PLA Notes 45: Community-based animal health care - Livestock ...

SPECIAL ISSUE1Overview: Community-basedanimal health workers, policies,and institutionsIntroductionIn April 1994 a special issue of RRA Notes 1 , was dedicated tolivestock. The issue focused on participatory methods andplanning, and drew heavily on experiences from communitybasedlivestock projects. The case studies in the 1994 issuereflected the range of interviewing, visualisation, and scoringmethods, which livestock workers were beginning to use andadapt at that time. Some papers discussed how communitieswere involved in analysing livestock problems and identifyingsolutions. One solution was the local selection ofpeople for training as community-based animal healthworkers (CAHWs). These workers were usually given a shorttraining and depending on the communities and livestockrearing systems in question, different animal health andproduction topics were covered in the curriculum.In the following years, participatory methods were usedand adapted by an increasing number and range of organibyANDY CATLEY and TIM LEYLAND1 RRA Notes 20: Special issue on livestock. C. Watson and A Collis (Eds). 1994. IIED:London2 PAVE – The Participatory Approaches to Veterinary Epidemiology project (1998-2000) examined options for using participatory appraisal in veterinary epidemiologyand focused on animal health services and information systems in pastoral areas ofAfrica. PAVE was led by Andy Catley and funded by the Animal Health Programmeof the UK Department for International Development. The project produced severaljournal articles, as well as a practitioner’s guide entitled, Methods on the Move:A Review of Veterinary Uses of Participatory Approaches and Methods Focussingon Experiences in Dryland Africa, which is available from IIED.sations involved in livestock research and development. Forexample, research conducted by IIED and others showed howparticipatory methods could be adapted into useful diseaseinvestigation and epidemiological tools. 2 When used by experiencedpractitioners, the methods were also reliable and validcompared with conventional methods. In Africa, interest inparticipatory methods has led to the emergence of participatoryepidemiology as a distinct but complementary branchof veterinary epidemiology, which is now attracting interestfrom national epidemiology units within government veterinaryservices in Africa. Thus, participatory approaches andmethods are becoming more mainstream and used by seniorgovernment epidemiologists and researchers, often in combinationwith conventional approaches.About this issueIn the mid to late 1990s more evidence began to emergeabout the positive impact of CAHWs, their capacity toprevent or treat livestock disease, and the effect on people’slivelihoods. Good impact was noted in communities, varyingfrom pastoralist communities in lowland Kenya, to settledfarmers in highland Nepal. However, despite encouragingstudies and reports from many countries, there were alsomajor concerns about the long-term viability of CAHWs. Notleast, in most countries where CAHWs existed, they were4 October 2002

Overview: Community-based animal health workers, policies, and institutions1officially illegal. In some countries, the veterinary authoritiessimply turned a blind eye to CAHWs, whereas in otherspowerful professional bodies launched anti-CAHWcampaigns. In nearly all cases, veterinarians were unwillingto work in the remote, underdeveloped areas where poorerlivestock keepers lived. Hence, without these frontlinecommunity-based animal health workers, there would befew, if any veterinary services at all in large parts of manydeveloping countries.This issue of PLA Notes focuses on the policy and institutionalaspects of scaling up and official recognition ofCAHWs. The first paper by the IDL Group and ConstanceMcCorkle presents some common arguments made byveterinarians against CAHWs in the context of policy reform,privatisation, and global trade in livestock products. The clearmessage from this paper is that important technical concernsabout the recognitions and wider use of CAHWs are wellknown and can largely be addressed, but professional normsand conservatism have hindered progress. Other papers showhow at national level, policy makers can be influenced indifferent ways.Looking at community-based approaches from a diseasecontrol angle, Jeffrey Mariner and colleagues show how theprofile of CAHWs and understanding of community participationwas improved when CAHWs were used to helpcontrol rinderpest. This disease was a huge concern for livestockkeepers, national veterinary services, and the internationalcommunity. When CAHWs proved to be crucial forvaccinating cattle against rinderpest in Africa, policy makersand senior vets in international agencies started to takenotice. Working in southern Sudan, Bryony Jones andcolleagues at VSF Belgium describe how a large-scalecommunity-based programme continued to assist rinderpesteradication by developing and disseminating messages aboutthe cessation of vaccination and the need for disease surveillance.As Cathy Watson and Adrian Cullis advised in theireditorial in the 1994 issue of RRA Notes, we need to ‘learnabout local communication methods and channels’. Thesouthern Sudan paper is a good example of this, as localknowledge and communication methods formed the core ofthis innovative initiative. Both papers on rinderpest control inthis issue discuss professional attitudes and how the processof ‘seeing is believing’ changed the way vets perceived theknowledge and capacity of livestock keepers.Cokro Leksmono and John Young view the adoption ofCAHWs from the perspective of institutional change andprivatisation in Indonesia. They describe how central and localgovernment learnt about and tested community-basedapproaches, and provide evidence of impact that helped to“Without these frontlinecommunity-based animal healthworkers, there would be few, if anyveterinary services at all in large partsof many developing countries”establish CAHWs as an accepted service provider. Impactassessment of CAHWs is certainly a useful way to influencepolicy makers, and two other papers in this issue describeparticipatory impact assessment. Working with Maasaicommunities in northern Tanzania, Stephen Nalitolela andRob Allport present a methodology for measuring change,attributing change to CAHWs (and others), and usingcommunity-derived indicators to assess benefits in terms ofhuman livelihoods. Charles Hopkins and Alistair Short linkparticipatory impact assessment to policy debate by involvingagencies that influence or make policy in Ethiopia. Theirwork with local stakeholders included the establishment of anational impact assessment team to look at CAHW issuesand tried to overcome the problem of policy makers rejectingstudies of which they were not aware or involved in.Experiences with developing a national skills test aredescribed by Karen Stoufer and colleagues in Nepal, which isalso related to recognition of CAHWs. This article shows howperceptions of training needs, duration of training, and previouseducation of trainees can vary between field-level NGOworkers and decision-makers in government. Despiteevidence that short training courses were successful andbetter suited to realities on the ground, official recognitionof the more appropriate training approach was slow toemerge. This is a common experience in other countries,where the quality of CAHW training tends to be judged byofficialdom according to the duration of training rather thanthe quality of training or the impact of CAHWs in theircommunities. Veterinarians with limited hands-on experienceof community-based approaches also tend to insist on higherlevels of education and literacy among CAHWs than is reallyneeded for them to work effectively.Finally, Susan Stewart describes the key elements of aprogramme to support community-based animal healthtraining and service delivery, which has been replicated inseveral parts of Bolivia. The programme distinguishedbetween training Farmer Trainers and CAHWs. Farmer Trainersare local people who own land in the community, have ahistory of service and a strong desire to serve, have a highemotional intelligence (people skills), have some experienceSPECIAL ISSUEOctober 2002 5

1Andy Catley and Tim LeylandSPECIAL ISSUEwith livestock production, are recommended by trustedinformants as gregarious people who connect people to oneanother, are part-time, paid staff of the project or local organisation,and work in teams throughout the region. CAHWs inthis programme are people who provide preventive and somecurative care with livestock as well as facilitate training in theirown villages. They are trained as change agents in theirvillage organisations, and trained as trainers with listeningand facilitation skills. Together, Farmer Trainers and technicianstrain the CAHWs. CAHWs are viewed as an integralpart of the village development process and are chosen bythe villagers themselves. These programmes continue toshow excellent results even after the project funding hasbeen discontinued because of the motivation and creativityof the local people involved.Future challenges facing community-based animalhealthcareFor many of the challenges facing CAHW programmesdescribed in this issue, there is evidence of progress. Morecountries are looking critically at CAHWs and deciding if andhow these workers can be supported by appropriate policiesand legislation. In some countries, processes are underway toharmonise CAHW training approaches and curricula atnational level. For example, in Kenya a national CAHW curriculumhas been developed and includes core skills and knowledgerequired by all CAHWs, but also allows scope for trainingin animal health problems according to local priorities.As governments become more aware of CAHWs, thereare also moves to strengthen the role of CAHWs in diseasereporting and contributing to national disease surveillancesystems. This becomes particularly important as countries tryto demonstrate national disease status to trading partnersaccording to WTO guidelines. Countries such as Ethiopia andTanzania are exploring ways to use information provided byCAHWs in remote areas to complement existing diseaseinformation systems. However, the challenge is how to feedback information to communities and create a two-way relationship,rather than using CAHWs for ‘data mining’.In an era of privatisation of veterinary services, one wayto improve the financial sustainability of CAHWs is to linkthem to private suppliers of veterinary medicines, such asveterinarians. As these linkages develop, it will interesting tosee how community perceptions of an ideal CAHW comparewith the qualities preferred by private pharmacy owners orsimilar. One viewpoint is that communities and a private vetboth want a local ‘agent’ who is knowledgeable about livestock,hard working, and trusted. If, for example, the selectionprocess for CAHWs involves both communities and aprivate vet, perhaps a joint decision can be reached regardingwhat makes a good CAHW. While profit may be the mainmotivation for the private sector, social norms and peer pressureexerted through traditional means will also have a stronginfluence on how CAHWs behave and the service theyprovide. With time, we’ll learn more about the compatibilityof participation and privatisation, and options for combinedapproaches to primary animal health service delivery.ABOUT THE GUEST EDITORSAndy Catley and Tim LeylandCommunity-based Animal Health and ParticipatoryEpidemiology (CAPE) Unit,Pan African Programme for the Control ofEpizootics,OAU-IBAR, PO Box 30786, 00100 Nairobi,KENYA.Tel: +254 (2) 2264447fax: +254 (2) 212289www.cape-ibar.orgEmail: tim.leyland@oau-ibar.orgEmail: andy.catley@oau-ibar.org6 October 2002

Glossary and acronymsGlossary andacronymsAnimal Health Assistant (AHA)A veterinary worker, sometimes calleda ‘veterinary assistant’ and usuallywith two years training at an officialtraining institute.Animal Health Technician (AHT)A veterinary worker, usually witharound six months training, at anofficial training institute.Community-based Animal HealthWorker (CAHW)A worker selected by the communityand given basic training in animalhealth and related issues, according tolocal priorities. Also called VillageAnimal Health Worker, CommunityLivestock Worker and similar names.Community-based Animal Health andParticipatory Epidemiology Unit (CAPE)A unit working with the PACEProgramme of OAU-IBAR (see below)specialising in community-basedanimal health systems, with a focus onpolicy and legislative issues.Cold chainA network of refrigerators fordelivering vaccines or medicines torural areas. The vaccines have to bekept cold to avoid deterioration.East Coast Fever (ECF)An important disease of cattle in EastAfrica, ECF is transmitted by ticks.EpidemiologyThe branch of medicine that dealswith the study of the causes,distribution, and control of diseasein populations.EpizooticThe animal equivalent of anepidemic; a sudden andwidespread disease outbreak.Global Rinderpest EradicationProgramme (GREP)Coordinated by the Food andAgriculture Organization of theUnited Nations, this programmeaims to eradicate rinderpestworldwide.Heat stable vaccineA vaccine that maintains itseffectiveness in the absence of coldstorage. Such vaccines can be usedat high ambient temperatures inplaces where there are norefrigeration facilities.Office Internationale des Epizooties(OIE)The World Organisation for AnimalHealth, the OIE advises theveterinary services of its memberstates about the eradication ofimportant animal diseases andestablishes the health standards forinternational trade in animals andanimal products.Organisation of the African Union’sInterafrican Bureau for AnimalResources (OAU-IBAR)A technical agency of the AfricanUnion with the mandate to promotelivestock development in Africa.OrmiloA disease of cattle also called bovinecerebral theileriosis, transmitted byticks and caused by the parasite calledTheileria taurotragi. Affected cattleshow signs of nervous system disease,including walking in circles.Pan African Programme for the Controlof Epizootics (PACE)A programme of OAU-IBAR aiming tocomplete the eradication ofrinderpest from Africa, improvecontrol of other epizootic diseases,and strengthen nationalepidemiological capacity.Participatory epidemiologyIn the context of animal health: usingparticipatory methodologies andapproaches to understand diseases inanimal populations as a means toimprove disease control.ProphylaxisA preventive disease control measure.RinderpestA highly contagious and severe viraldisease of cattle and wildlife.GLOSSARYOctober 2002 7

SPECIAL ISSUE2Community-based animalhealthcare, participation, andpolicy: where are we now?A changing landscape of veterinary servicesIn the early days of CAHWs, it was the norm in most developingcountries for all veterinary services to be delivered bythe state. Emulating patterns established by colonial administrations,many post-independence governments continuedto provide free or subsidised vaccinations, other basic prophylaxessuch as parasite control, and even some therapeuticcare. However, governments failed to appreciate the full costsof universal delivery of veterinary services. Under colonial rule,services were aimed mainly at benefiting only a small minorbyTHE IDL GROUP and CONSTANCE McCORKLEIntroductionAlthough community-based animal health workers (CAHWs)have been around for many years, few countries supportCAHW systems with appropriate policies and legislation.However, compelling economic and institutional forces havenow placed CAHWs on the desks of national policy makersand the veterinary profession, and real energy is beingdirected at policy reform to support CAHWs. Reasons forincreased attention to CAHWs include structural reform andprivatisation of veterinary services.This paper discusses some experiences and commonarguments when engaging central policy makers and veterinaryprofessional bodies in order to develop pro-CAHWpolicy.ity of wealthier producers and limited segments of the livestocksector: colonial settlers and elite or export markets.Government agencies suffered from a host of additionalproblems. An obvious one was the lack (or the post-colonialdeterioration) of basic infrastructure like roads and refrigerationfacilities for vaccines (‘cold chains’). Other problemsspanned corruption, financial crisis, constant shortages ofcritical inputs (e.g. drugs and vaccines), and political authoritieswho were insecure, indecisive, arbitrary, and interventionist.Indeed, it was not uncommon for up to 90% ofveterinary-agency funds to go on salaries alone, as governmentstried to staff up to provide universal coverage singlehandedly.Obviously, this left virtually nothing for operatingexpenses. But even when full operating expenses were available,government veterinary staff were (and in many countries,still are), too few and too poorly distributed andresourced to meet even the most fundamental animal healthcareneeds of their nations' rural citizenry.Veterinary privatisation has been widely promoted as asolution to state inefficiencies in service provision. However,efforts have focused in more intensive and commercial livestockrearing areas using models of private veterinary practicesimilar to those existing in the North. Here, we have a veterinarianproviding a mobile service to farmers and derivingincome from clinical services, sale of drugs and contracts from8 October 2002

Community-based animal healthcare, participation, and policy: where are we now?2government. More remote rural areas of the South haveusually been viewed as non-viable for private veterinary practiceand indeed, economic factors such as huge transactioncosts suggest that alternative approaches to privatisation areneeded. The relatively low cost and local acceptability ofCAHWs seems to offer a way forward, particularly if CAHWscan be linked to, and supervised by animal health assistantsor veterinarians running veterinary pharmacies.Five arguments in the debate about pro-CAHW policyEarly on in the debate, opposition to CAHWs among veterinarypolicy makers, professional bodies and academics wasoften intense and vocal. Some commonly expressed viewsand were as follows:1. We’ve already been doing this CAHW thing for decades.It doesn’t work and there is nothing new you can tell usabout itThis view relates to old, colonial-style veterinary services inmore remote areas. In these areas, a government DistrictVeterinary Officer would sometimes train local livestockkeepers as ‘Vetscouts’ or vaccinators. The approach recognisedthe value of local animal health knowledge and skills,but differed from later, well-designed CAHW projects basedon joint analysis of problems and solutions, community selectionof CAHW trainees and attention to local concerns ratherthan government priorities to control epizootic diseases,often in ‘high potential’ areas.In other countries, mass animal health trainingprogrammes in the post-colonial period were often targetedat school leavers and again, focused on priorities as perceivedby government and trained workers who were not necessarilyliked by livestock keepers. In both the vetscout andmass training programmes, workers received incentives fromgovernment that ultimately were not sustained. In contrast,CAHWs seem to work best when supported by the privatesector.2. These CAHWs are illiterate and backward. There is noway they can diagnose and treat diseasesVets receive a five or six year university education, often basedon curricula borrowed from Northern universities. The notionthat a short, say two-week, training course is sufficient toenable CAHWs to recognise and treat a few diseases is difficultto accept, particularly by veterinary schools and professionalassociations. There are many issues here:• Urban bias – vet schools tend to produce graduates whotraditionally have expected desk-bound employment withgovernment or who prefer to work in or near major urban“Recent evidence suggests that CAHWsactually improve use of veterinarydrugs. When there is a CAHW, over 70%of livestock keepers would rank them astheir preferred source of animal healthadvice. And in the vast majority of cases,their advice would be correct”centres. Others move into research careers, but mostresearch is conducted in accessible areas rather than thedistant communities where CAHWs are found. Institutionalknowledge of participatory training techniques for illiteratetrainees and the real, practical problems of delivering servicesin remote areas is often limited.• Professional bias – not least that professional diagnosticskills are automatically superior to indigenous knowledge,and that educated people must know more than illiteratepeople. This argument often overlooks the fact that professionalskill depends on practical, hands-on experiencerather than education alone. Yet government veterinaryservices have been severely under-resourced and overlybureaucratic. Are vets practitioners or administrators?• Where there is no vet – in the absence of access to professionalveterinary workers, livestock keepers try to make thebest of what is available. This often means using poorqualitydrugs from the black market, or unlicensed andunregulated shops. Sometimes human drugs are used totreat animals. Little advice on the correct use of drugs isavailable from these outlets.Much of the debate about drug usage by CAHWs centreson drug resistance. The argument goes that misuse of drugssuch as antibiotics encourages drug resistance. When resistancespreads to humans, the health of people is put at risk.Similarly, drug residues in foods are generally considered tobe harmful to people.Established strategies to minimise the risk of resistanceare now well understood. They involve:• Prophylaxis to prevent disease in the first place, meaningdirect measures such as vaccination, or indirect measuresto keep the animal’s overall immunity up.• Good treatment based on:1. Right diagnosis2. Right choice of medicine3. Right dose rate4. Right period of treatmentSPECIAL ISSUEOctober 2002 9

2The IDL Group and Constance McCorkleWhen there is noalternative, peopleuse whatever isaround. CAHWs areprobably the onlyway to improvequality of service inthese situations.SPECIAL ISSUEUnfortunately, this is not easy to guarantee in the conditionsunder which many poor livestock keepers operate.However, recent evidence suggests that CAHWs actuallyimprove use of veterinary drugs. For example, studies inMozambique and Ghana (Oakley et al., 2002) reveal thatfarmers use antimicrobials routinely but with no knowledgeof which to use, at what dose rate or for how long. Notuncommonly they are also using black-market medicines ofdubious quality. In the absence of a CAHW, most farmerswould cite the local drug seller, as being their main sourceof advice but in most cases that advice would be wrong.When there is a CAHW, over 70% of livestock keeperswould rank them as their preferred source of animal healthadvice. And in the vast majority of cases, their advice wouldbe correct.Interestingly, despite their greater knowledge, veterinariansdid not rank highly as sources of advice, as again, theywere simply too far away. It is therefore hard to see whatcontribution veterinarians could make to patterns of medicinesusage.The evidence is, however, that CAHWs do reduce thehazards of drug administration, by:• directly improving standards of administration;• increasing prophylactic use/improving overall herd health,and therefore indirectly reducing the number of animalsneeding antimicrobial therapy.This is not to say that incorrect drug administration doesnot occur when CAHWs are around. Both drug administrationby CAHWs and veterinarians were found to be lacking,as both were hamstrung by farmer reluctance to pay for fulldosetherapy. But from a policy angle it does suggest thatcontrary to the original assumption, CAHWs can be a largepart of the solution rather than being a large part of theproblem.When there is no alternative, people use whatever isaround. The herder seen in the photo above is trying to treata cow with pneumonia and his diagnosis is correct. However,he is untrained and has prepared a solution from oxytetracyclinecapsules designed for oral administration to humans.He has wasted his money as the treatment is unlikely to work.CAHWs are probably the only way to improve quality ofservces in these situations.10 October 2002

Community-based animal healthcare, participation, and policy: where are we now?2Well-regardedveterinary journalsnow publish‘scientific’ papersdescribing localdisease descriptionsand epidemiology,as captured byparticipatoryinquiryprovided they are well-trained, supervised and are integratedinto national veterinary services. This is a logical way tostrengthen capacity of national disease information systems.4. We already have thousands of retrenched but welltrainedgovernment animal health professionals andtechnicians. Why can’t these people provide the service?In some countries, structural adjustment resulted in dramaticdownsizing of veterinary staff employed by government. Theargument goes that CAHWs should not be promotedbecause there are large numbers of trained but unemployed,former government veterinary workers such as Animal HealthAssistants (AHAs) and Animal Health Technicians (AHTs) whocan provide services. This argument breaks down for at leastthree reasons.• CAHWs are usually part-time workers who also make aliving from rearing livestock. Their expectations with regardsto financial incentives are usually low compared with AHAsor AHTs, particularly in a private sector market.• CAHWs live within their communities. In pastoral areas,they move when herds move and therefore, can provide animmediate service. This differs from a sedentary, urbanbasedAHA or AHT who, in the case of disease problems,has to be located and then transported to the community.• Perhaps for the above reasons, when given a chance toselect someone for training communities rarely select (oreven mention) unemployed AHAs or AHTs.SPECIAL ISSUE3.The international community will say we have a secondrateveterinary service if we legalise these CAHWsIn an era of globalisation, developing countries are thinkingmore about export of animals and animal products withinthe framework of the World Trade Organization (WTO). Inthe animal health world, the Office Internationale desEpizooties (OIE) in Paris develops guidelines to ensure thattraded livestock commodities are disease-free. The guidelinesare largely based on the capacity of national veterinary servicesand systems of livestock production in the North. Theyrequire countries to demonstrate understanding of thedisease situation throughout their territory and provide verifiableevidence of disease status. Opponents of CAHWs claimthat such understanding can only arise from professionalassessment at all levels, but overlook the funding and logisticalpracticalities of placing sufficient numbers of vets in thefield to collect disease information.A more pragmatic approach links CAHWs with nationalanimal health surveillance systems and combines CAHWderivedinformation with some professional supervision andverification. At present, the OIE has no concerns with CAHWs5. This is just another donor-driven approach like structuraladjustment. We’re fed up with donors telling us what todo. All these people conducting studies on CAHWs havebeen bought off by donorsVets who are influential in national policy making arenassometimes resort to this argument when all else fails. Theargument usually includes strong criticism of donor-enforcedstructural adjustment programmes that apparently, led to thedecline of state veterinary services and loss of jobs. Occasionallythe argument extends to colleagues and peers whohave been persuaded by donors to support CAHWs. Implicitis the notion that at some time in the past, there was agolden age of public sector, universal veterinary service provisionthat reached all corners, communities and sick livestock.The outstanding feature of debate on these points is theabsence of alternatives to CAHWs, given the profoundresource and logistical constraints. Evidence of the positiveimpact of CAHWs, arising from different sources andmethodologies is rejected out of hand, because researcherswere ‘in the pocket’ of donors. This evidence includes:• Aggregating review findings from CAHW programmes inOctober 2002 11

