humane standards and practices. Depending on the sickness/injury and method of slaughter, some livestock carcasses may be fit for human consumption (see Veterinary public health standard 2: Sanitation and food hygiene).

Veterinary public health standard 1: Zoonotic diseases

Men and women have access to information and services designed to prevent and control zoonotic diseases.

Key actions

Include an assessment of zoonotic diseases and their prioritization in the initial assessment of animal health problems (see Guidance note 1).
Design and implement zoonotic disease control measures either in conjunction with the provision of clinical services or as a stand-alone activity (see Guidance note 2).

Guidance notes

Assessment. The rapid participatory assessment conducted under Clinical veterinary services standard 1: Service design should include a rapid assessment of zoonotic diseases in terms of actual cases or risk. During emergencies, zoonotic disease risk may be substantially increased. Causative factors include 1) anthrax associated with abnormal movement of livestock to grazing areas that are normally avoided; 2) rabies associated with local populations of wild or domestic predators, possibly attracted to carcasses or garbage; 3) zoonotic disease associated with close contact between animals and people; 4) unhygienic conditions arising from the crowding of people and animals in camps; and 5) water supply breakdown.
Zoonotic disease control. The disease control method varies according to the zoonotic diseases in question. For some diseases, veterinary paraprofessional workers may provide information to livestock keepers verbally or by using leaflets. Such workers might also assist with organizing vaccination campaigns, for example against rabies, or with the humane control of stray dog populations. Outreach to women can be particularly important because they can play a significant role in livestock health management but are often overlooked in disease control measures. Where private workers are used on a short-term basis, payment for their services by an aid agency is usually required. Zoonotic disease control efforts should be harmonized between agencies and between areas as part of the coordination effort. Collaboration with human health agencies and programmes helps harmonize approaches and enables the sharing of resources such as cold-storage facilities (see Clinical veterinary services standard 1: Service design, Guidance note 4).

Veterinary public health standard 2: Sanitation and food hygiene

Sanitary and food hygiene measures relating to the consumption of livestock products and the disposal of livestock are established.

Key actions

Construct slaughter slabs during protracted crises (see Guidance note 1).
Establish meat inspection procedures at slaughter slabs and abattoirs used by the affected population (see Guidance note 1).
Publicize good food-handling practices (see Guidance note 2).

Guidance notes

Slaughter facilities and meat inspection. In camp-like settings or in situations in which slaughter facilities have been damaged, it may be appropriate to construct slaughter slabs to encourage humane slaughter as well as hygienic handling and inspection by trained workers. Similarly, if emergency destocking is conducted, animal welfare, health, and hygiene standards will need to be met, and either fixed or mobile slaughter slabs may need to be constructed (see Chapter 4, Destocking). In all these cases, consultation with local livestock workers or butchers will help to determine the correct locations for slaughter slabs and their design. Meat inspection procedures are generally well known. Safe disposal of offal from slaughtered livestock should be ensured.
Public awareness. Based on the findings of the assessment, public education campaigns should be conducted as appropriate to raise awareness of best practices in safe food handling and preparation. For example, advice can be given to control tuberculosis or brucellosis through improved hygiene when handling either animals or meat, or when preparing food, and by encouraging consumption of boiled milk.

Veterinary public health standard 3: Disposal of dead animals

Dead animal disposal is organized hygienically according to need.

Key actions

Assess the needs for disposal (see Guidance note 1).
Dispose of carcasses to ensure good hygiene (see Guidance note 2).

Guidance notes

Needs assessment. When disasters such as fire or earthquakes occur, many animals may be injured and euthanasia required. Slow-onset emergencies such as drought and severe winter may cause large numbers of animal deaths, as may widespread floods or cyclones. The question then arises: do they require hygienic disposal? Animal carcasses may spread disease, are unsightly, produce noxious odours, and attract predators and scavengers such as packs of dogs, hyenas or jackals, and crows and vultures. On the other hand, in winter emergencies animals die from undernutrition and hypothermia (with diseases like pneumonia in terminal stages) but not from diseases that remain in carcasses and pose risks to human and animal health. Also, disposal by burial may contaminate water sources and thus change a potential land fertilizer into a pollutant. A key consideration may be the psychological effect on livestock keepers for whom heaps of dead animals are a reminder of their tragic loss. On these grounds alone, it may be justifiable to organize disposal.
Disposal. Environmental and health considerations should be taken into account. Burying animals where water sources may be contaminated should be avoided. Composting can be an effective way to dispose of animal bodies that also produces useful fertilizer. Cash-for-work schemes, in which community members are paid to undertake carcass disposal, have been used effectively (see Case study 5.6 below). See FAO, 2015 for technical details on carcass disposal, including composting.

