Impact Assessment of the Community Animal Health System in ...

Contents
Executive Summary..............................................................................................................................................i
1. Introduction ........................................................................................................................................... 1
1.1 Private veterinary practice in pastoralist areas................................................................... 1
1.2 The VSF Suisse/ELMT project ............................................................................................... 1
2. Methods .................................................................................................................................................. 2
2.1 Study design ............................................................................................................................ 2
Financial sustainability .................................................................................................. 2
Quality of CAHW treatments ....................................................................................... 2
2.2 Data collection ......................................................................................................................... 3
Key informant interviews.............................................................................................. 3
Methods with CAHWs .................................................................................................. 3
Proportional piling to estimate case fatality rate (CFR) ............................................ 3
2.3 Sampling method and sample sizes ..................................................................................... 4
3. Results ................................................................................................................................................... 5
3.1 Financial performance of pharmacies .................................................................................. 5
3.2 Number of CAHW treatments and income......................................................................... 7
3.3 Disease reporting by CAHWs ............................................................................................... 7
3.4 Quality of CAHW treatments................................................................................................ 8
Case fatality rates in sheep and goats.......................................................................... 8
Case fatality rates in camels .......................................................................................... 9
Case fatality rates in cattle............................................................................................. 9
3.5 Areas for improvement ........................................................................................................ 11
4. Discussion............................................................................................................................................. 12
4.1 Methodological issues .......................................................................................................... 12
Timing of the assessment ............................................................................................ 12
Disease diagnosis, recall issues and case fatality rates............................................ 12
4.2 Impact assessment findings................................................................................................. 13
Financial sustainability of CAHWs linked to private pharmacies ........................ 13
Quality of CAHW treatments ..................................................................................... 14
Disease reporting and links to government.............................................................. 16
Use of veterinary drugs by pastoralists..................................................................... 17
5. Conclusions and Recommendations................................................................................................. 17
Acknowledgements
The community animal health (CAH) system covered in this report was funded by the United States Agency for
International Development (USAID) through the Regional Enhanced Livelihoods in Pastoral Areas (RELPA)
program, Enhanced Livelihoods in the Mandera Triangle (ELMT) activity. Within ELMT, Veterinaires sans
frontieres Suisse (VSF Suisse) supported the CAH system. The participatory impact assessment was conducted
following a training conducted in Garissa, Kenya. Both the training and assessment were implemented by the
RELPA Pastoral Areas Coordination, Analysis and Policy Support (PACAPS) activity, implemented by the
Feinstein International Center, Tufts University. The assessment team acknowledges the intellectual
contributions of pastoralists and community‐based animal health workers in Geder, Wargudud, Kalwahil and
Wangaydahan, and the valuable information provided by the Takaba and Wargudud private veterinary
practitioners and the Vet Agro Company in Nairobi. We also acknowledge the support of VSF Suisse expert, Dr.
Simon Chuchu, and Mr. Anis Hassan, and the support of the CARE Takaba office. The PIA training was assisted
by Dr. Dawit Abebe of PACAPS and Mr. Charles Hopkins of CARE Ethiopia; Dr. Andy Catley of PACAPS
provided assistance with data analysis and edited the report.