2The IDL Group and Constance McCorkleSPECIAL ISSUETanzania, the Philippines, and Kenya, we found that familieswithout access to community animal health (CAH) lostbetween 15-25% of their herd each year. The presence ofa CAHW more or less halved these losses.• Data from elsewhere has found that patient recovery rateswere 70% in communities with CAHWs, but only 10% inthose without community-based paraprofessionals.• We also know that CAHWs are a low cost option. Estimatesfor training and establishing programmes vary between$200 and $500 per CAHW, with benefits over a 10-yearperiod being estimated at between 40 and 200 times theinitial investment.But clinical services are only part of the picture. By alsoconsidering the government (rather than the smallholder) tobe the client, CAHWs have demonstrated their ability todeliver government programmes on a contract basis. Vaccination,for instance, can be delivered more effectively thangovernment structures were ever capable of doing.ConclusionsWe now see that over a period of some 30 years, the desireof communities to have access to basic, affordable animalhealth care has remained undiminished, as have theeconomic and institutional forces that have led to thedemand being met through CAHWs.What has changed is the forum for the debate, as thetopical issues have moved from technical and institutionalissues at the community level, through (often) confrontationwith the veterinary establishment and government, to aWhen there are noroads to reachcommunities in remoteareas, it makes senseto use CAHWs assources of informationon livestock disease.National animal healthinformation systemscan be strengthenedgrowing recognition both nationally and internationally of itspotential in delivering on parallel policy objectives. It is issuesof regulation, defining the relationship between CAHWsystems and the larger animal health network that will mostlikely determine the pace of change for the foreseeable future.CAHWs are now legal in several countries. In others,perversely, their illegal status undermines the ability ofgovernments to regulate CAHWs or make full use of theirservices, while denying stockholder and CAHWs alike theprotection of the law.We are now in a dynamic but uncertain situation whereinstitutions and policy lag behind the technical and economicreality of CAHW systems. Institutional and policy reform takesa good deal of effort. For many countries, the next step istherefore to decide whether or not they really want it.ABOUT THE AUTHORSConstance McCorkle7767 Trevino Lane, Falls Church, VA 22043,USA.Email: mccorkle@boo.netThe IDL GroupPO Box 20, Crewkerne, Somerset TA18 7YW,United Kingdom.Email: info@theidlgroup.comNOTEConstance McCorkle holds an MA and a PhDin anthropology plus an MA in linguistics, allfrom Stanford University. She has lived,studied, lectured or conducted research in 45nations of Africa, Asia, Europe, and LatinAmerica. Since 1980, she has researched andpublished widely on livestock, communityanimal health and ethnoveterinary medicine.The IDL group, chiefly through their subsidiaryLivestock in Development, works with governmentsand development organisations in Asia,Africa, the Middle East and Latin America onthe economic analysis, reform and strengtheningof veterinary services.REFERENCE AND FURTHER READINGThis paper is drawn from the forthcomingbook Community-based Animal HealthWorkers: Threat or Opportunity? by the IDLGroup and due for publication in late 2002.The reference cited by Peter Oakley andcolleagues comprises a chapter in the book.12 October 2002

3Community-based animalhealth workers andinstitutional change: theDELIVERI Project in IndonesiaSPECIAL ISSUEby COKRO S. LEKSMONO and JOHN YOUNGIntroductionThis paper describes a pilot project introducing communitybasedanimal health worker (CAHW) services in Indonesia,focusing on the implementation process, institutional changeand impact. It also describes how the CAHWs has changedthe perception of all stakeholders about the provision of servicesin rural areas. The pilot project was one component of afive-year UK Department for International Development(DFID) funded project called The Decentralised LivestockServices in Eastern Indonesia (DELIVERI).BackgroundThe DELIVERI project’s aim was to help the Government ofIndonesia to reform livestock services. The project’s specificpurpose was to make livestock-related institutions moreresponsive to the need of small-scale farmers, including theresource-poor, through the adoption and replication of moreclient-orientated and participatory approaches.To do this, the project developed and tested new modelsof livestock service provision in four districts in North andSouth Sulawesi. The project also included human resourcedevelopment, institutional development and informationactivities at district, provincial, and national level to ensurethat the lessons learnt were institutionalised within DistrictLivestock Services (DLS), Provincial Livestock Services (PLS),and the Directorate General for Livestock Production (DGLP),so that any successful models could be replicated throughoutIndonesia.When the project started in 1996, towards the end of theSuharto era, government services were highly centralised,bureaucratic and inefficient, although policies promotingdecentralisation, privatisation and participation had been inplace for a number of years. All budgets, services,programmes, and projects continued to be designed andcontrolled from the capital, Jakarta, and regional and districtstaff simply followed orders. During the first two years,October 2002 13

3Cokro S. Leksmono and John YoungTraining community-basedanimal health workers inthe DELIVERI Project: thetraining course wasparticipatory and usedpictures to initiatediscussions aboutparticular problemsSPECIAL ISSUEalthough farmers and field-level staff were enthusiastic aboutthe project’s new approaches at field level, and a few enlightenedsenior managers recognised their value, the project hadlittle impact on policy or processes within the bureaucracy.Then the economic, social and political crisis in 1997/8pushed Suharto out of office and the new era of Reformasiforced ill prepared government departments to implementrapidly the long-shelved policies of decentralisation, privatisation,and participation. By that time, the project had anumber of successful pilot projects up and running, andsome charismatic champions among livestock service staff atall levels, and suddenly found itself in high demand.The CAHW pilot projects proved particularly popular withgovernment staff and farmers, and over the last two years ofthe project a total of 161 CAHWs were trained and establishedin six locations throughout the country. Five provincesin the island of Sumatera have been trying to replicate theCAHWs model in 12 districts.ApproachThe pilot project begun with a Participatory Rural Appraisal(PRA) exercise in each project location during which animaldisease and poor accessibility to veterinary services was identifiedas one of the most important problems. Further discussionswith communities and other stakeholders identified theCAHW approach as the best method to overcome theproblem.Each community nominated a representative to betrained as a CAHW by the project, and afterwards theyreturned to their community to provide basic clinical animalhealth services for a fee. They were also given a soft loan tobuy basic veterinary tools and drugs and were given an annuallyrenewable certificate by the local District LivestockServices (DLS) allowing them to provide services. Monthlymeetings were held to provide some continuing education,and to exchange experiences and information between theCAHWs and the DLS. In the year 2000, the CAHWs set up anassociation to represent their interests.Institutional impactA greater role for communitiesThe implementation of CAHWs in the pilot project areascompletely changed the delivery of basic clinical animalhealth services (Table 1). Local communities who used to relyon the free but intermittent and poor quality governmentservice, welcomed the opportunity to take control of theservice themselves. They were actively involved in the planning,implementation, and evaluation of the service and werewilling to pay for the service provided to them by membersThis picture is about antibiotic resistance. The text says ‘twenty yearsago Mr Bill, the farmer, treated his cow with penicillin. It was cheapand effective. Ten years ago penicillin was no longer effective and MrBill had to use a more expensive medicine called Baytril. But now evenBaytril doesn’t work, and Mr Bill has to find another, even moreexpensive drug’of their own community. The CAHWs were also highly motivatedto provide a high quality service to their clients, andthere was a significant increase in customer satisfaction withanimal health services and an ever-increasing trend in thenumber of cases treated by each CAHW per month.A decreasing hands-on role for governmentThe government role in the provision of basic clinical animalhealth services decreased dramatically and they graduallydelegated increasing authority to the CAHWs, while contin-14 October 2002

Community-based animal health workers and institutional change: the DELIVERI Project in Indonesia3Table 1Before the introduction of CAHWsPlanning, implementation, accountability & reaching poor farmersPlanning done by the government with almost no consultation with thelivestock owners. Policies tended to be implemented uniformly across thecountry with no consideration of locally specific needs, conditions oraspirations.DLS responsible for the delivery of livestock services. Service provided freeof charge (including private goods like basic clinical animal healthservice). Local staff accountable to the head of districts.Some consensus that DLS projects were targeted to poorer livestockfarmers but usually ended up servicing richer farmers.The service was planned from the perspective of the bureaucracy. It wassupply-driven and often below the expectations of the main benefactor ofthe service – the livestock owners.Key actors and decision-makingHead of local DLS made all major decisions, the rest (including livestockowners) had little influence on key issues.Decision-making followed central policy or made local decisions with littleclient consultation and then took a passive approach to ‘marketing’ andservice delivery. No public pressures were able to shape these decisions i.e.no popular participation in decision-making and no DLS accountability tocustomers.After the introduction of CAHWsPlanning of CAHWs done with the community. CAHWs are representativeof the community and all animal disease prevention and treatmentis done through or involving the CAHW.CAHWs responsible for delivering basic clinical animal health services.Government already sub-contracted them to do some public-goodservice (e.g. mass vaccination). Competition introduced to encouragethem to give their best service.Service accessible to all community members, regardless of wealth.CAHW provides animal health service with correct qualification, costand quality to the rural communities which are relatively poor comparedto urban areas.The service was demand-driven and planned from the perspective of theclients. Because they pay for the service, it gives them the right tocomplain if the service is below standard.As the communities are becoming more self-reliant and the CAHWs aremore confident in doing their job, they gradually are assuming thedecision-making activities regarding their livestock. The head of DLS isstill a key actor in maintaining the standard of service.The whole CAHW issue has encouraged more strategic thinking by thedecision makers and DLS staff about how to satisfy livestock animalhealth demands; encouraging a wider, longer term vision of needs andplanned action to meet them. Planning and thinking ahead is morerealistic.SPECIAL ISSUEuing to monitor the CAHW activities and standard of service.The transition proved difficult for some DLS staff who feltthreatened by their new role, or lacked the initiative andcreativity to develop it. Gradually however, even some publicgoodservices including mass vaccination, were subcontractedto the CAHWs.The change provided a powerful impetus for more strategicthinking by livestock service managers and decisionmakers at various levels in the bureaucracy to seek new waysof providing better services to local communities and to makethe community more self-reliant. As they became more familiarwith the principles of client-focused services, they beganto try to apply them to other services. There has been adramatic improvement in communication and exchange ofinformation between livestock service staff and their clients.The CAHWs also found themselves under pressure toimprove the quality of their service, from clients who, sincethey were paying for the service, felt they had a right to makedemands on the CAHW – something that they never felt theycould do with the government service.Economic impactAccessibility to basic veterinary services has increasedsubstantially. Livestock owners living in rural and marginalareas who used to have a limited access to basic veterinaryservices can now access basic services any time. This has ledto a significant increase in cattle population. Following theeconomic crisis in Indonesia, the Indonesian Rupiah (IDR) lostover 70% of its value in less than one year, and people,looking for alternative ways to save their money, wereencouraged to invest in livestock since they felt that the availabilityof improved services through the CAHWs reduced therisk of loss from disease.Most of the CAHWs have been able to make a profit outof their job within three to four months providing a big incentivefor them to stay in the job, and ensuring the sustainabilityof the service.Efficiency in treating animal disease improved substantially.In 1998 the cost to the government of treating one casewas between IDR 111,000 to 212,000. In 2000, the CAHWswere providing the same service for only IDR 5,000 to35,000. The implementation of CAHWs significantly reducedgovernment spending. A calculation of net benefit-cost in2000 showed a net present value of IDR. 88.96 million(discount rate 15%), proving that the cost to the Departmentof Livestock Services of establishing CAHWs is cheaper thanOctober 2002 15

3Cokro S. Leksmono and John YoungSPECIAL ISSUETable 2: Selected quality of service and economic indicators for DELIVERIBefore the introduction of CAHWsAfter the introduction of CAHWsAccessibility to animal health servicesOne animal health post in Minahasa district, North Sulawesi served 32 53 CAHWs trained in Minahasa in 1997.sub-districts and 502 villages.One animal health post in Barru district, South Sulawesi served five subdistrictsand 71 villages.17 CAHWs trained in Barru in 1998.Livestock owners travelled relatively long distances to make a request and Average time to make a report is 17 minutes; 75% of responses within> 40% of request require > than three days for a response; 15% of 30 minutes, 21% takes between 30 to 60 minutes, and 4% takes morerequests never received a response.than 1 hour.Quality of animal health servicesEach government animal health service provider treated 12, 24 and 21 Each CAHW treats 115, 183 and 104 cases in 1998, 1999 and 2000,cases in 1998, 1999 and 2000, respectively, per month.respectively, per month.Only 16% of clients rated animal health service as good or very good. 78% of clients rate animal health services as good or very good.Cost of animal health servicesThe cost of treating per animal disease case by the DLS was fromThe cost of treating per animal disease case by the CAHW is from IDRIndonesian Rupiah (IDR) 111,000 to 212,000.5,000 to 35,000 (Leksmono, 2002).Total DLS budget for the provision of animal health service was around The cost of establishing CAHW services is IDR 8.26 million in eachIDR 65.75 million for each DLS.district.continuing to provide the service themselves.The DELIVERI CAHWs also contributed to poverty alleviation.The DELIVERI socio-economic impact report showed asignificant redistribution of income from 1997 to 2000 in thedistrict of Barru and Bulukumba (South Sulawesi). While theproportion of respondents in the ‘medium’ wealth rankingcategory in each district remained constant in 1997 and2000, both saw an increase in the proportion of respondentsfalling into the ‘rich’ category, as well as a reduction in theproportion falling into the ‘poor’ category.ConclusionsThe DELIVERI CAHW project shows that:• privatisation of basic clinical animal health services is consistentwith the goals of the service and can substantiallyimprove accessibility, quality, and cost of the service;• involvement of local communities in planning and implementationof animal health service can increase the selfrelianceand decision-making capacity of individual livestockowner; and,• CAHWs have a comparative advantage to other animalhealth service providers in terms of transaction cost, qualificationand remuneration. They are suitable for the rural poor.The critical factors for a successful implementation of theCAHW approach are:• enthusiasm and active involvement of local communities isvital to the sustainability of the service;• participatory processes that were built in with the DELIVERIproject approach have been able to attract genuine interestand involvement of various parties in the programme;• a favourable policy context that enables local communities’enthusiasm to flourish and provides continuous supportwhenever needed; and,• close linkages with decision makers and managers createcommon understanding and experience-sharing with allparties involved in the implementation of the pilot projectand enable the replication of the CAHW approach elsewherein Indonesia.ABOUT THE AUTHORSCokro S. LeksmonoOverseas Development Institute111 Westminster Bridge, London SE1 7JD,United Kingdom.Email: c.leksmono@odi.org.ukJohn YoungOverseas Development Institute111 Westminster Bridge, London SE1 7JD,United Kingdom.Email: j.young@odi.org.uk16 October 2002NOTESCokro S. Leksmono was the livestock adviseron the DELIVERI Project. He has just completeda PhD on community-based animal healthworkers at the University of Reading, UK andnow works as a Research Officer at the OverseasDevelopment Institute in London.John Young worked on community-basedanimal health care projects in Kenya for tenyears before moving to Indonesia to managethe DELIVERI project. He is now a ResearchFellow at the Overseas Development Institutein London, UK.Information presented in this article is drawnfrom a number of papers and articlesproduced by DELIVERI, including work byAlwyn Chilver, Barbara Kirby, Agus Natasukarya,Michelle Phillips, and Dil Peeling.More detailed information is available atwww.deliveri.org

4A participatory approach toassessing the impact of acommunity-based animalhealth project with Maasaicommunities in TanzaniaSPECIAL ISSUEby STEVEN NALITOLELA and ROB ALLPORTFigure 1: Sketch map of Simanjiro District, northern TanzaniaIntroductionSimanjiro district, northern Tanzania is a semi-arid area thatis mainly occupied by Maasai communities. These communitiesare pastoralists, meaning that they derive their livelihoodfrom their mixed herds of cattle, sheep, goats, anddonkeys. In September 1997 the NGO VetAid established acommunity-based animal health programme in Simanjiro.This paper describes a participatory impact assessment thatwas conducted by VetAid in May 2001.The aim of the impact assessment was to:• enable livestock keepers to describe the positive and negativeimpacts of the project on their livelihoods;• identify indicators and a framework for monitoring futureimpact.When the project was started in 1997, community-basedanimal health workers (CAHWs) were trained to treat orprevent commonly occurring diseases which are perceivedto be a potential threat 1 . The impact assessment was carried1. These diseases were East Coast Fever (ECF) and other tick borne diseases, Footand Mouth Disease, anthrax, blackquarter, trypanosomiasis, mange, malignantcatarrhal fever, rinderpest, contagious bovine pleuropneumonia, contagiouscaprine pleuropneumonia, helminthoses, footrot, scours, and haemorrhagicsepticaemia. For ECF, treatment with Parvexon and Butalex, prevention bydipping, and immunisation were taught. Due to the low uptake of the methodstaught however, the project vet, CAHWs, and herders successfully tested andintroduced the use of oxytetracycline 30% for calf treatments.October 2002 17

4Steven Nalitolela and Rob Allportinterviews (SSI) to understand local perceptions of benefitsderived from the project. We then used proportional pilingto compare these benefits at two points in time – before theproject (pre-1998) and after (post-April 2001).2. Do people relate these changes to project activities, ifat all? e.g. how has the work of the CAHWs affected livestockmortality and morbidity?Again, we used SSI to identify factors that hadcontributed to these changes. These factors might be projectactivities or inputs such as the work of CAHWs, the veteri-Communitybasedanimalhealth workers inaction in Maasaicommunities,TanzaniaSPECIAL ISSUEout in May 2001 in Ngage, Loiborsoit B, and Ruvu Remitvillages.MethodologyWe focused on the following issues and questions:1. How do people describe changes that have occurredin the community since the start of the project e.g. how haslivestock mortality and morbidity changed since the CAHWsstarted to work?To answer these questions we used semi-structured18 October 2002

A participatory approach to assessing the impact of a community-based animal health project with Maasai communities in Tanzania4nary drug supply system, professional veterinary supervision,and community participation. Alternatively, factors could beidentified that had nothing to do with the project (e.g. rainfalland good grazing). We used simple ranking to rank thesefactors in order of importance.3. If and how do changes resulting from the projectimpact on people’s livelihoods? e.g. if our project hasreduced livestock disease, how has this change affected thelives of the people in the project area?We used ranking to show the relative importance ofmajor foodstuffs used by respective communities, and theorder of socio-economic benefits as perceived by communities.We also compared indicators such as numbers ofmilking cows to pre-project baseline data.Figure 2: ‘Before and after’ cattle deaths by health problemSPECIAL ISSUEResultsWhat were the main indicators of change?Semi-structured interview of groups revealed the benefitsmentioned below. The groups were split by gender. Benefitsperceived by men included:• decrease in calf mortality due to ECF• knowledge on the treatment of mange• improved animal husbandry• reduced abortion rate (one village only)• presence of CAHWs, although they are not enough• improved availability of veterinary drugs.Benefits perceived by women included:• increased milk availability• increased time for other activities as less time is spentfeeding, drenching, and collecting green grass for sickanimals.The next stage involved the use of proportional pilingto compare the situation prior to and after the start of theproject. Parameters used for comparison were milk availability,disease prevalence, and abortion rate. Abortion ratewas mentioned as a benefit in only one village. We thereforestudied it in that particular village alone. The communitydid not mention adult mortality decrease as a benefit,but since we were interested in it, we asked the groups toshow the situation before and after the project. We usedcattle parameters rather than all type of livestock firstlybecause many of the benefits mentioned are concernedwith cattle. Additionally, cattle are the most important livestockin these communities, which is probably why peoplekept referring to cattle. Thirdly, we had a view that sincewe are assessing impact, rather than taking every aspect ofoutcomes, we should use only the most important parameters,importance here being determined by communities.Proportional piling results are as follows:Notes:The ‘other’ causes of mortality in calves mentioned included:• in Ngage, diarrhoea, worms, and poor nutrition;• in Loiborsoit B, diarrhoea, worms, anaplasmosis, poor nutrition, andingestion of plastic bags; and,• in Ruvu Remit, diarrhoea, poor nutrition, worms, and babesiosis.Cattle mortalityResults from ‘before and after’ proportional piling ofdiseases causing cattle deaths are shown in Figure 2. Thisdiagram was created by summing calf and adult cattledeaths by disease in each village, and recognition that trendswere similar in each village.The overall picture was that cattle deaths reducedsubstantially during the project, particularly due to EastCoast Fever (ECF). However, a new disease called ormilo hadappeared and become the most important cause of death.Deaths due to ECF were reduced mainly by treating calvesshowing signs of ECF with oxytetracycline 30%. CAHWs,under veterinary supervision and monitoring, performedtreatments, taught herders how to treat, and provided fieldsupply of drugs.Increased milk availabilityIncreased milk availability was mentioned as one of the mostimportant household benefits perceived by women. Theywere asked to compare milk production before the projectand after in terms of quantity of milk available (Figure 3).The number of stones used in Ruvu was only 22 as thewomen had difficulty in understanding the concept of pilingstones to represent milk. When it was suggested that eachOctober 2002 19

4Steven Nalitolela and Rob AllportSPECIAL ISSUEFigure 3. Comparative increase in milk availability beforeand after the projectTable 1: Factors contributing towards project benefitsRank Ngage Loiborsoit Ruvu Remit1st Provision of drugs CommunityparticipationCommunityparticipation2nd CAHW activities CAHW activities Communitysensitisation andtraining3rd Presence ofsupportingveterinarianAvailability of drugs CAHW activities4th5th6th7th8thGood training givento CAHWsKnowledge of theimportance ofveterinary drugsCAHWs havingtransportCommunityparticipationClose-operationbetween communityand veterinarianKnowledge of theimportance of animalhealthFair price forveterinary medicinesCAHWs havingbicyclesEncouragement fromvisitors, both nationaland internationalCAHWs havingbicyclesTable 2: How had the project affected people’s livelihoods?Rank Ngage Loiborsoit Ruvu Remit1st Increased milkavailabilityIncreased milkavailabilityIncreased milkavailability2nd3rd4th5th6th7th8th9thMilk available for Improved humansale as previously health due to abilitythis was not possible to foot health billsGhee available forchildrenIncrease in livestockpopulationIncrease in livestocktrade and income* Increased ability topay school fees andcontribute incommunitydevelopmentprojectsIncreased incomeImproved ability toeducate childrenImproved quality andcleanliness ofclothingIncreased area undercrop cultivationGood meat available Increased ability tofor traditional meat build better housingeating camps, locallyknown as orpulImproved humanhealthAvailability of goodquality meatimprovedA sense of wellbeingresulting fromhaving a larger herdIncreased incomefrom the sale ofcattle has allowedan increase incultivationIncreased ability toprovide schooling forchildrenIncreased ability tobuild good housesImproved humanhealth* The attendance at community development sessions e.g. buildingclassrooms has increased as there is always a goat slaughtered at the endof the day. Larger herds have increased the ability of people to donategoats for development work.Relating benefits to livelihoodsConsidering the benefits described by the community interms of reduced cattle deaths and more milk, people wereasked how these benefits had affected their livelihoods. Findingsare summarised in Table 2.As milk availability seemed to be such an important indicatorfor the project, we looked more closely at the role ofmilk in the diet. We asked people to rank the foods makingup their staple diet in order of importance. They were thenasked to explain how dry years or times of high disease incidenceaffected their diet.In all cases milk was identified as the first food to disapstonerepresented one calabash they decided that 100calabashes of milk was too much. The actual figures in Ruvuwere one calabash before the project and 21 calabashesafter. These figures have been rounded to percentages inFigure 3 to enable comparison with the other two villages.Although cattle deaths due to ormilo have increased, theincreased calf survival is still large to offset increased cattlelosses and still remain with a large herd that increases milkproduction significantly.Project benefitsThrough semi-structured interviews, communities were askedto mention factors, which contributed to the project benefits(Table 1). The purpose of this exercise was to obtain communityperception on the linkages, if any, between project activ-ities and perceived benefits. The contributing factors werethen ranked in order of importance.20 October 2002

A participatory approach to assessing the impact of a community-based animal health project with Maasai communities in Tanzania4pear in times of stress, followed by meat and then maizemeal. Having a diet with plenty of milk was suggested as anindicator of high food security, whereas diets with moremaize and little or no milk indicate hard times. At the time ofthe assessment, milk constituted a large proportion of thediet in all communities and so they considered themselves tobe food secure.Comparing current situation of milk availability to establishedbaseline-using indicators identified by communitiesUsing ‘number of milking cows’ as an indicator for householdmilk availability we continued the impact assessmentconducting semi-structured interviews with 19 households. Ahousehold constituted a man, his wife or wives, children, andhis other dependants. The results were compared to a surveyof 121 households conducted in Simanjiro District seven yearsearlier (Muir, 1994) as shown in Tables 4 and 5.Future monitoring would involve periodic follow up ofthese herders to determine increase in milking cows in thehousehold.Lessons learnedLivelihood indicators for the futureThe assessment proved to be useful for identifying indicatorsfor future impact monitoring and assessment. For example,many of the livelihood benefits listed in Table 2 can be usedto assess future work. These benefits encompass aspects ofhuman health and nutrition, education, housing, trade, andsocial change. Therefore, the participatory approach clearlyshowed how improvements in animal health are linked to awide range of benefits in pastoralist communities.Improving the projectsCommunities in the three villages discussed project weaknessesand suggested future directions. Non-involvement indip rehabilitation was mentioned as the most importantweakness that needed to be corrected. Pastoralists in villagecommunities are the main beneficiaries of the animal healthservices. Conducting a participatory impact assessment gavethem a systematic means of explaining the benefits accruedfrom the project. It is important for sustainability that theysee the project as something beneficial to them. Impactassessment described here used simple participatorymethodologies to obtain community perceptions andimprove local ownership.Responding to new disease problemsThe impact assessment showed how a previously unknowndisease, called ormilo, had become a very serious problem.Table 3: The most important foodsRank Ngage Loiborsoit Ruvu Remit1st Milk Milk Milk2nd Meat Maize meal Meat3rd Maize meal Meat Maize4th – – Fat/oilsTable 4. Comparison of number of milking cows between1994 and 2001Number of cowsmilkedProportion of cattleowners in 1994 (%)(n=121)Proportion of cattleowners in 2001(%)(n=19)0 28 01 8 02 13 03 11 04 11 05 13 06-10 9 21>10 13 79Table 5. Comparison of milk-related indicatorsIndicator 1994(n=121)2001(n=19)Proportion of households milking at least one cow (%) 72 100Average number of cows milked per household 5 24Median number of cows milked per household 30 115Mean yield per milking (litres) 0.56 0.76Notes for Tables 4 and 5:Although the 1994 and 2001 figures are all derived from SimanjiroDistrict, the 1994 baseline was conducted in four villages and only one ofthese villages, Loiborsoit, was included in the impact assessment. As thereis also a marked difference in sample sizes (121 and 19), the comparisonis indicative only.Veterinarians had not been able to confirm the diagnosis ofthe disease and so a research project was initiated with thenational integrated tick and tick borne diseases controlproject coming in to investigate the problem. CAHWsassisted the research. They collected specimens such as bloodand gland smears, and brain squashes, and they recordedmorbidity and mortality in follow up herds in betweenresearcher visits. They also treated cases in accordance toinstructions given by researchers.Important aspects to consider while applying PRAmethods• Language: when using participatory methods, peoplemust understand clearly what is expected of them. Theyshould also be able to discuss and express themselves. InSPECIAL ISSUEOctober 2002 21