Livestock disease information systems standard 1: Livestock disease surveillance

During protracted emergencies, a livestock disease surveillance system that covers the crisis-affected population is supported.

Key actions

Include the collection of data on important livestock diseases during routine monitoring of emergency clinical veterinary services (see Guidance note 1).
Conduct livestock disease investigation in response to disease outbreaks to confirm diagnosis, trace the source of disease and where it may have spread, and instigate or modify control measures as necessary (see Guidance note 2).
In protracted crises, and for livestock diseases covered by national disease surveillance policies or eradication strategies, collect information in line with these policies and strategies (see Guidance note 3).
Ensure the coordination body compiles livestock disease data and submits the compiled report to the relevant veterinary authority (see Guidance note 4).

Guidance notes

Routine monitoring. Monitoring veterinary workers’ clinical activities can contribute to a livestock disease surveillance system by recording livestock disease events and treatment or control measures. Such data are most useful if livestock morbidity and mortality by species and disease are recorded in relation to the population at risk. Monitoring tasks should be designed in collaboration with government authorities where possible.
Veterinary investigation. Veterinary programmes and agencies should have capacity to conduct investigations of disease outbreaks. Within a multi-agency programme, this task may be entrusted to a team or individual with specialist training in disease investigation, including post-mortem examination and laboratory diagnosis. In the absence of such assistance, agencies should be prepared to collect relevant samples and submit them to a diagnostic laboratory either in-country or abroad. All activities need to complement government veterinary investigation systems, where these exist, with official reporting of diagnoses by government actors. During protracted crises, agencies should consider establishing a small, local diagnostic laboratory to support the capacity of clinical veterinary workers and disease investigations. Sharing facilities with medical laboratories may be feasible. Standard recording forms with checklist questions should be used by field workers to assist with collecting relevant information for tracing disease source and spread.
Animal disease surveillance. In many countries, specific animal diseases have national or international control or eradication programmes. Standardized surveillance procedures are set by international organizations such as OIE and FAO. Where possible, livestock disease surveillance systems in protracted crises should follow these procedures. If operational constraints prevent standard surveillance procedures from being implemented, liaison with national authorities (if working) and either OIE or FAO can enable surveillance methods to be modified to suit the field conditions.
Reporting. In protracted crises, all agencies should submit regular (usually monthly) surveillance reports to the coordination body for compilation and submission to the relevant government authority. Brief reports that summarize pooled surveillance data from the region should be provided to veterinary workers who submit data from the field.

Veterinary support case studies

5.1 Process case study: Veterinary voucher scheme in Kenya

To overcome common problems associated with free distribution of veterinary drugs by emergency programmes, and also to involve the private sector, the International Committee of the Red Cross (ICRC) piloted a voucher scheme in north-western Kenya. Vouchers were given to selected families, who could exchange them for specific types of treatments provided by private CAHWs and veterinary assistants. The vouchers were valued at 1,000 Kenyan shillings (US$14) and were limited to the use of four types of drug. The CAHWs and veterinary assistants then received payment plus their service charge from a private veterinarian in exchange for the vouchers. In turn, the private veterinarian was reimbursed by ICRC and added his own service charge. The scheme covered 500 households, equivalent to around 3,000 people.

The advantages included the targeting of vulnerable households using a strong community-based process, plus delivery of the service by a relatively efficient and pre-existing private network of veterinary-supervised CAHWs. The CAHWs had received prior training according to the guidelines of the Kenya Veterinary Board.

The disadvantages included a fairly lengthy time investment at the design stage, including the need to set up detailed procedures and formats for administering and monitoring the scheme. Given the potential need to address a variety of health problems in different species of livestock, the range of drugs needs to be expanded beyond four products. In turn, this further complicates the design and administration of the scheme (Source: Mutungi, 2005).