4Steven Nalitolela and Rob AllportSPECIAL ISSUEthis work the people were Maasai pastoralists. Althoughthey understood some Swahili (the national language),they spoke mostly the Maa language. For effectivecommunication Maa language was used. The main facilitatorused Swahili, which was translated into Maa by a cofacilitatorwho was fluent in Maa, Swahili, and English.During translation from local language to Swahili (orEnglish) there is a possibility that the local translator willgive his or her interpretation of what community membershave said rather than what they have actually said. Anunderstanding of local language even at rudimentary levelis useful to check such a trend.• Role of women: in pastoral areas, women have specificroles as far as livestock is concerned. Some project benefits,such as those related to milk production and calfdiseases, could be observed by women better than men.Therefore, women were given the chance to have separatediscussions on project impact.• Culture: issues discussed should not be culturally offensiveto the beneficiaries. As such, the checklist for SSI wasdeveloped jointly with the Maa co-facilitator in order toensure no culturally offensive topics were included.• Community description of diseases: as far as animal healthis concerned, pastoralists possess a rich body of knowledge.It is termed indigenous veterinary knowledge. Theydescribe various diseases in local terms, using locallanguage. Impact assessment involves the comparison ofanimal health situation before and after the project. Weencouraged community members to describe and namediseases in local terminology. Community description ofdiseases is therefore essential in order to obtain a reliabledisease situation trend.ABOUT THE AUTHORSSteven NalitolelaVetAid, PO Box 15249, Arusha, Tanzania.Email: pristeve@yahoo.comRob AllportVetAid, PO Box 15249, Arusha, Tanzania.Email: roballport@vetaid.netNOTESSteven Nalitolela is a veterinarian working withVetAid in Simanjiro district Tanzania. He hasworked in participatory animal health as wellas using an holistic approach to pastoralistvillage development. He has 16 years workexperience, with five years working atcommunity level with Maasai pastoralists.Rob Allport has been the Country ProgrammeCoordinator for VetAid in Tanzania sinceOctober 2000. He has experience inethnoveterinary knowledge research acquiredprior to becoming coordinator.FURTHER READINGA more detailed account of this work isavailable from the authors.Catley, A. 1999. Monitoring and ImpactAssessment of Community-based AnimalHealth Projects in Southern Sudan: Towardsparticipatory approaches and methods. Areport for Vétérinaires sans frontières Belgiumand Vétérinaires sans frontières Switzerland.Vetwork UK, Musselburgh.Muir, A. 1994. A Situational Analysis ofPastoralism in Simanjiro District, Tanzania.VetAid, Midlothian, UK.ACKNOWLEDGEMENTSThe impact assessment work described herewas funded by the Scottish CatholicInternational Aid Fund (SCIAF), Scotland. Thephotographs were provided by VetAidTanzania.22 October 2002

5Participatory impactassessment in Ethiopia:linking policy reform tofield experiencesSPECIAL ISSUEIntroductionThis paper describes how a national-level Participatory ImpactAssessment Team (PIAT) was set up in Ethiopia to informpolicy on the requirements for effective Community AnimalHealth Worker (CAHW) projects. There are two parts to thepaper. First, we describe how the PIAT was set up, its termsof reference and how training was provided in participatoryimpact assessment. We then summarise two impact assessmentsin the field, which were the first attempts by the PIATto use participatory approaches and methods.There is an increasing body of evidence from participatoryimpact assessment to show how community-basedanimal health workers (CAHWs) have a positive impact onlivestock-rearing communities (e.g. Catley, 1999; Nalitolelaand Allport, this issue). Improvements in basic animal healthcare provide more milk, meat, and livestock for sale. Moreprotein-rich food means healthier people and extra cash buysclothes and schoolbooks. Despite this, very few countrieshave policies in place to support CAHW systems and lack ofan appropriate ‘policy environment’ threatens the sustainabilityof such systems.Policy reform can refer to various types of information,collected using different methods. While it is often assumedthat objective, quantitative data is very important there are atleast three constraints facing the collection and use of statisbyCHARLES HOPKINS and ALISTAIR SHORTtically valid data in the areas where CAHWs tend to operate:• by definition, these areas are remote and little baseline datais available to guide randomised survey design;• the implementation of conventional surveys is logisticallydifficult, particularly in pastoralist areas where communitiesare widely dispersed and moving;• survey tools like questionnaires easily miss key perceptionsand opinions of local people, by asking the wrong questions.In addition to these well-known problems, policy makersmay dismiss even scientifically rigorous assessments if theyfeel isolated from the process or if work is conducted bypeople they don’t know and trust.The Ethiopian contextEthiopia is characterised by a huge livestock population andrural communities who depend highly on animals for food,income, draught power and social interaction. In thelowlands, pastoralists can keep mixed herds of camels,cattle, sheep, goats, and donkeys. In the highlands, settledfarming communities are also reliant on animals, particularlyoxen for ploughing, donkeys for transport, and varioususes of other animals. In both highlands and lowlands, theterrain is harsh, distances are long and infrastructure ispoorly developed.October 2002 23

5Charles Hopkins and Alistair ShortSPECIAL ISSUETable 1: Key veterinary agencies influencing policy change in EthiopiaNameFeaturesFederal government veterinary team, including staff from PACE Ethiopia Mandated to set national veterinary policy within the Ministry of AgricultureEthiopian Veterinary Association (EVA)Professional membership organisation with more than 485 members;influences professional norms and behaviour, and lobbies for policy andlegislative changeFaculty of Veterinary Medicine (FVM)Trains most veterinarians in Ethiopia and influences professional norms andbehaviour; conducts researchNational Animal Health Research Centre (NAHRC)Conducts research on animal diseasesNGOsClose and often long experience of working with communities to run CAHWprojects at field levelDuring the last ten years or so, non-governmental organisations(NGOs) have developed CAHW projects in Ethiopia,particularly in pastoral areas of the country. Despite this work,policy on CAHWs was poorly defined in Ethiopia andevidence of impact was limited. Veterinary professionalbodies had different views on whether or not to supportCAHWs, and how CAHW programmes should be developed.Forming and training the PIATIdentifying the key stakeholdersThe Pan African Programme for the Control of Epizootics 1(PACE) assists countries to revise policies to support CAHWs.Within PACE, this work is led by the Community-basedAnimal Health and Participatory Epidemiology (CAPE) Unit.In terms of influencing the veterinary profession and policymakers in Ethiopia, the actors described in Table 1 wereconsidered to be important by CAPE staff.Nineteen veterinarians 2 representing the agencies listedin Table 1 attended the workshop, including vets from eightNGOs 3 working directly with communities.Forming the PIAT in a review and planning workshopThe agencies listed in Table 1 were approached by the CAPEUnit and invited to a two-day review and planning workshop.It was explained that CAPE wished to support a PIAT inEthiopia with a view to using information derived from1 A programme of the African Union’s Interafrican Bureau for Animal Resources(AU/IBAR)2 From the Federal Veterinary Services Team, the head of the unit dealing withcommunity-based animal health workers and veterinary privatisation; from theFVM, the coordinator of postgraduate training, who was also the research andpublications officer for the faculty; from the EVA, a vet who was responsible foremergency preparedness and planning in the Ministry of Agriculture; from theNAHRC, a researcher who was already studying community-based deliverysystems.3 The NGOs were Save the Children UK, Save the Children US, Hararghe CatholicSecretariat, Action Contre la Faim, Pastoralists’ Concern Association of Ethiopia,CARE Ethiopia, Action for Research and Development, and the EthiopianPastoralist Research and Development Association.impact assessment to inform policy debate. Furthermore,CAPE could assist the new PIAT by supporting:• training in participatory impact assessment;• impact assessment of CAHW projects in the field;• presentation of findings to policy makers.The letter of invitation to the workshop was followed upby personal visits from CAPE staff to the heads of the FederalGovernment Veterinary Team (FVM) and NAHRC, and theEVA secretariat. During these meetings, the proposed roleand composition of the PIAT was discussed in detail. CAPEsuggested that the people representing these agencies in thePIAT should be people who already had an interest or knowledgeof participatory approaches, whose job descriptionalready covered issues such as CAHW delivery systems, andwhose seniority within the agency allowed direct feedbackto head of the agency.ObjectivesThe review and planning workshop was designed to:• introduce participatory approaches to impact assessment;• identify all the key stakeholders who were in a position toinfluence policy reform and discuss their roles;• review CAHW systems implemented in Ethiopia and identifykey policy issues;• understand the concept of monitoring and impact assessmentof CAHWs;• learn about experiences of participatory impact assessmentsconducted in other countries; and,• agree the composition of the PIAT and plan a participatoryimpact assessment exercise in Ethiopia, including a trainingevent and field assessments.MethodsThe workshop used various methods for critical analysis andsharing experiences of CAHW projects in Ethiopia. Forexample:24 October 2002

Participatory impact assessment in Ethiopia: linking policy reform to field experiences5Table 2: The ideal and the actual roles played by the important and influential veterinary policy makers in EthiopiaIdeal roleActual role• Creating enabling environment to endorse and legalise the system; • No enabling environment was established in some of the regions;• Producing training guidelines;• It was only recently that efforts have made in the area of training guidelinepreparation by the federal MoA;• Standardise the approach toward the CAHW system;• Little effort has been made to standardise the CAHW system so far;• Implement, supervise, monitor and evaluate the system;• MoA was not permitting some of the basic services to be included in theCAHW training courses (even though the needs assessments clearly indicateda demand for those services);• For the donor to fund the system and accept that the system needslonger funding periods.• Donors have been restricting the implementation to short duration fundingperiods in some cases.SPECIAL ISSUE• stakeholder analysis to determine who was important andinfluential within the CAHW systems;• SWOT analysis 4 for critically examining the effectiveness ofanimal health service delivery by CAHWs;• group work, in numbers between four and five persons, topermit as wide a range of points of view and experiencesto be shared amongst participants; and• plenary and brainstorming sessions to summarise progressand keep participants focused.The workshop was crucial in bringing veterinary professionalsin the NGO, state, research, and education sectorstogether to learn, listen, and share experiences. Commonunderstanding was reached on various issues related toCAHW projects, including assessment of the ‘ideal’ and‘actual’ roles of policy makers at the current time (Table 2).Key strengths and weaknesses of CAHW systems inEthiopia were also identified, such as the non-standardisationof the CAHW system, the duration and content of training,weak institutional linkages, drug source and supply,inadequate supervision of CAHWS, poor reporting, misuseof revolving funds, and also that the system was not yetfinancially sustainable. Added to this was the high drop-outrate of CAHWs. Factors seen as threats were subsidisedveterinary services (by government and NGOs), recurrentdrought, insecurity and conflicts (intra and inter), donor influenceand their short term funding horizons, the partialenabling environment, a lack of clear policy, and epidemiclivestock diseases.With these issues at the forefront of people’s minds, theywere able to describe how impact assessment of CAHWprojects was linked to policy. Key linkages are summarised inBox 1.At the end of the workshop, the dates and venue for atraining course in participatory impact assessment plus two4 SWOT – Strengths, Weaknesses, Opportunities and Threatssites for field assessment were agreed. Sixteen participantsconfirmed that they were available to form the PIAT, includingvets from the EVA, Federal Veterinary Services Team,NAHRC and seven NGOs.Training the PIAT in participatory impact assessmentFollowing the review and planning workshop, an eight-daycourse for the 16 participants of the PIAT was run with thefollowing objectives:• to introduce the principles of participatory approaches andsustainable development;• to understand importance of community entry and thecollection of background information;• to improve understanding and practice of participatorytools;Box 1: The need for linking project impact to policyreform for the future sustainability of animal healthservices in remote locations1. Impact of CAHWs to be shown to doubting policy makers andveterinary professionals;2. Assessments contribute to further harmonisation/standardisationof CAHWs;3. Better impact assessment results will attract more donor funding;4. Lessons learnt for future CAHW interventions;5. Provide agencies such as IBAR with a greater justification inpromoting CAHW systems;6. Justifies the bottom-up participatory approach used by CAHWs;7. Further enhances the surveillance and control of transboundarydisease;8. Identify weaknesses in the CAHW system and contribute topractical solutions for the service delivery agents;9. Show the impact of the CAHWs on the veterinary service deliverysystem;10. Positive impacts will convince policy makers to support moreenabling environment for CAHWs;11. Skill transfer to the veterinary profession will contribute toimproved assessments in the future and ‘better practice’ in thedesign, planning and implementation of CAHWs.October 2002 25

5Charles Hopkins and Alistair ShortParticipatoryimpactassessment withcommunities inNorth WolloParticipatoryimpactassessment withcommunities inAfarSPECIAL ISSUE• to understand how participatory assessments contribute tocommunity action;• to understand the value of participatory teamwork wheninteracting in the community; and,• to organise the impact assessment field work.The organisation of fieldwork included identification oftwo CAHW projects suitable for assessment. These projectswere selected using criteria such as:• areas that have well-established CAHW systems that havebeen running for around five years;• ideally, a pastoral area;• local partners who are willing to host the team, work withthem and create awareness with the community before theteam’s arrival.Using these criteria, a FARM Africa project in Afar regionand a Save the Children UK project in North Wollo wereselected for assessment. It was recognised that the assessmentof these projects was part of the training process forthe PIAT. The field-level work would be an opportunity topractice new methods while also generating information forpolicy makers.Using participatory impact assessment with twocommunities in Afar and North WolloThe impact assessments with communities followed onimmediately after the training course for the PIAT. Themethods used are summarised in Table 3.Some findingsIn North Wollo the CAHWs were especially successful but dueto policy, their services are limited largely to the treatment ofinternal and external parasites. In Afar their service is limitedas policy prevents them providing treatment for trypanosomiasisor to use injected antibiotics. In both locations, theregular supply of veterinary drugs remains a problem.Therefore, some important policy-related issues were:• there is a demand for services and a willingness to pay bypoor, often remote, rural livestock keepers;• with good training and follow up support, CAHWs can bevery competent deliverers of the service;• with a regular supply of veterinary inputs, funds collectedunder cost recovery can make the system financially viable;• with a relaxing of governmental control the services ofTable 3: Participatory methods used in the impact assessmentType of information requiredPRA tools used• Background about the communitySSI (semi-structured interviews) and mapping• Livelihood systemSSI, proportional piling• Livestock production systemSSI, mobility mapping• Livestock production and constraintsSSI, proportional piling.• Livestock diseasesSSI, ranking and matrixChanges due to CAHW projectBefore and after CAHWs• In veterinary services (quality, accessibility, sources)SSI, preference ranking• Morbidity and mortalityLocation Mapping• Livestock productivity and use of livestock productsSSI, scoring, proportional piling• Producers’ welfareSSI, scoring, proportional piling• Motivation of CAHWsSSI, scoring of income sources• Community’s general perceptions about the CAHW project SSI26 October 2002

Participatory impact assessment in Ethiopia: linking policy reform to field experiences5Table 4: Impact on the animal health service delivery systems in the two communitiesServiceindicatorsAfar (Telalak)Before CAHW project• clients travel 55km to access services;• government interventions focus on vaccinations and diseaseoutbreaks;• use of traditional healers important.After CAHW project• CAHWs make services more accessible and available;• growing importance of modern veterinary treatments at theexpense of traditional healers;• CAHWs are technically competent and provide 50% ofveterinary services;• there is strong supervision and follow up of the CAHWs.North Wollo (Sekota)Before CAHW project• since 1991 Government services responding to outbreaks 75kmaway;• since 1995 Government veterinary post in the community;• importance of traditional healers in the past.After CAHW project• declining importance of traditional healers and increasingimportance of modern veterinary services;• Woreda veterinary post provides antibiotics, diagnostic services,supervision of CAHWs and drug supply for CAHWs;• CAHWs provide treatments for internal and external parasites inthose more remote locations not accessed by the Governmentveterinary staff.SPECIAL ISSUECAHWincomesand welfareCAHWs are motivated to provide services due to theirtraditional obligations to clan and community; they lackbusiness management skills and have low cash incentive, butgain from the ‘free’ treatment of their own animals andimproved social status.CAHWs are motivated (with significant additions to their monthlyincome of up to 110 birr per month), they have strongadministrative skills (with excellent record keeping ability) andare technically competent (making their most significant impacton the health of goats through the use of acaricides).CommunitywelfareThe priority is for communities to access milk.There have been few welfare gains perceived by the localpeople largely to do with outside factors such as:• the poor health of camels (due to increased migration) whichprovide milk for children;• reduced cattle milk production as pastures declined, due toconflict;• this results in the need to purchase powdered milk as Afarcannot live without milk;• the increased sale of their animals in exchange for grain.The price of livestock is however increasing relative to grain(improved terms of trade).Oxen are especially important because of their draught power forploughing.• oxen draught power for ploughing has increased due topriority feeding strategy using crop residues and the CAHWtreatment of internal parasites;• weight gain of animals due to regular deworming servicesprovided by CAHWs;• increased added value of hides and skins due to thereduction of external parasites attributed again by thecommunity to the service provided by the CAHWs;• despite a general downward trend in milk yields (due to pastureshortage) the rate of this decline has been reduced due to theCAHW treatment of internal and external parasites.The impacts of the CAHW services have been most visiblyperceived by the community in the goat population and this hasresulted in increased income earning opportunities from thesale of these small ruminants.CAHWs can be improved to include vaccinations, the useof injected antibiotics, and other services;• the benefits of improved animal health are only fullycaptured if linked to other initiatives such as conflictmanagement and livestock marketing.Lessons learntUsing a participatory methodology is a way of linkingcommunities with the more influential professionals or‘outsiders’. The approach involved multiple professionalstakeholders, equipping them with powerful participatorymethods and placing them face-to-face with livestockkeepers. Using these methodologies is a way of bringingthe important and powerful more into contact with therealities in the field by observing, listening, sharing, andlearning from rural communities. It is essential to takeprofessionals out of the office if they are to realise theachievements and constraints of the CAHW projects to beassessed in remote and often harsh environments such asAfar and North Wollo.We encouraged a methodology that looked in detail atthe links between animal health and human livelihoods,rather than only measuring changes in the livestock diseasesituation. Therefore, we asked not only ‘How did livestockhealth change?’ but also, ‘What was the impact of thesechanges to people’s food, income or other measures of livelihood?’The approach also provided much scope for assessingthe affect of external factors on the projects.After the field assessments in Afar and North Wollo weasked the members of the PIAT to evaluate the process they’dbeen through, covering the initial review workshop, the trainingcourse and the impact assessments in the field. The threemost commonly expressed constraints were from the fieldwork:October 2002 27

5Charles Hopkins and Alistair ShortSPECIAL ISSUE• Not enough time – there was a general feeling within thePIAT that three weeks was insufficient time to conduct twoimpact assessments in the field, and that in future, moretime should be allocated to fieldwork.• Too much information – this problem was associated witha methodology that on reflection was probably too ambitious.The information needs listed in Table 4 were verycomprehensive. A balance has to be reached between thebackground information required on the project area interms of livelihoods, and the specific assessment of the projectsin question.• Difficulties in analysis and presentation – this was partly dueto the large amount of information collected by the team.They had problems compiling the information into formatssuitable for difference audiences, and within the time available.The findings from the impact assessments werepresented at the Ethiopian Veterinary Association 16thAnnual Conference in Addis Ababa in June 2002, and werewell received. The PIAT is now developing a work plan torefine the impact assessment methodology and conductfurther assessments of CAHW projects in representativeareas of Ethiopia. A more realistic timeframe will be developed.The intention is to build a national-level picture ofpolicy issues related to improved CAHW projects and involvinglivestock keepers.ABOUT THE AUTHORSCharles Hopkinsc/o VSF SwitzerlandPO Box 25656, Nairobi, KenyaEmail: charleshopkins29@yahoo.comAlistair Shortc/o VSF Switzerland (as above)Email: alistair3607@yahoo.comNOTESCharles Hopkins is a PRA trainer, formerly withSave the Children UK in Liberia but nowworking as an independent consultant.Alistair Short is an agricultural economistqualified from Reading University withexperience working for Vétérinaries sansfrontières in The Gambia, Liberia, southernSudan, and currently in north east Kenya.ACKNOWLEDGEMENTSWe’d like to thank the members of theEthiopia PIAT for their hard work and everyoneelse who contributed to this work and our sixweekmission to Addis Ababa, Afar, and NorthWollo.28 October 2002

6Community participation andthe global eradication ofrinderpestSPECIAL ISSUEby JEFFREY MARINER, PETER ROEDER and BERHANU ADMASSURinderpest and human livelihoodsRinderpest is a severe viral disease of cattle and wildlife thatcan cause near total mortality in its epidemic form. Historically,rinderpest was a disease of Europe and Asia, but thedisease was accidentally introduced to eastern Africa at theend of the 19th century by Asian cattle imported to feedcolonial armies. The epidemic spread as far as South Africaover the ensuing decade killing up to 90% of the cattle andsusceptible wildlife in its path. It is estimated that one-thirdof the human population of Ethiopia starved to death in thefamine that resulted. Rinderpest remained in Africa from thattime causing periodic epidemics with severe economic, foodsecurity, and social consequences.The disease is an important concern in internationaltrade. It was eradicated from Europe in the last century andonly ever occurred once in the Americas. The world veterinaryauthority, the Office International des Epizooties (OIE),was founded as a direct result of a rinderpest outbreak inBelgium and Brazil in 1920, caused by an infected shiploadof cattle originating from Asia. Countries that have rinderpestinfestation experience reduced access to internationalmarkets due to health restrictions on exports.The Global Rinderpest Eradication Programme (GREP)The Global Rinderpest Eradication Programme (GREP) wasestablished to coordinate and promote rinderpest eradicationworldwide. The strategy of the programme is timelyeradication in a sustainable and verifiable manner and reliesheavily on strategically focused vaccination and epidemiologicalsurveillance. The Food and Agriculture Organizationof the United Nations coordinates the global programme. InAfrica, GREP works in partnership with the African Union’sPan African Programme for the Control of Epizootics (PACE)that has the regional mandate for rinderpest eradication inAfrica.Only 15 years ago, rinderpest was present throughoutlarge parts of Africa, Asia, and the Middle East. By the early1990s, rinderpest had been eliminated from West Africa withthe help of mass vaccination campaigns. However, areas ofEast Africa still harboured the disease, particularly remote,pastoral areas. The disease persisted here due to the limitedavailability of livestock services and insecurity. For a period ofabout five years progress towards rinderpest eradicationappeared to stall.This paper will trace the evolution of ideas and reviewsome of the lessons learnt as part of the strategic revision ofthe rinderpest eradication programme. It is a story of progressionfrom top-down institutional design to grass-rootsempowerment where dialogue has mobilised communitiesand professionals to meet both local and international goals.October 2002 29

6Jeffrey Mariner, Peter Roeder and Berhanu AdmassuSPECIAL ISSUECalves dying ofrinderpest insouthern Sudan inthe early 1990s. Thedisease is knownfor causing highmortality in cattle.Conventional approaches to rinderpest control anderadicationTechnical issuesIn theory, rinderpest is an easy disease to eradicate. Animalsthat recover are immune for life and the rinderpest virus doesnot survive long outside the body. The virus is transmitted bydirect contact between animals. As a result, the diseasealways needs to find new, susceptible individuals to survive.Vaccination reduces the number of these susceptible animals.A vaccine developed in the 1960s, called by many thePlowright vaccine, is considered one of the finest animal orhuman vaccines ever developed and has contributed tremendouslyto the control of rinderpest. However, the vaccine hadone important constraint when used in the developing world– it required a strict cold chain from the point of productionin the factory to the cow, in order to keep the vaccine aliveand effective. This meant very costly and logistically complicatedinfrastructure was required to mount controlcampaigns. Refrigeration facilities, ice machines, cold boxesand fleets of vehicles were all essential. As a result, rinderpestcontrol was difficult to deliver and sustain in the lessdeveloped areas. Consequently, places such as remote andextensive pastoral regions, areas of insecurity, and othermarginalised areas lingered as reservoirs for the disease.In 1990, Tufts University and the US Department of Agriculturedeveloped a thermostable rinderpest vaccine (TRV)that utilised the Plowright vaccine virus but improved thepreservation process. The vaccine could be transported in thefield for up to 30 days without refrigeration. The thermostablevaccine was originally intended as a technical solutionto the problem of rinderpest control in remote,marginalised communities.The vaccine could now be delivered on foot, by horse,camel or bicycle. It could go to places without roads, electricity,generators or kerosene. Only the most basic equipmentwas required: a syringe, mixing bottle, needles, goodwater, and salt. Despite all these options, it was difficult forthe veterinary establishment to envisage change. Manyclearly wished to continue with conventional approaches tovaccine delivery based on government teams working fromvehicles, and requiring daily allowances.Socio-economic issuesAs TRV became available in quantity in early 1992-3, fieldstudies were undertaken to examine the options for vaccinedelivery to remote pastoral communities such as the Afar ofEthiopia, the Karamojong in Uganda, Nilotic peoples ofsouthern Sudan, and Arab and Fulani communities in easternChad. As conventional mass vaccination campaigns hadrepeatedly failed in these areas, the study team used a participatoryapproach to understand disease priorities, the dynamicsof rinderpest, and the root cause of the repeated failureof vaccination campaigns in each area.While communities explained how cattle raiding, intertribalconflict and war were common, they also noted howconventional vaccination was offered:• at inappropriate times relative to grazing schedules andbodily conditions;• at locations during seasons of high disease and parasiticburden;• at insecure locations;• for too short a period of time; or• not at all in some sub-sections of the community.Veterinary staff often acknowledged these local concernsbut noted that their budgets were woefully inadequate andthat when money did become available, it was often at thewrong time of year relative to the farmers’ needs. In severalcountries it was found that government or project accountingcycles determined the timing of campaigns. Teams wentto the field, fuel and allowances were spent, but the cattlesimply were not there.It was clear that a major communication gap existedbetween the livestock owners and veterinary services, whichcreated a loss of confidence on both sides. Veterinary staffwere rarely from the local community and often did not havean appreciation of the needs and mobility of the productionsystem, especially in the case of pastoral communities. Also,the community structure, leadership, and conflicts were oftennot fully understood. Knowledge of entry points for dialogueand decision-making was lacking – veterinary staff often didnot realise that services were not offered in a way thatallowed livestock owners to utilise them.Further discussion with livestock owners revealed how30 October 2002

Community participation and the global eradication of rinderpest6Communitybasedanimalhealth workersvaccinating cattlein the remoteAfar region ofEthiopia“It is a story of progression from topdowninstitutional design to grass-rootsempowerment where dialogue hasmobilised communities and professionalsto meet both local and international goals”SPECIAL ISSUEthey identified the training of local community members,working under the guidance of the veterinary department,as a good solution for their lack of services. This led to theidea that community-based animal health workers (CAHWs)could be trained in basic animal health care and rinderpestvaccination, using TRV.Community-based approaches to rinderpest controlEarly on it was recognised that for the community to fullyown the programme, it was essential that the CAHW systemshould meet their perceived needs and that they had beeninfluential in its design. When ranking diseases, rinderpestwas often ranked third or fourth priority. This was highenough to suggest that CAHWs would be able to addressrinderpest, but that other priority diseases needed also toreceive attention as far as it was possible to do so. Thus,CAHWs were trained and equipped on five to six other priorityissues in addition to rinderpest vaccination.Livestock owners identified the need for services whenand where the cattle were located by mapping. In somecommunities, specific grazing locations that lacked roadaccess were identified as areas where cattle from severalcommunities gathered. A good example was the swamps ofKaramoja. In terms of rinderpest eradication, the remotegrazing areas where cattle mixed were also a priority.Segments of the community that utilised these areas weresought out and asked to select trainees.The preparation of a rinderpest vaccine for injection andthe conduct of vaccination sessions requires good technicaland organisational skills. The CAHWs were trained by veterinariansin a ten-day course using participatory training techniques,first in the classroom and then in the field. By the endof the training they were able to complete the tasks faultlessly.Evidence of successWhen an animal (or person) is vaccinated correctly, thevaccine causes them to develop protection against thedisease in question. This protection can take the form of antibodiesin the blood of the animal, which neutralise thedisease agent should the animal become infected. One wayto measure the success of rinderpest vaccination is to checkhow many animals have produced antibodies. Therefore,vaccinations done by the CAHWs were assessed objectivelyat a number of project locations using blood samplescollected from cattle before and after vaccination, and measuringantibody levels at these two points in time.Under practical conditions, it is generally recognised thatan 80% vaccination success rate reflects good work. For themost part, conventional vaccination campaigns achievebetween 70-80% success rates; some are lower. It was foundthat CAHWs performed at least as well as the professionalservices. In fact, in the CAHW programmes that were evaluatedafter blood testing, all had success rates of over 80%.Some key lessons learntThe importance of dialogueThe more time that was invested in dialogue before trainingCAHWs, the greater the likelihood of smooth implementationand success. For example, experience showed thatcommitment to cost recovery, a key tenet of theprogrammes, was weak when communities were told of therationale and agreed to it after only brief discussion. Muchgreater success was achieved through repeated meetingswhere problems were posed in activities such as role-playingand communities identified their own responsibilities.Literate or illiterate CAHW trainees?Many educated stakeholders felt that literate CAHWs wererequired in order to read drug and vaccine labels and instructions.However, the project found that literate trainees wereover-qualified for the task. Often they accepted the trainingas a stepping-stone to higher life goals. Within six months,they had moved on. On the other hand, non-literate CAHWswere committed livestock owners firmly anchored within theOctober 2002 31

6Jeffrey Mariner, Peter Roeder and Berhanu AdmassuSPECIAL ISSUEExample of aproblempicture used inCAHW trainingcoursestraditional way of life and their communities. They were veryproud to be CAHWs and had no trouble mastering the issueswhen training materials were prepared in pictographic form.Seeing is believingThe thought of CAHWs conducting rinderpest vaccinationwas a concern in conservative professional circles. For some,this reflected a perceived threat to job security; in others itwas an issue of the quality of service. Both were validconcerns that needed to be addressed. Considerable effortwas invested in consulting veterinary stakeholders and insome cases, several years passed before pilot trials could beconducted. The key was to assure close monitoring andsupervision of all CAHWs by formally trained veterinarycadres and to design programmes with economic benefitsfor all stakeholders including formally trained veterinary staff.Despite positive technical reports and laboratory studies,many decision makers still remained sceptical. The realturning point came when policy makers got out to the field,interviewed participants and saw the CAHWs in action. Theimpact of field trips and study tours was truly remarkable.Years later, the Director of the Interafrican Bureau of AnimalResources of the Organization of African Unity humorouslydescribed one field trip as something akin to ‘a religious experience.’Perhaps, it was at this point that decision makersdeveloped a sense of ownership.Community-based approaches to rinderpestsurveillanceIn order to accomplish and sustain rinderpest eradication,vaccination programmes are followed by rinderpest surveillance.This involves stopping vaccination and being vigilantin case of disease resurgence. In order to verify the eradicationof rinderpest from a particular country, a set of internationalguidelines has been drawn up by the OIE. TheseBox 1: Participatory Disease SearchingParticipatory disease searching (PDS) is an inductive process of diseaseinvestigations. In the case of rinderpest, PDS can accomplish four basicgoals:1. find rinderpest if it is present, or provide evidence that it waspresent in the past;2. understand the way that rinderpest survives in a particular community;3. describe the epidemic cycle; and, thereby,4. help to identify effective intervention methods adapted to localconditions.Participatory disease searching is a hunt for disease. It has manysimilarities to good detective work where one starts by identifying thekey witnesses and interviewing them as to what they saw. Everywitness is interviewed and the testimony is weighed for credibility andcompared with the accumulating body of evidence. The attitude of theinterview team is one of respect for all views combined with criticalreview. Just as in good detective work, direct observations are madeand physical evidence, such as samples for laboratory investigation, iscollected. The results of observations and tests are interpreted togetherwith the oral testimony in group discussions by the PDS team, a multidisciplinaryteam including a veterinary and epidemiologists trained inPRA methods.Participatory disease searching is a targeted undertaking, but it isimportant that the process is not undertaken in a leading manner. ThePDS team usually presents the study as a general assessment of animalhealth and initiates interviews by asking general questions on animalhealth. If the respondents mention the target disease, the informationcan be followed up by probing questions and visualisation, rankingand scoring techniques.guidelines outline minimum surveillance requirements thateach participating country must meet in order to receiveinternational recognition of freedom from rinderpest. Inessence these standards are designed to ensure that countrieshave adequate systems in place to find rinderpest, if itwere present.Progressive veterinarians have long realised that pastorallivestock keepers often know a great deal about animaldiseases. Participatory methods are increasingly being usedand developed to make best use of this local knowledge forrinderpest surveillance. Although this might be viewed as anextractive use of the methods, rinderpest is nearly alwaysregarded as a devastating disease by livestock keepers and ifpossible they also want to eradicate the problem.The techniques of participatory rural appraisal offer keyadjuncts to laboratory-based epidemiology. Normally,pastoralists have a very well developed knowledge of clinicaldiagnosis based on symptomology and patterns of transmission,particularly in regard to major epidemic diseases such asrinderpest. They can very accurately recount the local historyregarding rinderpest and often are the first to recognise andreport the disease. The problem is that all too frequentlynobody listens. (FAO, 1996)32 October 2002

Community participation and the global eradication of rinderpest6One of the benefits of CAHW networks is improvedcommunication links between livestock owners and theveterinary establishment. As pastoralists and veterinariansestablish productive relationships, each group learns from theother. Although a lot remains to be done, most veterinaryservices are now more aware of the livelihood systems andthe animal health status of pastoral areas than they were tenyears ago. The mere presence of viable delivery systemsadapted to local conditions improves disease surveillance.In the process of setting up CAHW networks, it wasrealised that directly interviewing livestock owners on thepresence and history of rinderpest in their communitieswould greatly expand our understanding of the disease situation.This technique was termed participatory diseasesearching (Box 1). In high-risk areas, both GREP and PACEhave undertaken field studies that improved and in someinstances revolutionised the understanding of rinderpest fieldepidemiology in professional circles.Over the last decade, networks of CAHWs have beencreated in many parts of Africa and Asia. These networks,although endorsed by the veterinary services, are frequentlyhoused within development projects, emergency relief effortsor NGOs. They are ready-made disease information networksbut due to an absence of appropriate policies and frameworks,are not directly linked to national surveillance efforts.CAHW networks present a low-cost opportunity to respondto farmers’ reports with effective interventions tailored tosurveillance information. In the Horn of Africa, efforts arenow underway to develop stronger links with non-governmentaland private CAHW networks for official diseasesurveillance tasks.ConclusionCommunity-based animal health approaches have made aconsiderable contribution to the global eradication of rinderpest.The combination of appropriate technology, communityparticipation, and international rinderpest eradicationgave programmes a broad-based appeal that attracted theattention of communities, governments, NGOs, internationalagencies, universities, research facilities, and donors. Such adiverse range of organisations invariably brings together amotley assortment of individual perspectives. The process hasresulted in a significant exchange of ideas and an increasedunderstanding of the need for alternative methods to meeta common goal.No one involved doubts the need for strong conventionalveterinary capacities. However experience has shown thatthey are not enough to do the job in traditional productionsystems. Programmes must respond to the livestock owners’needs in order to succeed and this means that an element oflocal control must be included. More than just sterile technicaldata must pass up the chain of command. The paradoxand continuing challenge is how to effectively combine thetwo approaches yet it is certain that CAHWs can be effectiveeyes, ears, and hands at the service of communities andconventional veterinary services.SPECIAL ISSUEABOUT THE AUTHORSJeffrey MarinerRDP Livestock Services BVPO Box 523, 3700AM Zeist, The Netherlands.Email: jeffreymariner@yahoo.comPeter RoederAnimal Health ServiceFAO, via Delle Terme di Caracalla, 00100Rome, Italy.Email: peter.roeder@fao.orgBerhanu AdmassuCAPE, PACE ProgrammeAU/IBARPO Box 30786, Nairobi, KenyaEmail: berhanu.cape@telecom.net.etNOTESJeffery Mariner is seconded to the FeinsteinInternational Famine Centre, Tufts UniversitySchool of Nutrition by RDP Livestock Services.Peter Roeder is the Secretary of the GlobalRinderpest Eradication Programme working asan Animal Health Officer within the AnimalHealth Service of the UN’s Food and AgricultureOrganization.Berhanu Admassu works for the CommunitybasedAnimal Health and ParticipatoryEpidemiology (CAPE) Unit, Pan AfricanProgramme for the Control of Epizootics,African Union/Interafrican Bureau for AnimalResources.REFERENCESFAO, 1996. ‘Outreach to MarginalisedCommunities. The World Without Rinderpest.’Food and Agriculture Organization AnimalProduction and Health Paper 129, Rome, FAO.October 2002 33

7SPECIAL ISSUEVillage animal healthworkers in Nepal: the prosand cons of developing aNational Skills Testby KAREN STOUFER, NARAYAN D. OJHA and ANAND PARAJULIBackgroundThe Village Animal Health Worker (VAHW) training programmeof the United Mission to Nepal (UMN) began in January 1981,and is the longest continuously running programme of its kindin the world. United Mission to Nepal, (UMN), was establishedin 1954 as the first Christian consortium of its kind. Its objectiveis to serve the people of Nepal, especially the marginalised inunderserved areas, by enabling individuals and communities tosecure their basic needs in a sustainable manner through participationin effective and self-reliant Nepali organisations. Approximately90% of Nepal’s population earns their living fromfarming, and more than half of that is subsistence level farmingon farms of less than half a hectare. Livestock are an essentialcomponent of the farming system, providing manure forfertiliser and draught power in addition to products for food,cash, and social needs. Twenty eight percent of rural householdincome is directly from livestock.In the first 20 years, approximately 2000 VAHWs weretrained and approximately 75% of them were still servingtheir communities three to five years after their training. Theyprovide critical prevention and curative services to poorfarmers who are dependent on their livestock for survival, yethave no access to either private or government veterinaryservices. In 1991, there were 82 veterinarians serving farmersin a country with a human population of 22 million, andmore livestock per hectare of cultivated land than any othercountry in the world.Developing a National Skills Test for VAHWs in NepalAlthough widely respected in their communities, the VAHWstrained by UMN had no official recognition or legal registration.Therefore, in relating to the government veterinaryoffices in terms of referrals, vaccine procurement, or epidemiologicalcontrol measures, they were disadvantaged and notwell utilised. The government also trained VAHWs but evenrecognition of these VAHWs was variously applied.In 1997, the first conference in Nepal on the role of theVAHWs and their place in the national animal health care deliverysystem was held in Kathmandu. Participants included UnitedMission to Nepal representatives, Department of LivestockServices officials, representatives of the government agency fortraining certification (Council of Technical Education and VocationalTraining – CTEVT), European Union veterinary strengtheningprogramme, village animal health workers, andveterinarians. Participants were unanimous in their support forthe role of VAHWs, both those trained by United Mission toNepal and those trained by the government veterinary service.Small groups discussed and reached consensus on therole of the VAHW, quality assurance methods, and a list ofbasic skills that VAHWs should be able to perform. Perhaps34 October 2002

Village animal health workers in Nepal: the pros and cons of developing a National Skills Test7Village AnimalHealth Workersprovide valuableservices to thosedependent ontheir livestock“Perhaps the most difficult issue toresolve was the minimum standard ofeducation required by VAHWs, with thegovernment vets insisting on higherentry-level standards than NGO vets feltwas necessary or appropriate”SPECIAL ISSUEthe most difficult issue to resolve was the minimum standardof education required by VAHWs, with the government vetsinsisting on higher entry-level standards than NGO vets feltwas necessary or appropriate.At the end of the workshop, a resolution was passedwhich stated that a task force would be set up to carry forththe development of a nationally recognised skills test for allVAHWs under the auspices of CTEVT and with representationfrom both government and non-government organisationsand veterinarians. Networking groups and otherworking groups were also established, and three furthermeetings were held in 1998 to carry this forward.The final outcome of these efforts was the developmentof a standardised skills test for VAHWs to be administered bythe CTEVT. Successfully passing this practical examinationallows for the VAHW to be certified by the government andgiven status as equivalent to a government ‘level one’ post inthe civil service. This has resulted in greater recognition of thecontribution of VAHWs.In current practice, the certification process for UMNtrainedVAHWs works as follows:• VAHWs complete the two-week course. At the completionof the course, the VAHWs and the trainers jointly set goalsfor the next six months to apply and share their skills withtheir community.• After six months, the trainers meet with the VAHWs toreview their work and provide feedback. If at least 80% ofthe goals have been met by then, the participants receivea certificate for the training course.• Those who receive this training course certificate will beeligible to take the skills test examination after a minimumof one year's experience.Most VAHWs return for a four to five-day refresher coursepreceding the five-day skills test examination. Those passing theskills test examination receive the government CTEVT certificate.In contrast to the UMN approach to training, the Departmentof Livestock Services also trained VAHWs but using a35-day training course. These VAHWs were also required tosit the skills test.Experiences with application of the National SkillsTest for VAHWsWhile the development of the VAHW skills test was a greatstride forward, there have been problems in the practicalapplication of this. In some cases, the logistics of examinationshave been difficult, because many VAHWs live and workin very remote areas where it is difficult to conduct the skillstest examinations. In many cases, qualified and experiencedVAHWs cannot afford to come to the testing centres or payfor the examination, and the original sponsors who paid fortheir initial training are not willing, able or available to payfor their subsequent testing.But by far, the biggest difficulty has been inter-governmentagency issues. The Department of Livestock Services did notrecognise trainees from the UMN programme, despite theircertificates, because the training is only two weeks, and thegovernment trainees receive 35 days. The two-week trainingincludes a great deal of hands-on practical training, severalhours per day of instruction, quality trainee selection, subsidisedfunding, and trainers who are both professionally qualified aswell as trained in practical teaching techniques. Rather thanbasing recognition on examination results, or hours of classroominstruction, the Department of Livestock Services has beenOctober 2002 35

7Karen Stoufer, Narayan D. Ojha and Anand ParajuliBeing welltrainedas aVillage AnimalHealth Workerearned GyanMaya the respectof her farmingneighbours, bothmale and femaleSPECIAL ISSUEquite strict that a VAHW must have 35 days of instruction.Discussions are still going on, four years later, to resolvethese issues. Extending training to 35 days tends to eliminatemany qualified trainees who cannot afford to be away fromhome and farm, not earning income, for such a long time.Furthermore, the cost of the training increases significantlywhen the number of days is increased.However, this is still not fully recognised as equivalent tothe government-trained VAHWs who pass the same examinationbut have had 35 days training. There are now plans toadd a 15-day animal husbandry and management course sothe total number of training days will meet the Department ofLivestock Services requirement of 35 days (15-day initial training,5-day refresher, and 15-day husbandry and management).Evidence that a two-week training for VAHWs iseffectiveSince the VAHW skills testing began, a total of 223 peoplepassed out of a total of 381 taking the test, for a national 58.5%pass rate. If we look only at trainees of Animal Health andConsultancy Services (now an independent NGO partner ofUMN) that delivers the two-week training, 159 passed out of251 who took the test, for a pass rate of 63.3%. These resultssuggest that UMN trainees have acquired skills at least as goodas trainees of other programmes, whose composite pass ratewas 49.2%.ConclusionsGovernment certification and recognition has been seen asan important step in the development of VAHWs. It allowsthem to play a critical and essential role in national animalhealth programmes, and extends the reach of veterinary servicesto those who would otherwise have no access. However,this process has also tended to devalue those who, for whateverreason (such as no access to training centres), have notbeen able to achieve certification. The certification processof standardising requirements has also raised the selectionstandards for VAHW trainees. In some ways, this has been apositive step forward. However, it has also eliminated manyqualified and committed village people who lack the formaleducation standards (grade 10) required, which are seldomavailable to the poor, women, and those in very remote areas.One very positive outcome has been the recognition forthe VAHW training textbook produced by United Mission toNepal. Many training programmes around the world haverequested copies to use in their courses. The original Nepaliversion has been translated into English to facilitate this. Thegovernment of Nepal is also now using United Mission toNepal’s textbook in their own courses.Certification and recognition of the important role thatVAHWs play in livestock health and in poverty alleviationefforts for rural farmers have been positive steps forward thatbuild on the base of good trainee selection, adequate accessto medicines for VAHWs, practical training, and sufficientfollow-up after training.ABOUT THE AUTHORSDr. Karen Stoufer, Director, Rural DevelopmentDepartment, United Mission to NepalEmail: stoufer@wlink.com.npMr. Narayan Ojha, United Mission to NepalEmail: Narayan.Ojha@umn.org.npMr. Anand Parajuli, United Mission to NepalEmail: rdc@umn.org.npUnited Mission to Nepal, Box 126Kathmandu, Nepal.NOTESDr. Karen Stoufer, a veterinarian, currentlyserves as Director of Rural Development forUnited Mission to Nepal. She and her familyhave worked in community development andtechnical training with UMN in Nepal for 12years as fieldworkers for Christian VeterinaryMission, Seattle, WA, USA.Narayan Ojha is chairman of the Animal HealthTraining and Consultancy Services and hasworked with UMN in the areas of animalhealth training and community developmentfor 13 years. He has a Masters degree insustainable development from the School forInternational Training in Vermont, USA.Anand Parajuli is the Assistant Director of theRural Development Centre of UMN and has aBachelors degree in livestock from TribhuvanUniversity, Nepal. He has worked for 12 yearsin livestock development, the most recent fourwith UMN managing and delivering animalhealth and husbandry training.36 October 2002

8Doing it for themselves: howcommunities developedmessages and communicationmethods for rinderpesteradication in southern SudanSPECIAL ISSUEby BRYONY JONES, ALUMA ARABA, PETER KOSKEI and SAMUEL LETEREUWAIntroductionAs explained in the paper by Jeff Mariner and colleagues inthis issue of PLA Notes, rinderpest is a devastating livestockdisease of major international importance. In southernSudan, livestock keepers associate the disease with disaster.Without cattle, they lose their main source of food, socialcapital, and reason for being.The Operation Lifeline Sudan (OLS) Southern Sector LivestockProgramme is a consortium of non-governmentalorganisations (NGOs) coordinated by FAO-OLS (Food andAgriculture Organization of the United Nations and OLS). Theprogramme aims to improve food security for the waraffectedcommunities in southern Sudan through improvinganimal health. In 1993 a community-based approach wasdeveloped which focused on training of community-basedanimal health workers (CAHWs) to vaccinate cattle againstrinderpest and treat common ailments. In 2001, theprogramme comprised approximately 1400 active CAHWssupervised by 180 animal health auxiliaries (AHAs) and stockpersons.Overall technical supervision was provided by 35veterinarians and livestock officers working for 12 NGOs andFAO. In collaboration with the Pan African RinderpestCampaign (PARC), the programme contributed towards aglobal effort to eradicate rinderpest. In 2001, PARC wasreplaced with the Pan African Programme for the Control ofEpizootics (PACE) and Vétérinaries san frontières-Belgium(VSF-B) was given the task of implementing rinderpest eradicationactivities.Complex messages in a complex situationThe community-based approach to rinderpest control insouthern Sudan proved very successful and by late 2001there had been no confirmed outbreaks of rinderpest for overthree years. However, at this time the programme was facedwith a major dilemma. Typically, rinderpest eradicationinvolves mass vaccination followed by a period of no vaccination,but actively watching and waiting to see if the diseasereappears. During this surveillance period, new outbreaks aredetected rapidly and further, localised vaccination removesthe disease for good. Rapid detection of outbreaks requiresgood relationships with communities who act as theprogramme’s eyes and ears on the ground.However, for many years people had been very happywith regular vaccination campaigns and they recognised theireffectiveness. Therefore, programme staff realised that a newsurveillance strategy would be a major change for communitiesand field-level veterinary workers. It was anticipatedthat people would not be happy with the change, would notunderstand the reasons for change, and might lose confidenceand reduce their involvement in the programme. TheOctober 2002 37