5.2 Process case study: Veterinary voucher schemes in Ethiopia

Several NGOs collaborated with FAO and local government in Ethiopia on the implementation of veterinary voucher schemes during the recovery phase of a drought. The projects were in remote areas where private veterinarians did not operate, so government vets took on a supervisory role and worked with private veterinary pharmacies, CAHWs, and local communities.

The most successful model was supported by the Agency for Cooperation and Research in Development (ACORD), where people who received vouchers were still obliged to pay 30 per cent of the treatment costs provided by the CAHWs. The CAHWs were obliged to buy their initial drug stocks from a private veterinary pharmacy at full cost. Once treatment had been completed, CAHWs received the voucher worth 70 per cent of the cost of the drug and the remaining 30 per cent as cash. They returned the cash as a form of cost recovery to ACORD along with the spent voucher. ACORD then reimbursed the CAHW for the cost of the drug along with a small service payment, based on 20 per cent of the cost of the treatment. Other lessons from the voucher schemes were as follows:

In all the voucher projects, the target population consisted of the poorest and most vulnerable households, often female-headed, as selected by the community.
The value of the vouchers varied from project to project, but those projects that distributed vouchers with a higher value were the most successful. If the voucher value was too small, the beneficiaries complained and the process became overly bureaucratic.
The vouchers were for the treatment of a specified range of common diseases in the areas concerned, not for any disease.

FAO completed an assessment of the programme using key indicators of availability, accessibility, and quality of service as well as intervention impacts on the existing animal health services, both public and private. The assessment concluded that in areas with strong CAHW programmes and private veterinary pharmacies and where stakeholders participate in the design, implementation, and monitoring, a treatment voucher system is effective and efficient in addressing the immediate veterinary needs of targeted beneficiaries during emergencies (Source: Regassa and Tola, 2010).

Save the Children USA also carried out an impact assessment of their scheme and found significantly lower livestock mortality in herds treated under the voucher system relative to control herds. They concluded that, ‘Given that the veterinary voucher scheme impacted positively upon the privatised systems, upon pastoral livelihoods, and upon the health of animals in the intervention area, it is worth trying in other areas’ (Source: Simachew, 2009, quoted in Vetwork, 2011).

5.3 Impact case study: Limitations of livestock vaccination during emergencies

Livestock vaccination has been an institutionalized response to drought in pastoralist areas of Ethiopia for many years, with millions of doses of vaccine delivered through NGOs and government. An impact assessment of this approach aimed to measure its impact on livestock asset protection, and thus compare mortality by disease between vaccinated and non-vaccinated herds in drought years in three regions of the country. For herds of cattle, camels, and small ruminants, the results showed no significant difference in mortality in vaccinated and non-vaccinated animals from those diseases covered by vaccination programmes during drought. The lack of impact from vaccination was explained by reference to a range of technical issues, but the overall conclusion was that vaccination of livestock should take place during normal, non-crisis periods.

These findings led to emergency coordination bodies and donors in Ethiopia revising their support to veterinary care during drought, and placing more emphasis on veterinary voucher schemes with the private sector. More widely, the assessment showed the importance of understanding the livelihoods impact of livestock vaccination during emergencies, and the risk of assuming that vaccination automatically protects livestock assets and that it is a cost- effective approach in emergencies (Source: Catley et al., 2009).

5.4 Impact case study: Limitations of mass deworming of livestock during drought in Kenya

Large-scale deworming of livestock is a common veterinary response during drought in northern Kenya. For example, during 2008–09, no fewer than 474 emergency livestock interventions took place across six countries, and mass deworming was one of the most common activities. In 2012, researchers who wanted to measure the impact of deworming during drought conducted 120 household interviews in five districts. The study design showed the technical difficulties of measuring the impact of disease caused by worms in livestock because different types of worms have different impacts on animal health. However, the study managed to conclude that ‘There was clear evidence that administration (of worm medicines) within the drought itself was perceived to have little to no effect on livestock output. Although there was perceived to be an improvement in output after administration during the rains, it was not possible to attribute changes to anthelmintic [worm medicine] use because of the improvement in concurrent pasture quality and water availability’. The study report advised further impact studies to better understand the value of mass deworming of livestock during drought (Source: FAO, 2012: 4).