8Bryony Jones, Aluma Araba, Peter Koskei and Samuel LetereuwaSPECIAL ISSUE“The challenge was to explain the new,potentially confusing strategy tocommunities, remove fears about thecessation of vaccination, and createmomentum and commitment for aperiod of ‘watching and waiting’ “challenge was to explain the new, potentially confusing strategyto communities, remove fears about the cessation ofvaccination, and create momentum and commitment for aperiod of ‘watching and waiting’.As the need for a good communication campaign beganto emerge, there was also recognition of the operationalconstraints in southern Sudan. The area has very little infrastructuredue to chronic civil war, and mass media communicationmethods such as newspapers, radio or televisionwere not available. There was also the challenge of developingcommunication methods to maintain awareness andinterest in the issues for a long period – the surveillanceperiod after stopping mass vaccination and before declaringfreedom from rinderpest is five years.An approach to local development of extensionmessages and materialsFor many years, veterinarians have been describing how livestockkeepers in southern Sudan possess considerable indigenousknowledge on livestock diseases. This knowledgeformed the basis for the community-based programme andcontributed towards programme design, implementation,and impact assessment. Furthermore, it was known thatverbal communication and song was central to the cultureof cattle-keeping communities in southern Sudan.Given this situation, VSF Belgium decided to use communitymembers to assist them to develop appropriate messagesand methods for communicating the new rinderpest controlstrategy. The idea was to explain the new strategy to somefield-level workers, artists, songwriters, and storytellers andrequest them to develop stories, songs, poems, and illustrationsfor transferring the messages within their communities.Any new message and method was to be tested in the fieldusing a real community audience.Box 1. Creating awareness among partners and trainingveterinary workersAwareness-raising workshops for programme coordinators, fieldveterinarians, and county/district veterinary coordinatorsThe new strategy was introduced during two two-day workshops,which aimed to build on the existing knowledge of the participants,introduce the components of the new strategy and allow discussionand raising of fears, and then develop action plans of how toimplement the strategy for vet workers.Training course for field veterinarians and Animal HealthAuxiliaries (AHAs)A six-day training course was developed to train vets and AHAs indetail in the new strategy and the components, and carry out practicalsin outbreak investigation, active surveillance and develop action plans.This was field-tested and modified and then later edited again in thelight of further experience.Training course for CAHWsA training course was developed, field-tested and modified beforebeing documented and circulated for all animal health workers to useto inform the CAHWs of the new strategy. Also, a Community DialogueMeeting Programme was developed, field-tested and modified beforebeing documented and circulated. Some existing cloth flip charts(copied from the Pan African Rinderpest Campaign in Uganda) wereput into use to assist with training, and some photographs from FAOarchives were printed and laminated as rinderpest identification cards.Stage 1: Explaining the new strategy to programmemanagers and technical staffThe first stage was a series of awareness-raising and trainingevents with programme managers and various levels of veterinaryworkers in the programme. These events were designedaccording to the roles of the participants in the programmeand ensured that all technical staff were well informed aboutthe new strategy and had an opportunity to ask questions andclarify any misunderstandings. Bearing in mind the scale ofthe programme it was necessary for all animal health workersto understand and be able to explain the new strategy to thelivestock owners. Many participants were familiar with participatoryapproaches and worked closely with communitiesduring normal CAHW project activities.Stage 2: Developing messages and methods withcommunitiesOnce the programme staff and veterinary workers weretrained, a four-day workshop was organised to bring technicalstaff together with community members to develop andtest extension messages and methods for the new rinderpeststrategy. The workshop was carried out in Marial Lou, TonjCounty. Participants included AHAs and stockpersons, fieldveterinarians, animal health trainers, community membersfrom Tonj County (singers, composers, teachers, story-tellers),and an artist and a film maker, both from Equatoria in southernSudan. The participants from the community wereselected by asking local people for the names of people whowere known for their musical, story-telling or artistic skills.The teachers were invited from the local school.38 October 2002

Doing it for themselves: how communities developed messages and communication methods for rinderpest eradication in southern Sudan8Box 2. Activities in the first community workshop• Introductions and expectations.• Methods of communication: discussion on what methods people usewithin their community to pass information (traditional and modern).• The new rinderpest eradication strategy: explaining the key points ofthe strategy that needed to be communicated to the widercommunity.• The target community: discussion on who are the different types ofpeople who need to know about rinderpest eradication in order toplay their role.• Development of community awareness-raising materials: break upinto groups to develop different methods of communicating some ofthe key pieces of information; groups were song/dance, stories anddrama, pictures, community dialogue, education.• Demonstration of community awareness-raising materials: thegroups came back to the main workshop and performed orpresented their work, and received feedback from the otherparticipants.• Preparation for the community dialogue meeting: a programme for acommunity meeting was developed and different people assigned tolead different sessions, and pictures, songs, poems, and stories wereintegrated to introduce, illustrate or stimulate discussion.• Community dialogue meeting on rinderpest eradication: a four-hourmeeting was held for community leaders and members from in andaround Marial Lou. Participants numbered over 100 and includedmen, women, and children.• Review of community dialogue meeting: the workshop participantsevaluated the meeting and identified improvements for futuremeetings.Below: Practising a song in theworkshop in Marial Lou; and (bottom)Women’s Association in Akobo sing anddance with John Jooyul, VSF Belgium vetSPECIAL ISSUEThe workshop aimed to build on the existing knowledgeand experience of the participants, and used several participatorytechniques: plenary discussion, group discussion,brainstorm, and question and answer. The sessions wereconducted in English with translation into Dinka, the locallanguage.The workshop was felt to be a great success for the developmentof materials for extension of the rinderpest eradicationstrategy and as an opportunity to explore generally theprocess of dialogue and communication methods. Levels ofparticipation and innovation were high. The singing anddancing group attracted the most interest from the participantsand from the local community. This is a very entertainingand powerful way of passing messages. The use ofdramas and stories captured interest and appeared toincrease understanding of the points being made. The apparentlydifficult concept of stopping rinderpest vaccination waseasily understood.Stage 3: Scaling upFollowing the success of these workshops, the next stage wasto spread the approach throughout the programme. Thecommunity-level workshops (Stage 2) were incorporated intoA song: We are fighting rinderpest (led by Luka Malok)I do not like dwelling with the devil disease whose eyes look badWe are fighting rinderpestI do not like dwelling with devil disease whose horns look very roughWe are fighting rinderpestI do not like dwelling with devil disease whose claws look roughWe are fighting rinderpestThis disease which has comeIt used to give the cow diarrhoea, eye discharge, tearing and nasaldischargeCall the people of VSF to draw the blood for checking rinderpestCall the people of FAO to draw blood for checking rinderpestTraditional stories were also adapted to explain the newrinderpest strategyImagine you must to kill your most dreaded enemy and you see himenter his hut. You take your gun and fire into the hut. You fire a lot ofbullets into that hut to make sure your enemy is finished. But do youkeep firing forever? No, sooner or later you stop. You wait outside thehut to see if the enemy reappears. Then when you see no sign of him,you approach the hut and look very carefully inside to make sure thatonce and for all, your enemy has gone. This is like rinderpest. Wevaccinate for many years and then we stop, wait, and watch.October 2002 39

8Bryony Jones, Aluma Araba, Peter Koskei and Samuel LetereuwaSimon Gatweekand Thomas TutPal use cloth flipchart pictures inAkoboExample ofa pictureused in thecloth flipchartsSPECIAL ISSUEthe training course for field veterinarians and AHAs, so thatas they learned the new strategy, they also explored and practicedmethods of communicating that strategy to theircommunity.The rinderpest eradication training course has now beenheld in thirteen counties or states including the communicationcomponent. The communication component is alsoincluded in the AHA training course as a practical exampleof how to communicate important information to thecommunity. Innovation among the veterinary workers isencouraged so that communication methods can varyaccording to the preferences of different communities, andlanguage and cultural variations. The important point is toretain the key concept in all the methods – of stopping vaccinationand conducting surveillance.In different areas a variety of communication methodshave been developed. Some groups focused more on dramaand poems, others on songs, others on stories, and otherson pictures. All put these to use during the subsequentcommunity dialogue meeting. In one area, it was noted thatthe youth were not really included and therefore, a dancewas organised. Input from the project was some batteries forthe music system and some bars of soap for prizes. In aninterval during the dance the AHAs made a presentation onrinderpest eradication and gave a prize to the person whocould describe the clinical signs of rinderpest the best.In another area a football and volleyball match was heldfor competing teams of youth. Again the opportunity wasseized to pass some information on rinderpest eradication.In another area they went to the local school and madepresentations on rinderpest to the school children. There hasbeen demand for audiotapes and batteries so that songsdeveloped in their home areas after the training coursescould be recorded.Lessons learnt• In rinderpest eradication, the shift from mass vaccinationto surveillance is a difficult concept – some vets find it difficultto understand! Despite this, artists, songwriters, poets,and others in communities were able to grasp the idea andtransform it into locally appropriate messages andmethods.• The incorporation of songs, drama, pictures, and so onmakes communication with the community more fun, andeasier to get and hold people’s attention.• The animal health workers have reached a wide audienceincluding women, children, and youth. Serious formalspeech-type meetings mainly attract mature men, butwhen a song or drama is performed all members of thecommunity are attracted to find out what is going on andthe reduced formality allows them to stay and participate.• The approach has increasingly moved the responsibility forcommunication to the Sudanese animal health workers andaway from the field veterinarians (who are mostly fromother communities or countries). It has encouraged them tointerpret the information into their own language in a waythat lay people can understand and can actively communicate.40 October 2002

Doing it for themselves: how communities developed messages and communication methods for rinderpest eradication in southern Sudan8Nhial Riek andSimon Gatweekpractice a dramaabout rinderpestsurveillanceinnovatively and not to stick to the usual method oftalking only. Information flows quickly and as someanimal health workers have heard about what has goneon in other areas, the method has gained some momentumand almost competitiveness to produce better songsor pictures or dramas for their own area.• It is an effort for some field vets and animal healthworkers to be innovative and some are initially reluctantto participate, but as they see others getting involved thisreluctance breaks down and some individuals suddenlydemonstrate hidden talents!• More ideas for different communication methods areregularly coming up. It is hoped that these will continueto maintain interest and awareness in the programmeuntil rinderpest eradication is finally achieved.SPECIAL ISSUE• It has brought out skills of some of the animal healthworkers who may be less academic but are goodperformers and communicators.• The workshops tried to encourage people to think moreIs this a participatory process?Rinderpest is a disease of global concern and our workcontributes to the Pan African Programme for the Controlof Epizootics and the Global Rinderpest EradicationProgramme. The eradication strategy is designed byepidemiologists far from the field, who expect communitiesto ‘participate’. In southern Sudan, this is not aproblem. Here, people have long recognised the terribleimpact of rinderpest and have been working with theprogramme for nearly ten years. Therefore, the programmeis a good example of ‘outsiders’ and communities workingtogether.Now if you go to Marial, even the children are singingthe rinderpest songs.ABOUT THE AUTHORSBryony Jones, VSF-Belgium, PO Box 13986,Nairobi, Kenya.Email: bjones@vsfb.or.keNOTESAll the authors are veterinarians working forthe Fight Against Lineage One Rinderpest VirusProject for southern Sudan, implemented byVSF-Belgium.ACKNOWLEDGEMENTSThis work was initiated and supported duringthe early stages by the CAPE Unit, PACEProgramme, AU/IBAR and implemented byVSF-Belgium. The main donor of the CAPEUnit is DFID. VSF-Belgium has continued thework as part of the Fight Against Lineage OneRinderpest Virus Project for southern Sudan,which is funded by the PACE Programme ofAU/IBAR, an EC-funded programme.Thanks go to all the communities, animalhealth workers, and field personnel of NGOsand FAO who have enthusiastically participatedin this work.October 2002 41

9SPECIAL ISSUELinking research andcommunity-based animalhealthcare in East Africaby ANDY CATLEY, LIEVE LYNEN and STEVEN NALITOLELAIntroductionAlmost by definition, community-based animal healthprogrammes operate in more remote and marginalised areas.Difficult access to these areas often means that limited diseaseinvestigation or research has been conducted and therefore,basic technical information on livestock diseases is lacking.During participatory assessment, livestock keepers usually identifya limited number of important diseases that can beprevented or treated by community-based animal healthworkers (CAHWs). Typically, the selection of medicines to reduceproblems such as worms, ticks, trypanosomiasis or otherdiseases is decided by a veterinarian or animal health assistant.Professional judgements are made concerning the most appropriatetypes of medicines to use, and how to use them. Thisapproach enables CAHW programmes to become functionalrelatively quickly and people soon see the benefits of improvedanimal health. However, there are important limitations:• Some important diseases ‘look the same’. They showsimilar clinical signs and can only be distinguished usinglaboratory tests or other diagnostic procedures. To complicatematters, an animal can also be suffering from two ormore diseases at the same time. In remote areas, thenearest laboratory can be many kilometres away and bloodor tissue samples are easily spoiled in transit to the laboratory.Even when diagnostic tests are available for field use,veterinarians can lack the specialist skills required to useand interpret the tests correctly. If identification of a diseaseproblem is incorrect, CAHWs will be trained to prevent ortreat the wrong disease.• Even when diseases are correctly identified and successfullycontrolled in the short-term, long-term control strategiesrequire an understanding of the epidemiology andeconomics of disease. The epidemiology of livestockdiseases is often complex and sub-optimal use of medicinescan lead to drug resistance. Medicines used in CAHWprogrammes include drugs to control worms(anthelmintics), bacterial infections (antibiotics), blood parasites(e.g. trypanocides), and ticks (acaricides). Resistanceto all these drug types is common, even in relatively developedareas where veterinarians control drug distributionand use. As CAHW programmes develop, veterinary professionalsneed to provide advise on the use of medicinesbased on technical information.Both these issues indicate that CAHW programmes canbe strengthened through linkages with veterinary investigationspecialists and researchers. This paper describes howsuch linkages were developed in southern Sudan, Kenya, andTanzania. It discusses how both CAHW programmes andresearchers benefit from working together using participatoryresearch approaches.42 October 2002

Linking research and community-based animal healthcare in East Africa9What’s yourdiagnosis? A thincow in southernSudan could besuffering fromvarious diseasesSPECIAL ISSUELinking community-based projects to veterinaryresearchersThe Participatory Approaches to Veterinary Epidemiology(PAVE) project at IIED ran from 1998 to 2000 and aimed toassess the roles of participatory appraisal in veterinary investigationand epidemiology. The first stage of the project was asurvey of veterinarians working in Africa to find out if and howthey were using participatory approaches and methods. Animportant finding of the survey was that although many vetsconsidered participatory approaches to be good for buildingbetter relationships with communities, they also felt thatparticipatory methods were not reliable and therefore, notacceptable to senior decision makers (Catley, 2000). For veterinaryresearchers, there was a strong feeling that ‘we can’tpublish papers if we use these methods, and we mustpublish.’Therefore, PAVE focused on assessing the validity and reliabilityof methods. The research methodology was based ona series of disease studies and comparison of results derivedfrom participatory and conventional veterinary methods. PAVEhoped to work with field-level animal health workers todesign and implement studies on disease problems. The criteriafor selecting research partners and topics for researchincluded:• evidence that livestock keepers had requested assistance tosolve a particular disease problem;• presence of a well-established and functional animal healthservice at field level, with good links to communities; and• capacity for sharing of research costs with PAVE.PAVE was not restricted to specific disease problems. Withthese criteria in mind, PAVE approached government veterinaryservices, research institutes, and non governmentalorganisations to identify research topics and partners. TwoPAVE studies involved work with CAHW programmes insouthern Sudan and Kenya, as summarised in Table 1.The Ormilo Research Project is based at the VeterinaryInvestigation Centre, Arusha, Tanzania and is ongoing. Ormiloemerged as a problem in northern Tanzania around 1980 andwas diagnosed by veterinarians as bovine cerebral theileriosis1 (using molecular diagnostics tools). The outputs of theproject were to confirm the incidence of the disease, to assessits true social and economic impact, to record the presence ofblood parasites and other possible disease agents and riskfactors, and to make a start in understanding the epidemiologyof this disease. One interesting feature of the disease wasthat the causal parasite was previously thought to be harmlessto cattle. The project also aimed to evaluate possible treatmentregimes and to develop appropriate control methods.1 This disease is caused by a parasite called Theileria taurotragi that is transmittedby ticks. Affected cattle show signs of nervous system disease.October 2002 43

9Andy Catley, Lieve Lynen and Steven NalitolelaSPECIAL ISSUETable 1: Research activities involving community-based animal health programmesDescriptionCommunity-based animal healthprogrammesTechnical partnersSouthern SudanPAVE Project:Diagnosis of liei, a chronic wasting disease in cattle WesternUpper Nile, Upper Nile, and Bahr el Ghazal, with Nuer andDinka communities. Local characterisation of diseases andcomparison with veterinary opinion, pathological examination,and laboratory investigation.KenyaPAVE Project:Studies on bovine trypanosomiasis or gandi with Ormacommunities in Tana River District. Local characterisation ofdisease, incidence estimates, and analysis of preferences fordisease control methods.TanzaniaOrmilo Research Project:Studies on bovine cerebral theileriosis or ormilo with Maasaicommunities in Arusha region. Sampling of clinical cases,estimates of disease incidence, drug trials on clinical cases• Operation Lifeline Sudan (SouthernSector) Livestock Programme• VSF Switzerland• Save the Children UK• Catholic Relief Services• Diocese of Malindi• VETAID-Tanzania• Ilaramatak (a local pastoralist NGO)• Kenya Trypanosomiasis Research Institute(KETRI)• Kenya Trypanosomiasis Research Institute(KETRI)• Veterinary Investigation Centre, Arusha(Ministry of Water and LivestockDevelopment)• Sokoine University of Agriculture, Tanzania• University of Pretoria, South AfricaWho was saying that the research was needed?In the three studies outlined in Table 1, there was strongevidence that the research topic was a priority for livestockkeepers. In southern Sudan, the disease called liei wasmentioned with increasing frequency by herders to NGO vetson the ground. The exact diagnosis of this chronic wastingdisease, and therefore the most appropriate treatment, wasthe subject of debate among vets and herders. In Kenya,trypanosomiasis in cattle was considered a priority by cattleherders in Tana River and there was regular purchase of drugsto prevent and treat the disease. However, the KenyaTrypanosomiasis Research Institute was keen to test alternativemethods of disease control, and was also concerned thatsub-optimal use of drugs might lead to drug resistance.Therefore, the Tana River study included participatory analysisof control methods for trypanosomiasis and identificationof best-bet solutions. In both studies, research objectives andstudy locations were defined with partner organisationscentrally. However, the detailed design of the research wasconducted at field level with the assistance of various localplayers, including CAHWs.In the Ormilo Research Project, the need to investigatethe disease was articulated by livestock keepers during participatoryranking of priority diseases in 2000 and 2001 carriedout by another project, the Tick and Tick-borne DiseaseControl Project. Ormilo was ranked as the highest diseasepriority by pastoralist communities and up to 80% of affectedanimals died. Conventional and ethnoveterinary controlmethods had proved to be unsuccessful.Roles of community-based workersResearch designIn more effective community-based animal healthprogrammes, communities select workers who arerespected, active, good communicators, and who possessknow-how of livestock management and diseases. Therefore,when designing research activities it is useful to forma team comprising the ‘outsider’ researchers and field-levelworkers. CAHWs and other workers can provide informationon issues such as:• history of the communities;• community leadership and organisation, and local politics;• location of livestock and communities, and seasonal movements;• appropriate ways to approach communities and convenienttimes for meetings and other activities;• logistics – condition of paths, roads, and rivers; areas ofinsecurity; and,• possible expectations of communities.Although CAHWs may be illiterate, methods such asparticipatory mapping by groups of CAHWs can be veryuseful for visualising the research area and identifying specificcommunities or livestock herds for research activities. Thisapplies to either purposive or random sampling approaches.In all three studies described here, CAHWs were involved inidentifying research sites.Research implementationIn addition to helping with planning the research activities on44 October 2002

Linking research and community-based animal healthcare in East Africa9Well establishedcommunitybasedprogrammes insouthern Sudanuse participatorymethods toanalyse livestockdisease problemsSPECIAL ISSUEthe ground, community-based workers can also greatly assistwith research implementation. For example, in the PAVEstudy in southern Sudan, local workers were trained as translatorsand facilitators for participatory methods.Another important task can be sampling animals andwith some additional training, CAHWs soon become skilledat taking blood or other samples. Commonly, livestock areless disturbed by CAHWs than by visitors, and the samplingis actually easier with CAHWs than people with more formaltraining. Also, livestock keepers may prefer to have localCAHWs rather than outsiders handling their animals. In thePAVE Project in southern Sudan, CAHWs had been previouslytrained by UNICEF, Save the Children UK, and Vétérinairessan frontières-Switzerland depending on location. Forthe research, further hands-on training was provided incollection of blood samples from the jugular vein into bloodtubes (vacutainers). A vet supervised the CAHWs when theywere sampling. Here, it was clear that pastoralist CAHWswere used to bleeding cattle and easily located a jugularvein, even in fractious animals.In the Ormilo project a different approach was usedbecause the project involved regular monitoring of sentinel 2herds in locations where no vets were present. The CAHWshad already undergone a two-week training course in 2000at the Simanjiro Animal Health Training Centre, implementedby an NGO called Ilaramatak in collaboration with VetAidTanzania. They had also received an additional two weeks offollow-up (refresher) training in 2001. At the start of theproject, further training was given to CAHWs on samplecollection, filling in of clinical cards, and clinical examinationof animals as well as post mortem examinations.Drug treatments were discussed as well as dosage andweighing of animals. Equipment such as microscope slides,slide storage boxes, alcohol preservatives, drugs, and needleswere handed over to the CAHWs. A researcher or fieldofficer visited the CAHWs every two weeks and all samplescollected were handed over. This project also used CAHWsto administer on-the-spot treatments to cases of ormilo andin some cases, administer daily injections for up to four days.2 The sentinel herds comprised livestock managed under normal field conditionsby their keepers, and which were used to detect new cases of Ormilo and testdifferent treatments.October 2002 45