5.5 Impact case study: Veterinary interventions in Afghanistan

Over a five-year period in Afghanistan, 60–80 per cent of livestock were lost because of the conflict. In 2002–03, ICRC conducted a veterinary intervention in two districts in the central highlands that aimed to rebuild herds through improved animal health. The project planned to treat 100 per cent of the animals in order to significantly reduce parasite numbers. The project team comprised two Afghan veterinary surgeons and a team of CAHWs.

Each animal was treated free of charge with anthelmintic and acaricide in the autumn of 2002, in the spring of 2003, and again in the autumn of 2003. Every livestock owner was also given an acaricidal powder to treat the stables or sheds where the animals stayed during winter. The first treatment involved 57,000 animals, the second 154,000, and the third 248,000. The livestock belonged to a total of 5,300 families. Of the animals treated, 80 per cent were sheep or goats, 14 per cent cattle, and 6 per cent equines.

Monitoring was conducted during the treatments, and extension services were provided after the intervention. The intervention had the following impacts: herd sizes doubled, average live weight increased, herd fertility and survival of young stock improved, and the impact was so great that, after the project stopped, the two veterinary surgeons were able to earn a living treating the livestock and getting paid in full by the livestock keepers (Source: Oxfam, 2005).

5.6 Process case study: Carcass disposal in Mongolia

Mongolia is prone to severe winter weather as well as to drought in summer. When lack of summer rain prevents pasture growth, livestock enter the winter in poor body condition. Blizzard conditions, ice over pasture, and very low temperatures – as low as -50oC – result in a winter emergency known as dzud. Horses, cattle, sheep, cashmere goats, camels, and yaks starve and freeze to death.

Dzud occurred over two consecutive winters between 1999 and 2002, and again between 2009 and 2010, leading to large-scale livestock mortality. In the 1999–2002 period, 11.2 million animals died out of around 30 million nationally according to government reports. In rural areas, a large proportion of the population were nomadic herders, and livestock mortality on this scale resulted in a great loss of livelihoods. National and international agencies responded by providing animal feed and veterinary support.

In 2010, a United Nations Development Programme (UNDP) intervention assisted in the removal of around 2.7 million animal carcasses from three aimags (provinces), which amounted to 20 per cent of the total dzud-affected territory. Individual cash-for-work (CFW) transfers to 18,605 beneficiaries and reimbursements of fuel costs, totalling $121,600, were disbursed with the assistance of a local bank that did not charge bank fees or make service charges. The CFW scheme also addressed social equity and gender equality through inclusive collective action, and helped those worst affected with overcoming the psychological trauma that they had suffered. International development agencies such as the Swiss Agency for Development and Cooperation and Mercy Corps began replicating the CFW initiative in other aimags in conjunction with the Government of Mongolia. The UNDP intervention complemented the Mongolian Government’s carcass removal programme in the remaining aimags (Sources: Baker, 2011; UNDP, 2010).

5.7 Process case study: Emergency animal health response to drought in Kenya

Farm Africa’s Northern Kenya Pastoralist Capacity Building Project works in the Marsabit and Moyale Districts of northern Kenya. During the 2005/06 drought, government veterinary officers reported livestock losses of between 65 and 85 per cent. Pasture and water were in scarce supply and livestock were exposed to starvation, and their susceptibility to disease increased.

In collaboration with government veterinary services, Farm Africa requested funds from FAO to conduct an emergency animal health initiative. The objectives were to improve the health status of core breeding livestock in the project area and reduce their parasitic load so that they might withstand stress-induced outbreaks of livestock diseases and sustain productivity. The project targeted 20 per cent of the livestock in the two districts with mass treatment and deworming.

Teams comprising Farm Africa staff, local government veterinary officers and animal health assistants, partner organization staff, and CAHWs conducted the treatment. The basic package consisted of a dewormer and a trypanocide. An optional package targeting sick or weak animals was also available, comprising multivitamins, an anti-parasitic, and antibiotics. Payment for the treatment was made in cash or kind, as shown in Table 5.3.

Table 5.3

Payment for treatment during 2005/06 drought

Cost item

Payment in kind

Payment in cash

Cattle/donkeys

1 goat per 20

KSh50 (US$0.70)

Sheep/goats

1 goat per 100

KSh5 ($0.07)

Camels

1 goat per 10

KSh50 ($0.70)

KSh = Kenyan shillings

The direct beneficiaries of the project were 2,107 households in Marsabit District and 1,560 households in Moyale District – a total of approximately 27,600 people.