9Andy Catley, Lieve Lynen and Steven NalitolelaSPECIAL ISSUEBox 1: CAHWs and research implementation■ Identifying informants and organising groupsAs CAHWs can have very good relationships with communities andknow who is who, they can assist with identifying informants andorganising groups for discussions and sessions using participatorymethods. CAHWs can be key informants for identifying otherinformants of various categories e.g. men and women, rich and poor.■ TranslationCAHWs can be good translators if they speak the languages of theresearchers and the community, but the usual rules apply. They can bebiased and careful practice of interviews is required to ensure thatquestions and answers are properly translated. Translation is a skill –despite practise, not all CAHWs will make good translators.■ SamplingRoutine training of CAHWs does not usually include sample collection.However, with additional training they often become skilled at takingblood or other samples. Teams of CAHWs, supervised by researchers,can be very efficient at this task.■ Administering trial treatmentsAfter sampling, a research project may require administration of trialmedicines. As CAHWs are always with the animals, they can providethese treatments and record their activities. As with sampling,additional training is usually needed.■ Disseminating findingsAn existing network of CAHWs is a ready-made system fordisseminating research findings to livestock keepers. Dissemination canbe via community meetings or individual contact with people. Methodsinclude simple oral transfer of news about a project to disseminationof leaflets or other materials.■ Applying new disease control strategies, better use ofmedicinesWhen research leads to recommendations about improved ways tocontrol disease, researchers can work with trainers of CAHWs toincorporate new information into CAHW refresher training courses.Again, CAHW systems are ready made networks for actually applyingnew methods of disease control.Again, the close proximity of the CAHWs to the livestockand the understanding between CAHWs and herders madepossible this aspect of the research.Sharing the findingsAs findings start to emerge from research, the presence ofa CAHW system means that a mechanism for disseminatingand discussing results is already in place. For example, insouthern Sudan research findings were used to revise CAHWtraining courses and materials, and so better equip them tohandle cases of liei. In Tanzania, results were discussedduring the regular field visits by researchers or field officersto the study sites and CAHWs disseminated messages tocommunities during village meetings.Should CAHWs be paid for their work?Whatever the role of CAHWs, it is important at the beginningto discuss and agree incentives. When CAHWs work inthe private sector, they cannot be expected to work fornothing and payments need to be defined. Also, manyresearchers use free treatment of animals as an incentive forlivestock keepers to ‘participate’ in research. We prefer notto do this, but use CAHWs to provide treatments using theirusual charging system. If the problem being investigated isa local priority, people are usually willing to take time todiscuss the problem.In the Ormilo project, CAHWs were paid a monthlyallowance of Tanzania Shillings 20,000 (USD 20) after theyhad been appraised on their performance during thatmonth. If irregularities occurred, such as poor compliance infilling in clinical cards, identification and fixation of samples,poor documentation of treatments and follow-up, andmisuse of the drugs, the allowance was not paid. In southernSudan, the research was more short-term and CAHWswere recruited on a daily basis and payments in cash, foodor soap agreed beforehand.Outcomes of the researchPAVE Southern SudanAs described above, information about the diagnosis of lieiwas used to revise some training courses for CAHWs andother veterinary workers in southern Sudan. The researchalso led to a proposal to work with communities to testdifferent treatments for liei, including assessment of clinicalresponses to treatment by both livestock keepers and vets.An important lesson however was that this proposal did notattract donor support, apparently because it lacked a quantitativedescription of liei in southern Sudan and evidencethat communities perceived the disease as a major problem.At this time, two papers about the research had beenpublished in a leading veterinary journal, including anaccount of how communities expressed a need for theresearch. This indicated that while an independent peerreviewedassessment of the research was positive, donorassessment was driven by other values.PAVE Tana RiverThe study in Tana River enabled KETRI, the main researchpartner, to revise their project. Initially, the project focused onthe control of tsetse flies that transmit the disease trypanosomiasis.However, community assessment revealed thatpeople were already accustomed to using drugs to preventor control the disease, and they preferred information onhow to use the drugs properly rather than control tsetseflies. They also assessed various control options in terms ofthe likely sustainability of each option and again, opted for46 October 2002

Linking research and community-based animal healthcare in East Africa9Community-basedanimal health workersare experiencedhandlers of livestockand with someadditional training,soon become adept atsample collection.SPECIAL ISSUEthe improved use of drugs. Although this was a goodexample of how community-based analysis can helpresearchers to refine their work, the actual implementationof the revised project was stopped by conflict between Ormapastoral communities and neighbouring Pokomo farmers.This experience indicated that in common with conventionalresearch approaches, more community-based research isalso affected by factors outside the control of theresearchers.Ormilo Research ProjectThe close monitoring of the sentinel herds by CAHWs aswell as treatment of Ormilo cases has provided a betterunderstanding of the age groups of cattle affected by thedisease. It has also allowed an interim evaluation of differenttreatment options and confirmed the presence of thedisease and causal parasite in the areas in the study. Thework is ongoing and so far, disease confirmation could onlybe done (using molecular tools) on post-mortem samples.Therefore, care has to be taken on the treatment messagesdisseminated back to communities via the CAHWs aboutwhich drugs work best. However, the communities involvedare happy with progress because the research hasconfirmed their opinion at the start of the project thatOrmilo was different from classical East Coast Fever (ECF).This is an important scientific finding as the limited literatureavailable restricts the condition of cerebral theileriosis inEast Africa to ECF.Lessons learntStrengths of using CAHWs for research• Researchers addressing local problems with local people,rather than working in isolation of realities on theground.• CAHWs are key informants with good understanding ofdisease; they can be trained in research tasks (e.g. samplecollection, translation) and because they are trusted locally,can assist with communicating with and organisingcommunity involvement.• CAHWs are willing to work in remote areas under difficultconditions i.e. their normal working conditions, and willwalk long distances to follow up reports of sick animals.• CAHWs are close to the animals so that sample collectionand treatments happen soon after animals become sick.• Solutions to problems are tailored to local needs andcapacity.• A delivery system for research findings, via CAHWs, isalready in place.• A monitoring system for measuring both uptake and theimpact of uptake of research findings is already in place.• Although CAHWs need financial incentives, they are stillrelatively inexpensive.• Improves technical credibility of CAHW programmes andhelps to establish acceptance among policy makers.Limitations of using CAHWs for research• Needs more time to arrange the research, e.g. writtenOctober 2002 47

9Andy Catley, Lieve Lynen and Steven NalitolelaThese CAHWs inTanzania prepareand store bloodsmears in the OrmiloResearch ProjectSPECIAL ISSUEagreements need to be made with more agencies than isthe case with conventional approaches.• Researchers need to be adaptive to constraints in moreinaccessible areas and willing to adopt more participatoryresearch approaches: this can require training ofresearchers, and lengthens the research process andincreases costs.• CAHWs make useful informants, translators, interviewers,and sample collectors, but bias needs to be considered –good supervision is important.• CAHWs can be influenced by powerful elders or villageleaders to use project medicines to treat animals affectedby diseases other than those under investigation. Again,good supervision and monitoring is needed.• Researchers need to work with good translators duringCAHW training and when disseminating research findings.Poor translation can lead to confused messages beingpassed back to the community.• A strong, well-established CAHW programme is neededto work with, as misunderstandings regarding financialremuneration between an implementing agency such asan NGO and the CAHWs can arise. This can interfere withthe research process.• Research using CAHWs is subject to some of theconstraints facing more conventional approaches, such asinsecurity and donor support.ABOUT THE AUTHORSAndy CatleyCAPE Unit, PACE, OAU-IBARPO Box 30786, 00100 Nairobi, KenyaEmail: andy.catley@oau-ibar.orgLieve LynenPO Box 1068, VI Arusha, TanzaniaEmail: llynen@habari.co.tzSteven NalitolelaPO Box 15249, Arusha, TanzaniaEmail: pristeve@yahoo.comNOTESAndy Catley is a veterinarian working for theCommunity-based Animal Health and ParticipatoryEpidemiology Unit, Pan AfricanProgramme for the Control of Epizootics,African Union’s Interafrican Bureau for AnimalResources, on secondment from the FeinsteinInternational Famine Centre, Tufts UniversityUSA.Lieve Lynen is a veterinarian acting as TechnicalAdvisor for the National Tick and Tick-borneDisease Control programme in Tanzania andworking as Research Officer in the OrmiloResearch Project in Arusha region.Steven Nalitolela is a veterinarian working withVetAid in Simanjiro district Tanzania. He hasworked in participatory animal health as wellas using an holistic approach to pastoralistvillage development. He has 16-years workexperience, with five years working at communitylevel with Maasai pastoralists.REFERENCESCatley, A. (2000). The use of participatoryappraisal by veterinarians in Africa. OfficeInternational des Epizooties Scientific and TechnicalReview, 19 (3), 702-714.ACKNOWLEDGEMENTSThe PAVE project was implemented by IIED andthe African Union’s Interafrican Bureau forAnimal Resources. Both PAVE and the OrmiloResearch Project were funded by the AnimalHealth Programme of the Department forInternational Development, United Kingdom.48 October 2002

10Community-based animalhealth training and creativechange in BoliviaSPECIAL ISSUEby SUSAN E STEWARTIntroductionIn 1988, farmers from villages in lowland, primarily resettlementareas (San Julian/Brecha Casarave and Berlin zones) ofSanta Cruz, Bolivia requested training in livestock healthcare. In the early 1970s many people who had lived in thehighlands of Bolivia migrated to the Amazon basin area ofSanta Cruz to practice slash and burn (swidden) agriculture,leading to the development of sometimes massive settlements.The in-migration continues to this day. Because ofthe rapidly declining fertility of the land due to swidden agriculturalpractices, some farmers decided to switch from arice and corn based cash crop economy, in which they couldnot compete with large producers in the region, to a livestockbased economy.The programme that developed with local farmer’s organisations(Asociacion de Ganaderos de San Julian, AsociacionPecuaria de Berlin, Cooperativa Agropecuaria de Berlin,Asociacion de Pequeños Ganaderos de Santa Rosa de Sara,Union de Pequeños Ganaderos de Bolivia en Yapacani), alocal non-governmental organisation (Fundación Integral deDesarrollo), and two international non-governmental organisations(World Concern/Christian Veterinary Mission andHeifer Project International) was later successfully replicated(with local modifications) in other resettlement areas, and inlong established lowland and highland communities ofBolivia and Peru. In the initial programme in San Julian, eightfarmer trainers trained 1,500 villagers and 24 communitybasedanimal health workers (CAHWs). The programmebegan in the San Julian/Brecha Casarave region in 1989 withfunding spanning nine years. In 1990 work began in theBerlin Colony and continued until 1997. In Santa Rosa it ranfrom 1991-95. In Yapacani and Las Gamas work began in1997 and is ongoing.The initial programme in Brecha Casarave and Berlin wascalled Proyecto Pecuario de la Comunidad (PROPECO) –Community Originated Livestock Training. The programmewas general community training in livestock production andhealthcare in a sustainable farm system for any communitymember who wanted it. Local men and women farmers astrainers also administered the training programme throughtheir local associations. In each instance, priorities were to trainevery farmer who requested it, and build local people’s andorganisations’ capacity to develop and administer their ownprogrammes. For the system of animal production to changeon a large scale (from causing erosion and poor productiondue to bad health to being part of a sustainable system withexcellent production), a critical mass of informed people applyingwhat they had learnt was required. Training village animalhealth workers came later as a result of village requests forpeople who could act as extensionists and trainers in theOctober 2002 49

Susan E Stewart10SPECIAL ISSUEcommunities, with a better understanding of the use of medicinesand vaccines. There are three basic premises that guidedthese programmes and a number of approaches common tothem. These programmes continue to have excellent resultsafter the project funding has discontinued because of themotivation and creativity of the local people involved.Basic Premise OneEvery farmer should have access to as much informationabout livestock care in her/his primary language as she or hewants.Why? The more women and men farmers know, themore they use and demand the development of local animalhealth care services, the healthier the animals, the less incidenceof disease transmittance to people (zoonotic diseases),and the greater the livestock production. Wherever possibletraining should always be in the local first language of thepeople. Written materials in the local language were lessimportant in Bolivia because most people who could readand write did not read in their first language.ApproachesFarmers as local trainers and facilitatorsTrain women and men farmers (at least bilingual, average 4thgrade formal education) to be the trainers and facilitators inthe programme. The programme should also have a verysmall number of technical people trained at university level.Their job is to replicate their posts by training, supporting,and acting as mentors to local Farmer Trainers who facilitateall of the village level training.Farmer Trainers are people who:• own land in the community;• have a history of service and a strong desire to serve;• have a high emotional intelligence (people skills);• have some experience with livestock production;• are recommended by trusted informants as gregariouspeople who connect people to one another;• are part-time, paid staff of the project or local organisation;and,• work in teams throughout the region.A Farmer Trainer and a community animal health worker(CAHW) are very different. A CAHW in this programme issomeone who provides preventive and some curative carewith livestock as well as facilitating training in her/his ownvillage, and acting as change agents in their village organisations.All CAHWs are trained with listening and facilitationskills. Together, Farmer Trainers and technicians train theCAHWs. CAHWs are viewed as an integral part of the villagedevelopment process and are chosen by the villages in a decision-makingprocess, and not labelled as vaccinators or medicineshop operators (although the CAHWs certainly do vaccinationsand some have medicine shops).Designing participative village-level trainingTogether with the local trainers, project technical staff designbasic, village-level, participative modules which are fun, easyto use, and require no reading or writing, no secondlanguage skills, and no special expertise in order for peopleto participate. Designing the tools so that a vivid problem orsituation is brought to life for participants is the greatest challengeand the most important aspect of the training design.Other important training design issues include:Focus on what farmers wantIn the general community-based training, focus on key issuesthe farmers are interested in. Most things are fairly simple to acton, e.g. what would make the biggest difference in production,or the most money for people, or protect their childrenfrom getting sick. To set this focus requires a very good assessment– lots of time sitting and listening to women and menfarmers and visiting their livestock and fields with them.Teach prevention and management in the context ofdiseaseFocus on prevention but from a disease perspective, not fromthat of the value of prevention alone. The people want tolearn about treatment of disease because that is what mostconcerns them. However, prevention will often make a biggerdifference. We teach about the disease first (the sicknesscaused by malnutrition or parasites and the diseases preventableby vaccination) then the treatment (where possible) butreally stress prevention. Every community member whowants to, learns how to vaccinate, de-worm, and keep themedicines and vaccines cold. They may do their own vaccinatingor not, but they do require accuracy on the part of theCAHWs because they are well informed.Give enough time for people-to-people learningPlan a big enough block of time for training sessions so thatpeople get to know and trust one another. We give three- tofive-day workshops depending on the topics and participants.This allows enough time to discuss and plan for tricky issues,and the workshop becomes a forum to discuss and solve anyissues or conflicts arising within the community, and allowsspace for creative solutions to begin.Conducting the trainingA minimum of ten people must attend a community-level50 October 2002

Community-based animal health training and creative change in Bolivia10training, with no more than 20 participants in any onesession, so that everyone can have a chance to practice onanimals. Villagers supply food for the trainers, a place to stay,and animals for the practice sessions. The training is notlinked to any other benefits or services.Since women are the primary livestock caretakers in allthe areas we work in (men do farming), we design the basictraining for preliterate women – although many men laterparticipate. All basic community-level training is in the firstlanguage of the villagers. Because the training is for thepeople who actually care for the animals, we have foundthere to be dramatic improvements in livestock health andproduction. For example, when work began in the BrechaCasarave of San Julian there was a serious and disseminatedproblem with iodine deficiency in the livestock, causing birthand weaning rates to be very low, and the poor developmentof most calves. During training, women learnt simpleways to prevent this problem using locally availableresources. Within two years of the initiation of the community-leveltraining, the problem had disappeared in the zoneof the Brecha, and calving and weaning rates shot up.Basic Premise 2If farm families have an understanding of some farmeconomics, and good income and nutrition from their livestock,they will want to invest in the health and care of theirlivestock so that they keep producing a good income.This is appropriate for the Bolivian context becauseincome was the highest motivator. In another context themotivation might be bride price or prestige. It is importantto discover the motivating factors and emphasise them asoften as possible in the training.ApproachesFarm planning for the futureWork with farm families to plan their farm, to heal andregenerate the land, or to prevent degradation whileimproving livestock production. This includes seeing livestockas an integral part of the farm (rather than an isolatedproduct), for manure and nutrient redistribution, agroforestry,zero grazing, public health concerns, and so on.Farm planning includes helping families to think throughwhat they want from their farm and for the future of theirchildren.We have an exercise in the five-day community workshopwhere people draw or create on the ground a groupfarm plan for an average land parcel at the beginning of theworkshop. Because swidden agriculture is prominent andlivestock are not seen as an integral part of the farm system,“Because the training is for thepeople who actually care for theanimals, we have found there to bedramatic improvements in livestockhealth and production”the group will usually have a very traditional initial plan. Theydo it as a group because cooperative work is very commonin Bolivia. People can visualise a whole farm in a small areaand as they talk together they begin to get ideas from oneanother. During the workshop, farms are visited, and thewhole group discusses the conditions and planning. At theend of the workshop, as a synthesis tool, participants makea farm plan together again, with a new piece of land andthe new concepts they have learnt. They are encouraged tosee the concepts in action on the drawing or model, andmany go home to plan their own farm with their family.Basic livestock economicsHelp farmers to understand the basic economics of a farmand the specific economics of livestock, for example,discussing the cost of vaccines versus the earnings fromhealthy animals.Develop alternatives to intermediariesWork with farmers’ organisations to overcome middlemencharges, and to market livestock and livestock products. Inworkshops, unity and collective work aspects of local cultureare emphasised, and participants have opportunities todiscuss marketing and design creative solutions.Basic Premise 3CAHWs are most valuable in the long term as an integralpart of a local organisation rather than only as an individualentrepreneur (it’s good if they are also an individual entrepreneur).Why? Because with difficult tasks such as vaccinating alllivestock, testing, marketing, and communal pasturemanagement, the organisation helps and encourages theCAHW. And in the development of the organisation, theCAHW becomes a change agent and facilitator.ApproachesBuild organisational capacity in livestock issuesHelp the local organisation build their capacity to deal withlivestock related issues. The organisation is where conflictsSPECIAL ISSUEOctober 2002 51

Susan E Stewart10SPECIAL ISSUEare resolved over things like fencing, paying for vaccines, andproperty destruction. Work with them on developingproblem solving and conflict resolution skills. The organisationcan organise the marketing of livestock and livestockproducts. Help them to plan together and be successful attheir projects and assist them in developing negotiation skills.Enhance team, visioning, and planning skillsTeach the CAHWs and interested Farmer Trainers someorganisational capacity building skills, such as how to facilitatevisioning and planning processes, set values, implement,monitor, and evaluate projects, and how to write projectgrants, design a budget, and so on. Support the CAHWs asthey use these skills with their local organisations. Not everyCAHW will have the desire or capacity to facilitate theseprocesses. Work with those who do and encourage them inthe challenges they meet.Establish commonly held organisational valuesHelp local organisations and CAHWs focus on commonlyheld values such as unity, honesty, and mutual encouragement,which are the spiritual core of the community. Whenthe members of the organisation have identified these values,people often revisit them to encourage one another. Valuesguide the decision-making of the local organisation. If theorganisation has decided they value having good land fortheir children’s children, then they may decide not to marketchemical fertilisers, or to market instead tree seedlings forwindbreaks, green manure, and erosion control. Workingwith the local organisation on their values encourages theCAHWs in their work.Encourage linkagesHelp the local organisations to develop sound linkages to livestockrelated government, non-government, and businessinterests. The organisation practices and builds their negotiationskills as they set up working relationships with vet medicinesuppliers, regional livestock associations, governmentregulatory agencies, veterinary laboratory services, and veterinariansin the area.What are the results of this work with CAHWs?Long term service providersIn the San Julian Zone in Bolivia, after PROPECO finished,women and men Farmer Trainers and CAHWs formed theirown local training and livestock health organisation. SinceBolivia’s Popular Participation Law was passed in 1997,government development funds have been decentralised toregional administrative areas. Thus, the mayor of the SanJulian area has funds to develop livestock and agricultureproduction. The organisation of Farmer Trainers and CAHWshave written project proposals, negotiated with their localgovernment, and are now handling most of the livestock careissues for their region encompassing about 6,000 families.They run training programmes, and help with the organisationand implementation of vaccination, de-worming, andtesting campaigns in the zone. They are well liked andrespected, and are called on individually to provide animalhealth care services. There are no veterinarians to serve theirarea and yet the livestock health and production has greatlyimproved.In the Brecha Casarave region, the incidence of Brucellosisin cattle was unusually high when PROPECO began.Training for all farmers included understanding the diseaseand it’s prevention, and the local associations, CAHWs, andtrainers’ organisations have worked on a testing and eradicationprogramme. By 2001, disease incidence levels haddropped well below comparative levels in other lowland areasin Bolivia. According to monitoring by the Bolivian NationalEpidemiological Organisation, the same has happened withFoot and Mouth disease. In project evaluations it is commonfor the women to remark, ‘We wanted to have trainingabout our sheep because we wanted to treat their sicknesses.But when we started to practice all we had learnt in theworkshop, our sheep did not get sick’. Because of improvedanimal nutrition, vaccination, and de-worming, commonproblems such as diarrhoea have dramatically decreased.Effective change agentsThe Farmer Trainers have all become important changeagents in their communities as a result of the training theyreceived in leadership, facilitation, and community organisationand capacity building. Never before were women votedinto office in community organisations. Now the womentrainers regularly hold elected posts and accomplish significantchange in their villages.Confidence to negotiateCommunities who have learnt how to manage their livestockhave the confidence to negotiate with government andNGOs. A large government project wanted to give farmersloans to bulldoze shallow ponds to provide dry season waterfor the livestock. Since they had discussed water in the basiclevel training workshops, community members knew theseponds would be very contaminated and would becomeempty in the dry season. So they negotiated with the governmentfor the same loan funds to build wells for each farm.They received the loans and helped one another to dig and52 October 2002

Community-based animal health training and creative change in Bolivia10protect the wells and to use locally appropriate pumps andcoverings. Now their livestock have clean water all yearround.Marketing initiativesWith improved livestock production comes the need forimproved marketing. Because trainers worked with all theinterested people in the villages and the CAHWs worked withthe local organisations, they have had some success inmarketing together. For example, a village called Las Gamasmarkets milk and yoghurt in the village, in outlying communities,and in the city.Responsiveness to changeSome of the villages have found cohesiveness around theirlivestock production. When one village had to abandon theirfarms because a large river changed course in the Berlin zone,they decided to move together to another location. This wasvery unusual because the families were not related to oneanother and normally would have gone separate ways. Theirlivestock walked out with them and provided the financialbacking for their new start. Within a short time, they hadbuilt houses for everyone, a new school for the children, hadhealthcare through a clinic, and a clean water supply. Muchof this success was due to the cohesiveness of their villageorganisation, which had formed around livestock production,but was flexible enough to transform to this new situation.A former Farmer Trainer of animal health care training andthe CAHWs became the leaders of this new organisation.With the confidence they had gained through training facilitation,and their skills in negotiation and organisationmanagement, they were able to transform devastation intoopportunity.ConclusionLivestock are integrated into the fabric and rhythm of thelives of rural villagers in Bolivia. Livestock programmes shouldrecognise this and seek to build capacity into all of the areaswhich livestock and livestock production affect. Building onthe locally held values or spiritual core of the organisationwith Farmer Trainers and CAHWs as change agents, whilestrengthening the physical core via livestock health andproduction improvement, could be a key to a holisticapproach which broadly empowers communities as diseaseis controlled and they improve livestock production and theirlivelihoods.SPECIAL ISSUEABOUT THE AUTHORSusan E Stewart, World Concern Myanmar,37/1 Soi 15 Phetburi Road, Bangkok 10400,Thailand.Email: Musesuz@myanmar.com.mmNOTESCurrently senior technical advisor for WorldConcern Myanmar, Susan Stewart is a veterinarianand organisation development specialist.She worked with Christian VeterinaryMission in Bolivia from 1988 to 1997.For more information on designing aprogramme and participatory techniques seeLearning Together, The Agricultural WorkersParticipatory Sourcebook by Susan Stewartwith Karen Stoufer, Jennifer Shoemaker, andBJ Linquist. Available through Heifer ProjectInternational, PO Box 808, Little Rock, AR72203 USA, Tel: +1 800 422 0474Website:www.heifer.orgFor guidance on local capacity building see TheCornerstones Model Values-Based Planningand Management by Jerry Aaker and JenniferShumaker. Also available through HeiferProject International.October 2002 53

11GENERAL SECTIONThe Innovation Tree: a newPRA tool to reveal theinnovation adoption anddiffusion processby PAUL VAN MELE and A.K.M. ZAKARIASummaryA new Participatory Rural Appraisal (PRA) tool called theInnovation Tree has been developed. It has helped people tovisualise and analyse the way in which an innovation isspread over time between community members. We foundit to be a very useful tool, both to distinguish between innovators,and early and late adopters, but also as a way ofhelping both outsiders and the community to understandsome of the social and psychological dimensions that influencethe adoption and diffusion of an innovation within thatcommunity. The Innovation Tree also enables you to investigatehow different personalities or types of innovators playa different role in promoting the technology to theircolleagues, which is of direct relevance for developingfarmer-to-farmer extension activities. The ‘type one’ innovatorcan inspire a wide range of people from different levelswithin a community and has a modest, mild, and inquiringcharacter. Type one innovators can easily engage in farmerto-farmerknowledge strengthening, both within andoutside the community. The ‘type two’ innovator enthusesfewer and mainly like-minded people within the community,and has a strongly competitive character. These innovatorsare more eager to go outside the community to promotethe technology, rather than getting engaged in educationalactivities.IntroductionThe Seed Health Improvement sub-Project (SHIP), whichoperates under the Poverty Elimination Through RiceResearch Assistance (PETRRA) project in Bangladesh, startedin 1999 and has mainly focused on seed cleaning, properdrying, and proper storing as three pillars to improve rice seedand seedling health. Activities have been undertaken in fourvillages in each of the seven agroecological zones. As SHIPbegan its fourth year, increased emphasis was put on howto improve scaling-up strategies. CABI Bioscience, as one ofproject partners, alongside the International Rice ResearchInstitute (IRRI), has been at the forefront of developing, validating,and disseminating innovative discovery learning toolsand approaches to increase farmer participation in crop andpest management.During a national workshop in April 2002, potentialuptake pathways were explored from the point of view ofthe national project partner organisations. These included theBangladesh Rice Research Institute (BRRI), the Rural DevelopmentAcademy (RDA) at Bogra, and four different nongovernmentalorganisations: CARE, PROSHIKA, BRAC, andGKF. Farmer-to-farmer extension and the use of local leadersand institutions were mentioned as important uptake pathways,yet with no clear understanding as to how to proceed,and without information on the point of view of the end-54 October 2002

The Innovation Tree: a new PRA tool to reveal the innovation adoption and diffusion process11Photo 1. Participantsfrom Maria village lineup in two rows, one forthe light and one forthe heavy tablesPhoto 2. After having placedtheir cards in chronological orderof adopting the innovation, oneby one they explain who or whatinspired them to do thisGENERAL SECTIONusers. The following illustrates how the community in Mariavillage, Bogra, expressed their point of view and expertise,after using the new PRA tool to analyse their own innovationadoption and diffusion process. Adoption is considered asthe individual dimension of the process: individual householdswill refuse or adopt an innovation for various reasons,while diffusion is the next step explaining how and why (orwhy not) the adoption spreads between individual households.Stimulating innovationIn Maria village, the key site for SHIP activities implementedby RDA, multipurpose seed drying tables were developed ina participatory way by stimulating people’s creativity. Peoplein Bangladesh traditionally dry their rice seed on the floor oron bamboo mats, also called chatai. The introduction of tubewells and new rice varieties over the past ten or so yearsenabled a lot of farmers to grow a second rice crop duringthe dry season. However, properly drying this boro seed hasbecome one of the major bottlenecks, because it is harvestedat the onset of the rainy season.As post-harvest activities are mainly the responsibility ofwomen, we organised a learning session with mainly thewomen of the 30 participating households. To ensure fullownership, the concept of improved drying was introducedthrough a visualisation and reflection session on physicalprocesses such as ventilation and evaporation, rather than byshowing a ready-made drying table and trying to get peopleto adapt it to their own needs and means. A limited numberof questions, embedded in real-world situations, were developedto stimulate the thinking process, and by the end ofthis two-hour session, all agreed upon useful criteria formaking seed drying platforms or tables.In a next session these criteria were further discussed withboth husbands and wives, and the participants developed amonitoring sheet. We transferred this to an A4 sheet. Allhouseholds received a copy and were asked to record thedate at which they would make their table. It was made clearfrom the early onset that if they wished to make one, itwould be at their own expense.Within a period of only five months all the 30 householdsengaged in the project had adopted the idea of this technology,each bringing in their own innovations. More than60% of the multipurpose drying tables were designed andmade after close consultation between husband and wife.Personal observations and informal talks also revealed animportant exchange of ideas between households. Wewished to know how could we find out how people withinthe community inspired one another, and what could weactually learn from this?Why analyse the innovation diffusion process?We believe that visualising the innovation diffusion processcould help:October 2002 55

Paul Van Mele and A.K.M. Zakaria11Photo 3. Hamidaindicates whoinspired her toadopt theinnovationPhoto 4.Zabed Aliindicateswho inspiredhimGENERAL SECTION• provoke community reflection and raise awareness aboutthe dynamics of the process;• provide insights into the social and psychological dimensionsunderlying the innovation diffusion process; and,• identify which people, or more specifically, which personalities,to engage in a particular farmer-to-farmer extensionactivity.A better understanding of the innovation diffusionprocess could help outsiders to better target their communityinnovation activities. Secondly, it is generally agreed uponthat, for the selection of extension workers, not only thetechnical but also the facilitation skills are important criteria.This is equally important when selecting farmer facilitators,and as such we have looked for a way to gather insights inthe underlying social and psychological dimensions of theinnovation adoption and diffusion process. As far as we wereaware, no PRA tool existed to visualise such a process andencompass some of these factors.Flexibility and creativity are key factors in participatoryapproaches. Through brainstorming we ended up with theInnovation Tree, in which ideas from a flow chart and amethod to identify indigenous specialists have been adjustedand combined.MaterialsEach household needs a card about half an A4-size, andthere should be enough markers. The session is best held inan open space in the village, but could also been doneindoors presuming a large enough floor or wall can be found.Lines can be drawn with either a stick in the sand, or withcrayons on harder surfaces.How it works• Invite those households who have adopted or adapted atechnology for a meeting, brief them about the objective ofthe exercise, and provide cards and markers.• Ask them to write their name on the card, along with thedate on which they adopted the technology. The fact thatthey have recorded this date on their monitoring sheet mayhelp at this point. If the illiteracy rate is high, pictures of theparticipating households can be used instead of writtennames.• Explore with the participants whether the technology couldbe classified into broad groups. In our case, for instance,the participants clearly distinguished two broad classes ofdrying tables, namely light ones and heavy ones.• Draw one line for each group, leaving ample spacebetween each line. The length of the lines depends on thenumber of participants, and whether you do it indoors oroutdoors. In the open you should allow for at least half ametre per household.• Ask the participants to bring their cards and place them onthe line according to which broad group they belong to(photo 1).• Ask them to re-arrange themselves according to the dateat which they have adopted the innovation. At completion,innovators should be at one end, while late adopters shouldbe at the other. After having laid their card on the line, theycan go back to the group.• The person or household who first made the innovation isasked to take the floor and explain who or what inspiredthem to do this (photo 2). One facilitator guides theprocess, while another records all the comments.• Consequently, and in chronological order, all the others areasked to draw one or several lines to cards of householdswho inspired them to also adopt the idea of the innovation,while adapting it to their personal needs and limitations.Lines can be drawn within or between groups56 October 2002

The Innovation Tree: a new PRA tool to reveal the innovation adoption and diffusion process11Table 1. Some social and psychological characteristics influencing the innovation adoption process.Factors identified in our project by applying the Innovation Tree are indicated by an *Social factorsPsychological factorsStimulating adoption Inhibiting adoption Stimulating adoption Inhibiting adoptionPersonal communication network* Opposition in the farming community Innovation proneness* Complexity of technologySocial participation* Social isolation Risk taking ability Risk avoidanceExternal pressure* 1 Poverty Extrovert* High level of stressCommon need for solving a problem Overall knowledge Lack of knowledge about thetechnologySelf fulfilment*Lack of motivationPride in ownership*Mistrust of project staffLevel of aspirationGENERAL SECTION(photos 3 and 4). The facilitator tries to find out whatexactly convinced them to do it, and what other thanpersonal factors were involved in the decision-makingprocess. Although subtlety is the master of the facilitator,the underlying question is ‘Why was household x a sourceof inspiration and not household y, while both adopted theinnovation before you did?’. Preferably a third facilitatorsimultaneously copies the name cards and lines on a sheetfor later processing (figure 1).• The last part of the exercise is the most important one, asthis is the time to facilitate group discussion and stimulatereflection. The first step in the discussion should deal withthe innovation process itself, and depending on the objective,focus more on either the technical, economic, social,or psychological dimensions.• During the last part of the discussion the facilitator tries todraw on the insights gained from the exercise, and exploreswho could contribute in which way to scaling-up the innovationdiffusion process.Revealing social and psychological factorsFarmer decision-making in adopting a technology is influencedby institutional, economic, cultural, social, and psychologicalcharacteristics. A whole range of anthropological andsocial tools exists to reveal mainly the first three categories.The social and psychological factors enhancing or inhibitingthe actual adoption can be analysed directly with thecommunity through the Innovation Tree. As these factors areoften location- and technology-specific, a list of factors isgiven in Table 1 based on a literature review and personalexperience.The above factors partly determine whether a technologyis adopted or not, but the Innovation Tree exercise hasalso enabled us to investigate how different personalities ortypes of innovators play a different role in promoting the1The presence of the project and visits of international staff contributed to certainpeople being eager to make a good impression.Table 2: Profiles of two types of innovators as identifiedin the Seed Health Improvement sub-Project, BangladeshType 1 Innovator Type 2 InnovatorMain interest Knowledge TechnologyPersonalityModest, mild, and inquiring CompetitiveSocial interaction Intense Limited to likemindedpeoplePotential contribution Action learning Technologyto extensionpromotionFigure 1: Example of the Innovation Tree transferred topaper. Note that participants decided to distinguishbetween two broad groups of innovations in this case:light and heavy multipurpose drying tablesABDUL12.05ALEPA18.06ANISA07.07SALIM12.07BABLU15.07HAMIDA10.09HELENA02.10ISNAD10.05ABOUR20.05OSMAN21.06ALTAB10.07DULU14.07ALI18.08NASMA21.09PARUL15.10ZABED23.12October 2002 57

Paul Van Mele and A.K.M. Zakaria11GENERAL SECTIONtechnology to their colleagues. We have identified two typesof innovators (Table 2).The first type of innovator has inspired a wide range ofpeople from different levels within a community and has amodest, mild, and inquiring character. This innovator hasenthusiastically engaged in farmer-to-farmer knowledgestrengthening of seed health management, both within andoutside the community. The second type has enthused fewerand mainly like-minded people within the community, andhas a strongly competitive character. This innovator has beenmore eager to go outside the community to promote thetechnology based on his innovation, rather than gettingengaged in education activities.ConclusionsAlthough the Innovation Tree has so far only been used on asmall-scale in a few villages and with a focus on a technologicalinnovation, it can be applied with any type of innovation,whether triggered by a project, a workshop, or anyother communication channel.As illustrated above, we believe the Innovation Tree is auseful tool to distinguish between different types of innovators,but also to better understand the psychological andsocial dimensions underpinning the decision-making process,which would be difficult to disclose in other ways. This mayyield valuable information about which people or, more“We believe the Innovation Tree is auseful tool to distinguish betweendifferent types of innovators, but also tobetter understand the psychological andsocial dimensions underpinning thedecision-making process, which wouldbe difficult to disclose in other ways”broadly, personalities (and even institutions) to engage in aparticular scaling-up activity.However, as with any PRA tool, none can stand ‘on itsown’ and therefore we stress the need to complement thistool with other PRA tools or techniques such as semi-structuredinterviews and personal observations. The tool mayneed to be modified to take account of the different adaptationsmade to the innovation by the different participants.And last but not least, it is important to realise that theoutput from the discussion following this PRA exercise goesmuch further than the actual innovation, adoption and diffusionprocess. Indeed, as is often the case, discussion topicsquickly evolve towards social development issues and howcommunity members see their role in this process.ABOUT THE AUTHORSPaul Van Mele, CABI Bioscience, Bakeham Lane,Egham, Surrey TW20 9TY, UK.Email: p.vanmele@cabi.orgA.K.M. Zakaria, Rural Development Academy,Bogra 5842, Bangladesh.Email: rdadtw@bogra.desh.net58 October 2002

12In our own words:investigating disabilityin MoroccoGENERAL SECTIONby CHRIS MCIVORIntroductionSave the Children (UK) worked in Morocco for almost 40years and for most of that time concentrated on the area ofdisability. Like many programmes elsewhere the organisationbegan its work as a response to an emergency. In the case ofMorocco this arose out of two events. The first was the earthquakein Agadir, which devastated the southern coastal cityin 1960 leaving thousands dead and many children orphanedand homeless. The second emergency arose out of theconsumption of contaminated cooking oil in the Fez andMeknes area of northern Morocco in 1959 and 1960. Some10,000 adults and children were left paralysed, resulting inappeals for assistance by the Moroccan authorities to externalagencies and well wishers.In later years, the principal intervention supported by Savethe Children consisted in the establishment and support of amajor residential institution for physically disabled children inthe northern town of Khemisset. One of the first of its kindin Morocco, the school became one of the organisation’s‘flagship’ projects. It was shown off to visiting royalty, to localand international dignitaries at every opportunity, and at itsheight consumed the vast proportion of the organisation'sbudget for the entire Morocco programme. Claimed one ofits former expatriate staff:I have been approached by many people, both Moroccanand English, who would dearly like to preserve theschool in the form that the director created it and ran it fora quarter of a century. It was regarded by many as a bit of‘Best of British’ in a foreign land and a wonderful exampleof our aid to a developing country.Issues around sustainability and institutionalisationThe last sentence is revealing. In many ways the Save theChildren programme in Morocco consisted in exporting amodel of service provision relevant for the UK, to a locationwhere the value of such a project was neither questionednor investigated. Some of these tensions were to surface inlater years, prompting the organisation to rethink its strategy,but not without leaving a certain amount of resentmentand confusion behind.One issue that arose was related to the problem of costand sustainability. The kind of investment in staff and infrastructurereached a level of expenditure that could never beassumed by the local Moroccan authorities. At the same timesome critics also questioned the spread of benefits generatedfrom such a massive expenditure, relative to the smallnumbers of children who actually passed through the establishment.Claimed one programme officer:Such a facility could only cater for an extremely smallnumber of disabled children in the country, a maximum of 120October 2002 59

Chris McIvor12GENERAL SECTIONpeople at any one time with an average intake of only 20 childrenper year. At the same time children who were blind, deafor had learning disabilities were not even considered by theadmissions board which regulated the school intake.It was also claimed that, as with establishments elsewhere,many of the children who passed through this residential facilitybecame ‘institutionalised’, separated from their communitiesand families to such an extent that their later reintegrationproved difficult. Some of the previous residents of the schoolcomplained of over-protective attitudes among its managementand staff, an approach that reinforced their perceptionof difference to other children and made them feel that theywere somehow ‘apart’. When some of these children werelater reintegrated into the ordinary school system they werenot prepared for the hardships and ridicule among otherpupils that sometimes accompanied this transition.Our right to be heardAt the core of much of Save the Children’s programme inMorocco for many of the 40 years it worked in the country,lay the fact that when designing its strategies andprogrammes in the area of disability it made little attempt toinvolve anyone but the expatriate professionals who thoughtthey knew best about the interests of the constituency theywere supposed to be helping. Even the later ‘indigenisation’of the programme, the involvement in management decisionsby local Moroccan staff, did not genuinely encompassthe views, wishes, and opinions of disabled people themselves.While many of the interventions were well meaning,disabled people and their families were regarded for manyyears as project beneficiaries, as recipients of well meaningcharity but not as partners in the process of identifying whatwould best assist them.This inability or unwillingness to listen to disabled peopleis not an issue that was specific to Save the Children in itsMorocco programme. The charitable models of care andprotection that characterise much of the response to disabledpeople’s needs in many parts of the world have only relativelyrecently been questioned by disabled people themselves. Aswith issues affecting children, for example, organisations arebeing challenged to adopt a more participatory, rights basedapproach to programming. The issue of equal treatment,social integration, improved access to services, respect forissues of difference is replacing a previous discourse largelyframed in terms of charity and welfare.Investigating disabilityThe realisation that both Save the Children, as well as severalof our partners in key support ministries, remained ignorantabout much of what faced disabled people in Moroccoprompted the organisation to undertake a participatory studyin the country in 1995. One of its key objectives was toensure the genuine and meaningful inclusion of disabledpeople themselves in the research exercise so that a moreaccurate picture of their lives could help inform the futuredevelopment and management of programmes.An editorial team comprising Save the Children staff andseveral disabled people who represented different organisations,was formed that year to undertake the research andcarry out interviews. Arising from this investigation, a publicationin both English and Arabic was produced entitled InOur Own Words. The rest of this essay will focus on some ofthe issues raised during this process of consultation, and inparticular the lessons learned from a programme of researchthat sought to include disabled people in the identification ofthe problems that affected them and the solutions theyproposed.Lessons learntRepresentationOne of the first issues to surface among the team of peopleselected to carry out the research and produce the publication,was the issue of representation. The disabled people in theeditorial committee were identified through a number ofindigenous Moroccan organisations set up to support the interestsof their particular constituency. Yet it was clear that acertain elitism characterised many of these organisations, andthat the focus on the particular disability that characterisedtheir membership had left a whole range of other factors, suchas poverty, gender, ethnicity etc., unaccounted for.This meant that the original text submitted by severalmembers of the research/editorial team failed to adequatelyrepresent the priorities of a large number of disabled peoplein Morocco. There was very little written, for example, onwhat difficulties were encountered within poor families, orwhat unique set of issues disabled women might face. Aconscious effort, therefore, had to be made to spread the netof consultation much wider. A mechanism of communicationalso had to be developed whereby disabled people, whowere illiterate, unemployed, less articulate etc., could havetheir concerns represented.One issue that proved to be particularly contentiouswithin the Moroccan context was the issue of how existinggender bias and discrimination added to the burden imposedon disabled women. The inclusion of this dimension withinthe study fuelled concern among some that the research wasstraying beyond its original mandate, and that in challengingthe gender stereotypes prevalent in Moroccan society the60 October 2002

In our own words: investigating disability in Morocco12publication might prompt a negative response that wouldreduce the impact of its focus on disability. But in the end thedecision was made that an investigation of the stigmasurrounding disability could not be divorced from a range ofother prejudices and factors that confronted disabled individualsin their social context. Claimed a disabled womanfrom Rabat:We are not saying that ours is the only problem. Bothwomen and disabled people in general encounter difficultiesand discrimination. But join the two issues together and youmagnify the difficulty. Disabled women have a unique set ofproblems, which demand a unique set of responses.Hierarchies of acceptanceA second related problem around the issue of representationalso surfaced in the course of the study. It became clear thatin Morocco there was a kind of ‘hierarchy’ of acceptancerelating to disabled people that was evident within disabledpeople's organisations themselves. At the top of the ladder,those who were physically impaired found it easier to gainacceptance from their families and communities. Those whohad visual and hearing impairments found it more difficult,while those with learning and mental disabilities seemed toexperience the worst rejection and discrimination, not onlyfrom so called ‘normal’ society but from other disabledpeople themselves.Again, this was reflected in the initial study by a heavyfocus on the problems facing physically disabled people. Theviews and opinions of those with visual and hearing impairmentswere rarely included. A decision had to be made toensure that the research was inclusive of as wide a range ofdisabilities as possible.This issue is common to other kinds of research focusedaround problems of discrimination. In the field of gender orchildhood, for example, it is sometimes assumed that thesecategories define a unique set of problems that can bedivorced from other sets of issues. Yet women and childrenbelong to class, economic, and ethnic structures that can inturn create other kinds of bias that need to be acknowledgedif either research or subsequent action aims to be truly representativeof a wide range of opinions.Considerable work, therefore, had to be done with theresearch team to alert them to the fact that many of theviews expressed in the original study, had been solicited fromkey informants who largely had the same problems, backgrounds,and level of articulacy as themselves. While the finaltext reversed some of this original bias, in general the Moroccanstudy and subsequent publication inadequatelyaddressed the issue of ensuring equitable recognition of the“While many of the interventions werewell meaning, disabled people and theirfamilies were regarded for many years asrecipients of well meaning charity butnot as partners in the process ofidentifying what would best assist them”problems facing different sectors of the disabled community.While members of the research team were instructed to interviewpeople with as wide a range of disabilities as possible,the tools used to gather this information were too blunt andinsensitive to accommodate those people who throughvisual, hearing, or learning impairments could not adequatelycommunicate during direct interviews.In discussions with groups of disabled children, forexample, only those more articulate, assertive individualsspoke out, leaving a large section of other children’s viewsand preoccupations ignored. The use of drawings, personaldiaries, drama, and role-plays would have provided a moreinteractive and relaxed fora for bringing another set of viewsto the table. Claimed one member of the research team:On reflection more and broader training on differenttechniques and styles of communication for all those involvedwith the gathering of information, might have helped toensure that a wider cross section of disabled people wouldhave had their opinions registered.Establishing trustThe original research schedule had envisaged a time span ofseveral months to complete the interviews and focus groupdiscussions, so that enough material could be generated toproduce a publication useful for advocacy and programmingpurposes. Yet in the end it took much longer, partly becausethe time and effort required in carrying out a meaningfulconsultation and establishing the trust of people who hadnever been consulted before took longer than expected.There was scepticism among many of the disabled peopleconsulted, as to why they were being asked their opinions.Would the political authorities view their criticism as a sign ofdisloyalty to the Moroccan state? In recent years, the state hadstrongly and publicly expressed its commitment to socialjustice, improved welfare provision and integration of disabledpeople into Moroccan society. Several disabled children whoderived a living from begging were worried about sharingtheir views, since they were already harassed by the authoritiesfor conducting an activity that might negatively impact onGENERAL SECTIONOctober 2002 61

Chris McIvor12GENERAL SECTIONthe image the country wanted to project to Western tourists.From those disabled children who had benefited from institutionalcare, like that offered by the Khemisset School, therewas concern that they might lose their scholarships if they wereseen ‘to bite the hand that fed them’. In the end a significantamount of time had to be taken to win the trust of people,many of whom claimed that this was the first time their viewshad ever been solicited, and to reassure them that their opinionswould be registered anonymously if they so wished.One consistent question recurred throughout the discussionswith disabled people, namely what would happen as aresult of this exercise? Would better services be provided?Would aids and appliances now be readily available? Wouldaccess to buildings be improved? Several informants indicatedthat this was not the first time research and studies hadbeen conducted, and that they had seen very little evidenceof an improvement as a result of the previous exercises.Minimising unrealistic expectations in the context of anyresearch is always problematic, and the answer to how this isbest done is never an easy one. At a time when Save the Childrenwas moving away from direct provision of disability servicestowards handing over its programme to local authorities,no guarantees could be provided that the views of disabledpeople would be listened to and respected. The only argumentwe could offer was that we hoped that disabled people’s voicesmight promote change and more acceptance of their needs inMoroccan society, but that in the end this would depend onpolicy makers and structures outside our direct control.ConclusionTowards the end of 1995 In Our Own Words was publishedin Morocco, and subsequently translated into Arabic anddistributed throughout the Middle East. The reactions werevaried. Several ministries responsible for disability provisionin the country found it too critical and unappreciative of thework carried out on behalf of disabled people in theircountry. In particular the language of rights and obligationsseemed unwelcome to some, who felt that disabled peoplewere now being ungrateful to those who had tried to helpthem in the past.The response of several former residents of Khemisset“One consistent question recurredthroughout the discussions withdisabled people, namely what wouldhappen as a result of this exercise?Would better services be provided?Would aids and appliances now bereadily available? Would access tobuildings be improved?”School was also negative. Having benefited considerably fromthe opportunities for schooling and other assistance providedby the establishment, they found some of the criticisms raisedabout sustainability, lack of community involvement, issuesaround institutionalisation of residents etc. offensive to thememory of its original founder. Yet others were more accommodatingof the criticisms offered, indicating that while theyhad personally benefited from the time they had spent in thisestablishment, there was no escaping the fact that theexpenses incurred in running such a facility could have beenextended to a much wider net of beneficiaries if morecommunity based programmes had been developed.Finally, one set of comments was received that could beinterpreted as either criticism or commendation. Somereaders complained that they were surprised and disappointedthat no uniform view had emerged from the researchand subsequent publication, and that it was full of contradictoryand conflicting voices from which a single, coherentview would be hard to derive. Yet in many ways this confusionof voices represented for others one of the strengths ofthe publication. It indicated that the editorial team hadgenuinely sought to listen to what was being said and hadtransmitted the voices of disabled people in as honest andtruthful a manner as possible. At the same time it delivereda clear message, namely that there are no easy solutionsavailable, that the issue of discrimination against disabledpeople is a complex subject that is intolerant of uniform andsimple solutions.ABOUT THE AUTHORChris McIvor,Save the Children Fund (UK),PO Box 4689, Harare, Zimbabwe.NOTESChris McIvor was Programme Director for Savethe Children (UK) in Morocco for three years.Subsequent to working in Morocco he occupiedthe same posts in both the Caribbean andZimbabwe, where he is currently located.62 October 2002ACKNOWLEDGEMENTSChris McIvor edited and contributed to thepublication In Our Own Words – Disability andIntegration in Morocco. Contributing authorsalso include Joan Carey, Save the Children (UK)disability advisor; Khadija Sabil, a Moroccanjournalist; Fatima Lemrini, a disabled Moroccanactivist; and several disabled people contributeda chapter entitled ‘In Our Own Words’, which isa collation of their experiences as disabledpeople in Moroccan society. The book has beenpublished in both English and Arabic. Allquotes are taken from the publication.REFERENCESColeridge, P. (1993) Disability, Liberation andDevelopment. Oxfam, UK.McIvor, C. (Eds). (1995). In Our Own Words –Disability and Integration in Morocco. Save theChildren (UK).