The anticipated impact of the project was improved livestock health over time, which in turn would contribute to higher milk and meat production, increased immunity to disease, and improved condition of draught oxen prior to the next planting season. In the longer term, it is anticipated that livestock reproduction rates will increase and that ultimately food security will improve.

In the interim, beneficiaries were positive about the intervention and felt that their livestock were stronger, more capable of withstanding the effects of drought, and likely to increase their milk production for immediate consumption (Source: Farm Africa, 2006).

Appendix 5.1: Assessment methods and checklist for veterinary service provision

Indicator

Useful method

1. Accessibility
The physical distance between livestock keepers and the nearest trained veterinary workers

Participatory mapping:

Simple sketch maps of given area
Locations and owners of livestock
Nearest veterinary services/types
Distance (km, hours, etc.)

2. Availability
A measure of a service’s physical presence and concentration/ availability in an area

Participatory mapping: as above
Direct observation:

Veterinary workers
Facilities

Interviews:

Assess existing stocks of veterinary products
Quality of medicines and equipment
Barriers to availability on the basis of caste, gender, etc.

3. Affordability
The ability of people to pay for services

Semi-structured interviews Observation:

Veterinary facilities
Livestock markets
Price lists

Determines normal service costs and livestock values Allows comparison of service costs against livestock worth – if livestock markets are still functioning or if a destocking programme is taking place, it is more likely that people will be able to pay for veterinary support

4. Acceptance
Relates to cultural and political acceptance of veterinary workers, which is affected by socio-cultural norms, gender issues, language capabilities, and other issues.

Interviews: with male and female livestock keepers

5. Quality
This includes veterinary workers’

Level of training
Technical knowledge and skills
Communication skills
Quality and range of veterinary medicines, vaccines, or access to equipment

Interviews:

Veterinary workers

Direct observation:

Veterinary facilities
Education certificates
Licences to practice or equivalent

All indicators

Matrix scoring:
Scoring different types of veterinary workers operational in the area against the five indicators shows the relative strengths and weaknesses of each type

Appendix 5.2: Examples of monitoring and evaluation indicators for veterinary service provision

Process indicators
(measure things happening)

Impact indicators
(measure the result of things happening)

Designing the system

Completion of participatory survey and analysis
Number of meetings with community/ community representatives
Number of meetings between private veterinary workers and implementing agency

Identification of most important animal health problems in the community according to different wealth and gender groups
Analysis of options for improving animal health

Veterinary vouchers

Value of vouchers agreed with community and local private veterinary service providers
Beneficiary selection criteria agreed
Number of veterinary paraprofessionals linked to private veterinary drug supplier or agency
Reimbursement system for private sector workers and suppliers agreed
Field-level monitoring system agreed

Implementing agency provides medicines

Number of veterinary paraprofessionals supplied by agency and geographical coverage

Rapid veterinary training/refresher training

Number and gender of workers trained
Number and type of animal health problems covered in training course
Cost of training

Improved veterinary knowledge and skills among trainees

Veterinary activities

Veterinary vouchers

Number of vouchers distributed by area and type of household
Number of treatments per disease per livestock type per household
Number and value of vouchers reimbursed

Medicines provided by agency

Quantities and types of medicines supplied to veterinary workers
Cost of medicines supplied to veterinary workers
Number of treatments per disease per livestock type per worker per month
Number of monitoring forms submitted by veterinary workers
Number of disease outbreaks reported by veterinary workers

Livestock mortality by species and disease against baseline
Geographical coverage of veterinary workers
Proportion of livestock-rearing households serviced
Proportion or number of workers functioning after training
Action taken according to disease outbreak reports
Human nutrition – consumption of animal- sourced foods in community in relation to improved animal health and according to wealth and gender groups
Income in community in relation to improved animal health and according to wealth and gender groups
Influence on policy

Source: Catley et al., 2002

See also the LEGS Evaluation Tool available on the LEGS website: <http://www.livestock-emergency.net/resources/general-resources-legs-specific/>.

References and further reading

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Aklilu, Y. (2003) ‘The impact of relief aid on community-based animal health programmes: the Kenyan experience’, in K. Sones and A. Catley (eds), Primary Animal Health Care in the 21st Century: Shaping the Rules, Policies and Institutions, proceedings of an international conference, 15–18 October 2002, Mombasa, Kenya, African Union/Interafrican Bureau for Animal Resources, Nairobi, <http://www.eldis.org/go/home&id=13563&type=Document#.U38tmbkU_Vh> [accessed 17 May 2014].
Baker, J. (2011) 5-Year Evaluation of the Central Emergency Response Fund, Country Study: Mongolia, United Nations Office for the Coordination of Humanitarian Affairs (OCHA), Ulaan bataar. Available from: <http://www.alnap.org/resource/11664> [accessed 24 May 2014].
Burton, R. (2006) Humane Destruction of Stock, PrimeFact 310, New South Wales Department of Primary Industries, Orange, New South Wales. Available from: <http://www.livestock-emergency.net/resources/veterinary-services/> [accessed 23 May 2014].
Catley, A., Leyland, T. and Blakeway, S. (eds) (2002) Community-based Animal Healthcare: A Practical Guide to Improving Primary Veterinary Services, ITDG Publishing, London.
Catley, A., Leyland, T., Mariner, J.C., Akabwai, D.M.O., Admassu, B., Asfaw, W., Bekele, G., and Hassan, H.Sh., (2004) ‘Para-veterinary professionals and the development of quality, self-sustaining community-based services’, Revue scientifique et technique de l’office international des épizooties 23(1): 225–252 <http://sites.tufts.edu/capeipst/files/2011/03/Catley-et-al-OIE-Apr-04.pdf> [accessed 18 May 2014].
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Mutungi, P.M. (2005) External Evaluation of the ICRC Veterinary Vouchers System for Emergency Intervention in Turkana and West Pokot Districts, International Committee of the Red Cross (ICRC), Nairobi.
Oxfam (2005) Livestock Programming in Emergencies Guidelines, unpublished draft, Oxfam, Oxford.
Regassa, G. and Tola, T. (2010) Livestock Emergency Responses: The Case of Treatment Voucher Schemes in Ethiopia, FAO, Addis Ababa, <http://www.disasterriskreduction.net/fileadmin/user_upload/drought/docs/Livestock%20Treatment%20Voucher%20Experience%20in%20Ethiopia.pdf> [accessed 20 May 2014].
Schreuder, B.E.C., Moll, H.A.J., Noorman, N., Halimi, M., Kroese, A.H., and Wassink, G. (1995) ‘A benefit-cost analysis of veterinary interventions in Afghanistan based on a livestock mortality study’, Preventive Veterinary Medicine 26: 303–314 <http://dx.doi.org/10.1016/0167-5877(95)00542-0>.
Simachew, K. (2009) Veterinary Voucher Schemes: An Emergency Livestock Health Intervention – Case Studies from Somali Regional State, Ethiopia, Save the Children USA, Addis Ababa.
UNDP (United Nations Development Programme) (2010) 2010 Dzud Early Recovery Programme, UNDP Project Document, United Nations Development Programme, Ulaan bataar, <http://www.undp.org/content/dam/undp/documents/projects/MNG/00059396/Dzud%20early%20recovery_ProDoc.pdf> [accessed 18 May 2014].
Vetwork (2011) The Use of Cash Transfers in Livestock Emergencies and their Incorporation into the Livestock Emergency Guidelines and Standards (LEGS), Animal Production and Health Working Paper No. 1, FAO, Rome. Available from: <http://www.livestock-emergency.net/resources/general-resources-legs-specific/> [accessed 18 May 2014].

Notes

1.
Leyland, T., Lotira, R., Abebe, D., Bekele, G. and Catley, A. (2014) Community- based Animal Health Care in the Horn of Africa: An Evaluation for the US Office for Foreign Disaster Assistance, Feinstein International Center, Tufts University, Addis Ababa and Vetwork UK, Great Holland.
2.
Secondary data sources are, for example, government disease surveillance reports, disease studies from local research institutes, and published data.
3.
In the case of a ‘private good’, the person who paid for the good or service benefits exclusively from it (for example, treatment of an animal’s injury). With a ‘public good’, an individual’s consumption does not reduce its entitlement for others; the person who pays for the service cannot exclude access by others (for example, meat inspection).