13Sustainable DevelopmentObservatories in Manizales,ColombiaGENERAL SECTIONby LUZ ESTELA VELÁSQUEZ, translated by KIMBERLY VILARIntroductionLocal government in Colombia has come a long way inpromoting environmental awareness and citizen and institutionalparticipation in local sustainable development planningprocesses. There are several valuable experiences underway,namely Local Agenda 21s, Local Environmental Action Plansand innovative Sustainable Development Observatories.In practice, organising local government, other local institutions,and citizens in the promotion of integrated managementrequired for sustainable development is not easy. Infact, technical staff in charge of designing citywide planswere unable to fully engage the community. For this reason,new methods of coordinating with the community weredeveloped. User-friendly information and monitoring systemsin the municipalities have become a new and effectivemethodological tool for local sustainable development. Citizenshave been more attracted to public life and motivatedto engage in improving the quality of life of their street,neighbourhood, town, city, and municipality once they havetaken part in the processing of updated and accurate informationthat affects their lives.The Sustainable Development Observatories in Manizales,Colombia are an example of shared management andcitizen participation in local sustainable development. In practice,the successful development of the Observatories hasbeen due to the active participation of the city municipality,universities, trade unions, institutions, non-governmentalorganisations (NGOs), and community organisations. Thetechnological, economic, and information support they haveprovided have been essential to the advancement of theproject. This support has undoubtedly enabled many of theeconomic, social, and environmental programmes and projectsin Manizales to be carried out.The observatories in Manizales are basically a monitoringsystem designed as a support system for local urban governance.Their main features are regularly updated economic,social, and environmental indicators formulated with citizenparticipation and updated by technical support staff. Theyare available to citizens, who are encouraged to permanentlyevaluate the achievements of the social, economic, and environmentalprogrammes and projects carried out by theMunicipal Development Plan, and participate in its monitoringand implementation. In this way, the information that theuniversity and research centres produce about the municipalityis easily transmitted to the community through userfriendlymethods, especially the project’s most visible andappealing feature, the Quality of Life Traffic Lights.These Quality of Life Traffic Lights are located in strategiclocations around the city, in order to raise awareness andinterest in the Local Environmental Action Plans and motivateOctober 2002 63

Luz Estela Velásquez, translated by Kimberly Vilar13GENERAL SECTIONcitizens to take part in their ongoing monitoring process. Theelectronic billboards display the quality of social, economic,and environmental indicators for the city's eleven districts orneighbourhoods, under a familiar, distinctly urban symbol(traffic lights) and colour scheme (green, yellow and red).ObjectivesThe Sustainable Development Observatories in the Manizalesmunicipality aim to fulfil the following specific objectives:• support sustainable development planning and managementwith an information system, which pools economic,social, and environmental data;• encourage the management and efforts of the localgovernment in fulfilling the policies of the DevelopmentPlan and facilitate the objective analysis of the indicatorresults in order to monitor and define ongoing programmesand projects;• fittingly provide the required information on the citysustainable development performance for use in the planningprocess;• share knowledge with all sectors of the community bymeans of user-friendly Quality of Life Traffic Lights whichillustrate comprehensive indicators that accurately reflectthe city level of sustainable development;• permanent monitoring of the programmes and projects ofthe Municipal Development Programme: the Biomanizales;• increase the range of participation of the citizens in theprogrammes and projects according to the Local Agenda21: the Bioplan; and• give priority to the shared urban management to coordinateand execute common interest projects in order tocreate a dynamic planning process and greater institutionalinvolvement.Frequently asked questions and answersWhat is a Sustainable Development Observatory?The Observatories are the physical locations where thecommunity has access to social, economic and environmentalinformation. They are strategically located in high-densityand appealing places throughout the city so that local residentscan see them. In order to strengthen the communitymanagement capabilities needed to make good use of theObservatories, the universities are providing trainingprogrammes for community organisations, trade unions, andinstitutions. Furthermore, environmental education sessionsare carried out in the Observatories themselves.Who manages and administrates the Observatories?The municipal government is the essential leader of the“The Observatories in Manizales arebasically a monitoring system designedas a support system for local urbangovernance. Their main features areregularly updated economic, social, andenvironmental indicators formulated withcitizen participation and updated bytechnical support staff”project. Additionally, government authorities have providedtechnical, human, and financial resources for the managementof the Observatories. However, the strong precedentof shared leadership between the municipality and theuniversity in Manizales has allowed for joint governance.Who designed the Observatories system?The system was designed by a technical team of municipalemployees and researchers from the Environmental StudiesInstitute of the Colombian National University and the IndependentUniversity of Manizales, both acknowledged fortheir commitment to local sustainable development. TheEconomic Commission for Latin America and the Caribbean(ECLAC) also technically assisted the design. As a test for thedesign the technical group implemented a prototypelaunched in the community awareness phase of the project.Why is inter-institutional coordination vital for the runningof the Observatories?Consensus building between institutions is absolutely necessaryfor the implementation of the Observatories becauseimplementation is based on the information supplied by institutionson national, regional, and local levels. By means of aformal agreement with the municipality, these partnerscommit to making economic, technical, and logistical contributions.However, local government leadership is inherentlyfundamental to the signing of Cooperation Conventionmeetings.How do Observatories seek to promote participatorycitizenship education?By increasing local citizen knowledge about city economic,social, and environmental conditions, the Observatories seekto increase citizen interest and engagement in the MunicipalDevelopment Plan’s promotion of sustainable developmentprojects and programmes. By promoting active study groups64 October 2002

Sustainable Development Observatories in Manizales, Colombia13in each district and the participation of support committees,district action committees, local management committees,and the different economic sectors, trade unions, institutions,and NGOs, the citizen education projects are increasingcitizen participation. When the results of the quality of lifeindicators of the municipality, district, and neighbourhoodsare published, the Observatories become citizen participationvenues.Who is leading the Observatories’ community educationprocess?The process is being led by the secretary of District Developmentand the Institute of Municipal Training, with thesupport of the universities registered in the BiomanizalesCooperation Convention. Some experienced NGOs that workin the various district-specific population participationprogrammes are also involved.How do the indicators reach people?The system is made up of factors, variables, and indicatorsthat will be processed by sophisticated computer softwarespecially designed for the project. The design includes a setof technical tools that will allow for speedy adjustments toindicators and their periodic evaluation, as well as convenientmonitoring of the most fundamental variables. Nevertheless,the system has been especially geared to be equallyaccessible to the general population and specialists. Duringthe design process, indicators were selected in order tocompare the levels of sustainable development between citydistricts or communes, as well as between Colombian orother Latin America cities. Manizales citizens are now able totrack the qualitative changes in their commune and citythrough the electronic traffic lights as well as through indicatorsoftware set up at the observatory venues.How will the quality of the municipality's sustainabledevelopment be displayed?The Quality of Life Traffic Light System developed by theNational University of Manizales will be used; the samesystem used by the municipality to make continuous environmentaland social evaluations. Due to its simplicity, thismethodology has been employed in many other cities in thecountry.Who is involved in the running of the Observatories?The involvement of the municipal government is crucial. Forthis reason it was incorporated into the Development Planproposals as a management tool. It is essential for the planningoffices of the municipality and corpocaldas, the supportinginstitutions, the trade unions, and the organised communityto commit themselves according to their interests andcapabilities. In this way, it is absolutely necessary that duringthe process only those groups that will support the localgovernment leadership in the objective evaluation of theprogrammes and projects and those that will supply appropriateinformation for the analysis of the indicators bebrought together.Who will support the running of the Observatories?Initially, the necessary financial resources will be allocated fromthe municipality's budget, although specific projects andprogrammes will need backing from other local, regional, andnational resources, as well as international technical assistance.Likewise, it is vital to quantify the technical potentialand human resources available in the municipality, as well asthe information resources they provide. Currently, the NationalUniversity, the Independent University, the Ministry of Environment,and Economic Commission for Latin America andthe Caribbean (ECLAC) have agreed to participate.Understanding the political culture of the participatingpopulation.It is important to note that political action taken by the urbanpopulation should reaffirm their leading role in the systemand their importance in the local community. At the sametime, comprehensive work must be carried out in order forthe municipal Development Plans to serve as tools to consolidatea political culture associated with the participatingpopulation. Feasible projects and programmes that alsoencourage political participation and membership should beincorporated in the Observatories.What is the role of the Area Council of Municipal Planning?The Area Council of Municipal Planning is the highest representativeof civilian society in the shared planning processes,which is why its leadership is fundamental to the project.Here it is urged to form links with the Assembly and activelyparticipate in familiarising itself with the project.What are the community leaders´ roles?Any real possibility of establishing permanent observatoriesgreatly depends on the role of the community in its runningof them. Due to the shared management of the observatoriesit is important to stress that the leaders of the communitywho have previously backed the increase in socialawareness of the Districts, are involved from the FamiliarisationPhase of the project onwards. Likewise, this phaseinvolves defining the appropriate participation mechanismsGENERAL SECTIONOctober 2002 65

Luz Estela Velásquez, translated by Kimberly Vilar13GENERAL SECTIONfor the different members (the government, institutions, andcitizens).Will there be monitoring and evaluation of theObservatories?The running of the Observatories must be evaluated, whichentails monitoring them with management indicators. Thisis a definitive phase for the objectives of the Observatories.In this sense, it is necessary to maintain up-to-date informationon the municipality and continue permanent monitoringof its condition. At the same time any changes made inthe implementation of the Municipal Development Planshould be made as well as establishing indicators to allowbetter control of management processes that are promotedand developed with the technical cooperation of local,national, or international institutions.The challenge: the permanent operation of theObservatoriesThe running of the Sustainable Development Observatories inManizales depends to a large extent on the way in whichpopulation participation is mobilised and how the communityrole is defined in the planning and leadership of the MunicipalDevelopment Plan´s programmes and projects. In thissense, it is clear that the role of local government institutionsin Manizales must be increased in order to develop theObservatories as an important part of a methodology thatcatalyses the total involvement of government institutionswith the population.The permanent status of the Observatories and qualitativechanges in the long run is for the sustainability indicators toreveal if the quality of life in the municipality is increasing ordecreasing. They should also point out whether the municipalgovernment (through the implementation of“It is clear that the role of localgovernment institutions in Manizalesmust be increased in order to developthe Observatories as an important partof a methodology that catalyses thetotal involvement of governmentinstitutions with the population”programmes and projects) is meeting the current and futuredemands and desires of the population, in terms of resourceallocation. For this reason the Development Plan has the taskof integrating, in a more balanced way, economic, social, andenvironmentally beneficial programmes and projects, in orderto extensively increase the population's quality of life.It is also important that complementary community trainingbe carried out simultaneously to allow for the Observatories´optimum performance. Furthermore it is essential thatthe set of technical tools is included in the process to alloweasy adjustment of the indicators for convenient and efficientsustained evaluation.Likewise, the number Observatories that the system cantolerate, not just from the technical point of view, but alsofrom the ability to inspire population participation, is key. It isalso important that the Observatories are accessible, userfriendly,and facilitate population participation in the shortandmedium-term objectives of the Development Plan. In aprocess of permanent and participatory planning, thereshould be periodical control and monitoring of the more criticalareas in order to define, together with the community,comprehensive and concrete measures and planning.ABOUT THE AUTHORLuz Estela Velásquez, IDEA: UniversidadNacional Manizales, Facultad de Arquitectura,‘El Cable’, Manizales, COLOMBIA.Email: bioluz@emtelsq.com.coTRANSLATIONKimberly Vilar, IIED America Latina, Av. GeneralPaz 1180, Capital Federal,Buenos Aires, 1429, ARGENTINAEmail: kvilar@iied-al.org.arBIBLIOGRAPHYVelásquez, L.S. (1998) ‘Agenda 21: a form ofjoint environmental management in Manizales,Colombia’. In D. Satterthwaite and J. Bicknell(Eds.), Environment and Urbanization: Sustainablecities revisited, Vol. 10, No. 2, London:IIED.IDEA Universidad Nacional de Colombia SedeManizales – Municipio de Manizales. PlanSectorial Ambiental del Biomanizales. Bioplan1997-2000.Velásquez, L.S. (1997) ‘Sistema de monitoreo,seguimiento y control de la actuación del Plande Desarrollo Manizales Calidad Siglo XXIAlcaldú de Manizales, Colombia’. DiscussionPaper. Proyecto gestión urbana en ciudadesintermedias seleccionadas de América Latina yel Caribe. Santiago de Chile: ComisiónEconómica para América Latina y el Caribe(CEPAL).Velásquez, L.S (2000) Estrategias einstrumentos de gestión urbana para eldesarrollo sostenible en América Latina y elCaribe. Observatorios para el DesarrolloSostenible del Municipio de Manizales –Colombia. Manizales: IDEA, CEPAL, UnitedNations, Municipio de Manizales.66 October 2002

14Los Observatorios para elDesarrollo Sostenibles enManizales, ColombiaGENERAL SECTIONby LUZ ESTELA VELÁSQUEZIntroducciónEn Colombia, los municipios comienzan a promover la vinculaciónconsciente de los ciudadanos e instituciones en losprocesos de planificación del desarrollo sostenible. LasAgendas Ambientales Locales articuladas a la Agenda Local21, Los Planes de Acción Ambiental Local y los Observatorios,son los principales instrumentos con los que cuenta laciudadanía para la participación en este proceso.En la práctica, existen dificultades para articular elgobierno local, las instituciones y los ciudadanos en el avancede la gestión integral requerida por el desarrollo sostenible yse reconoce que los técnicos que elaboran los planes noencuentran los métodos apropiados para vincular a la comunidad.Por esto, se plantea la necesidad de implementar enlos municipios sistemas de información y monitoreo de fácilcomprensión ciudadana, que sean parte integral de losnuevos instrumentos metodológicos requeridos para lagestión local del desarrollo sostenible. Si los ciudadanospueden participar en las fases de procesamiento de la información,y conocer sus resultados, llegarán mas fácilmente amotivarse para vincularse a programas y proyectos de mejoramientode la calidad de vida de su calle, su barrio, sucomuna, su ciudad y su municipio.Una experiencia que demuestra que existe la posibilidadde una gestión compartida y de amplia participaciónciudadana para el desarrollo sostenible local, es la de losObservatorios para el Desarrollo Sostenible del municipio deManizales. En la practica, el montaje de los Observatorios hasido posible gracias a que se ha logrado la participación delmunicipio, universidades, gremios, instituciones, organizacionesno gubernamentales (ONGs) y organizaciones comunitarias,su aporte con recursos técnicos, económicos y deinformación ha sido fundamental para el avance delproyecto. Sin duda alguna, esto es lo que ha permitido llevara cabo muchos de los programas y proyectos de mejoramientoeconómico, social y ambiental en Manizales.Los Observatorios para el Desarrollo Sostenible del municipiode Manizales en Colombia, hacen parte del sistema demonitoreo propuesto como apoyo a la gestión urbana local.A partir de los resultados de indicadores económicos, socialesy ambientales, los ciudadanos pueden evaluar de formapermanente el desempeño de programas y proyectos sociales,económicos y ambientales del Plan de Desarrollo Municipal, yparticipar en su seguimiento y realización. Uno de los mayoresaportes de este proceso, ha sido posibilitar que la informacióncientífica y técnica que se produce sobre el municipio, en lasuniversidades y centros de investigación, se transmita a lacomunidad utilizando medios y códigos de fácil comprensión:Los Semáforos de Calidad de Vida.Estos semáforos están ubicados estratégicamente dentroOctober 2002 67

Luz Estela Velásquez14GENERAL SECTIONde la ciudad, para concientizar e interesar a los ciudadanos enel seguimiento de los planes ambientales. Los carteles electrónicosmuestran la calidad de los indicadores sociales,económicos y ambientales para las once comunas deManizale, a través de una escala de color netamente urbana:verde, amarillo o rojo.Los Observatorios buscan cumplir los siguientesobjetivosLos Observatorios para el Desarrollo Sostenible del municipio deManizales se sustentan en los siguientes objetivos específicos:• apoyo al proceso de planificación gestión del desarrollosostenible del municipio con un sistema de información queintegra aspectos económicos, sociales y ambientales;• apoyar de forma permanente la gestión y desempeño delgobierno municipal en el cumplimiento de las políticas delPlan de Desarrollo y posibilitar el análisis objetivo de resultadosde indicadores para definir la continuidad de programasy proyectos;• suministrar oportunamente la información lógica que sobreel desarrollo sostenible del municipio se procesa en lasuniversidades, los centros de investigación, instituciones ydependencias del municipio para que repercuta en elproceso de planificación;• socializar la información entre todos los sectores comunitariosa través de indicadores integrales que permitanconocer el estado del desarrollo sostenible del municipiocon códigos de fácil comprensión ciudadana a trabes de losSemáforos de Calidad de Vida;• facilitar el suministro permanente de la información paraque esta trascienda con sus resultados a las comunidadesy ciudadanos e incida sobre la validación objetiva de laspolíticas, los programas y proyectos del Plan de Desarrollo;• monitoreo permanente de los programas y proyectos delPlan de Desarrollo Municipal: El Biomanizales;• incremento de la capacidad de participación de losciudadanos en los programas y proyectos de la AgendaLocal 21: El Bioplan;• dar prioridad a la gestión urbana compartida para laconcertación y ejecución de proyectos de interés comúnpara generar un proceso de planificación dinámico y orientadorde amplia participación institucional; y,• los Observatorios deben ser lugares eficientes de transmisiónde información sobre el desarrollo sostenible municipaly de apoyo para la comunicación entre el gobierno localy la ciudadanía.¿Que es un Observatorio para el Desarrollo Sostenible?El Observatorio es el espacio donde se conoce, se propone yse evalúa a través del resultado de indicadores, la gestión yplanificación del desarrollo sostenible del municipio. A travésde los Observatorios se orienta y facilita la ejecución deprogramas y proyectos económicos, sociales y ambientalesincluidos en el Plan de Desarrollo y se canaliza la participaciónciudadana en la planificación. En este sentido, su carácterdebe ser participativo y permanente.¿Quiénes los lideran y quien administrará losObservatorios?El gobierno municipal es el líder natural del proyecto. Sinembargo, en el caso de Manizales los antecedentes de unliderazgo compartido entre el municipio y la universidad hanposibilitado la administración conjunta. Igualmente, se hanvinculado instancias gubernamentales con aportares enrecursos técnicos, humanos y financieros para la administracióny funcionamiento.¿Quién diseñó el sistema de Observatorios?El sistema lo diseñó un grupo técnico integrado porfuncionarios municipales e investigadores del Instituto deEstudios Ambientales de la Universidad Nacional de Colombiay de la Universidad Autónoma de Manizales, ambasuniversidades con reconocida trayectoria en la gestión deldesarrollo sostenible del municipio. Para ello se contó con laasistencia técnica de la Comisión Económica para AméricaLatina (CEPAL). Como prueba, el grupo técnico realizó unprimer prototipo que puso en funcionamiento en la fase desocialización comunitaria del proyecto.¿Porqué es importante la concertación interinstitucionalpara el funcionamiento de los Observatorios?La concertación interinstitucional es necesaria para la implementaciónde los Observatorios porque el funcionamientode los Observatorios depende de la información que sesuministra en instituciones de orden nacional, regional y local.Estos ‘socios’ adquieren el compromiso con el municipio encuanto aportan recursos económicos, técnicos y logísticos.Sin embargo, es fundamental el liderazgo del gobierno localen las convocatorias para la firma de los Convenios de Cooperación,según las particularidades de la gestión interinstitucional.¿Que se entiende en los Observatorios por educaciónciudadana participativa?Se pretende ampliar el conocimiento sobre la realidad parapromover el compromiso de la ciudadanía con los proyectosy los programas que el Plan de Desarrollo Municipal tieneprevistos para mejorar las condiciones económicas, sociales y68 October 2002

Los Observatorios para el Desarrollo Sostenibles en Manizales, Colombia14ambientales del municipio. La promoción de grupos de estudiosdel desarrollo sostenible en cada comuna, la participaciónde los comités de apoyo, juntas de acción comunal,juntas administradoras locales (JAL) y de los distintos sectoreseconómicos, gremios, instituciones y organizaciones nogubernamentales en los proyectos de educación ciudadanaintensificará la participación ciudadana consiente. Los Observatoriosdeberán constituirse en espacios de participaciónciudadana a partir del momento en que se conozcan losresultados de indicadores de calidad de vida del municipio,de su comuna y de su barrio en particular.¿Quiénes lideran el proceso de educación comunitaria parael funcionamiento de los observatorios?La Secretaría de Desarrollo Comunitario y el Instituto deCapacitación Municipal de desempeñarán esta función, conel apoyo de las universidades inscritas en el Convenio deCooperación del Biomanizales. También se integraronalgunas de las ONG’s que estén trabajando en los diversosprogramas de capacitación ciudadana de las comunas.¿Cómo se conocerán los indicadores?Durante el proceso de elaboración, actualización y selecciónde los indicadores que harán parte del sistema de Observatoriosde desarrollo sostenible del municipio de Manizales, setuvieron en cuenta tanto indicadores de aplicación genérica,que permitirán comparar el estado de desarrollo sostenibledel municipio con el de otros municipios de Colombia o deAmérica Latina, como aquellos que permitirán conocer alnivel local el estado de desarrollo sostenible de las distintascomunas que integran la ciudad. A través monitoreo permanentede los indicadores y su expresión de calidad en lossemáforos electrónicos localizados en los observatorios, losciudadanos podrán detectar oportunamente los cambioscualitativos que se produzcan en su comuna. El sistema secompone de factores, variables, indicadores que serán procesadosa través de un programa de computador, especialmentediseñado para el proyecto y que tiene como objetivoser accesible tanto a los expertos o especialistas, como a laciudadanía en general. Igualmente, el diseño incluye unconjunto de herramientas técnicas que permitirán agilizar elproceso de ajuste de los indicadores y su evaluación periódicay realizar un control y seguimiento oportuno sobre las variablesmás críticas.¿Cómo se expresa la calidad del desarrollo sostenible delmunicipio?Se utilizara el Semáforo de Calidad de Vida sistema que desarrolloel Idea de la Universidad Nacional en Manizales y que ha“Los Observatorios para el DesarrolloSostenible del municipio de Manizalesen Colombia, hacen parte del sistema demonitoreo propuesto como apoyo a lagestión urbana local”sido utilizado por en el municipio para hacer la evaluaciónpermanente de aspectos ambientales y sociales. Estametodología ha sido utilizada en muchas otras ciudades del paíspor la sencillez de su expresión metodológica, su evolución yaplicación en el caso del municipio de Manizales ha permitidollegar a establecer indicadores articulados a un sistema de evaluacióny seguimiento a través de los Observatorios.¿Quiénes participan en el funcionamiento de losObservatorios?La participación del gobierno municipal es indispensable, poresta razón se integró a las propuestas del Plan de Desarrollocomo instrumento de gestión. Es necesario que la Oficina dePlaneación del Municipio y Corpocaldas, las instituciones deapoyo, los gremios y la comunidad organizada se comprometansegún sus intereses y posibilidades. Por esto, es definitivo quedurante el proceso se constituyan los grupos que apoyarán elliderazgo del gobierno local en la evaluación objetiva de losprogramas y los proyectos y en el suministro oportuno de lainformación para el procesamiento de los indicadores.¿Quiénes aportarán los recursos para el funcionamiento delos Observatorios?Los recursos provienen en primera instancia del presupuestomunicipal, pero para los proyectos y programas específicoses necesario concertar el apoyo de otros recursos locales,regionales y nacionales, y concretar el apoyo técnico internacional.Igualmente, es necesario cuantificar el potencialtécnico y de recursos humanos que existe en el municipiocomo recursos de contrapartida en el suministro de información.Hasta el momento se han comprometido la UniversidadNacional, la Universidad Autónoma, el Ministerio deMedio Ambiente y la CEPAL.¿Que se entiende en los Observatorios por cultura políticade la participación ciudadana?Es importante reconocer que la acción política de lospobladores urbanos debe recuperar su protagonismo eimportancia local. Igualmente, hay que trabajar integralmentepara que los Planes de Desarrollo Municipal se convier-GENERAL SECTIONOctober 2002 69

Luz Estela Velásquez14GENERAL SECTIONtan en instrumentos de consolidación de una cultura políticaarticulada a la participación ciudadana. En los Observatoriosdeberán integrarse programas y proyectos que sean defactible realización y que generen procesos políticos de participacióny pertenencia ciudadana.¿Que papel cumple el Consejo Territorial de PlaneaciónMunicipal?El Consejo Territorial de Planeación Municipal es la máximarepresentación compartida de la sociedad civil en los procesosde planificación participativa, por ello su liderazgo esfundamental para el proyecto. Se sugiere que se vincule a laConvocatoria y participe activamente en el proceso de ambientalizacióndel proyecto.¿Que papel juega los líderes comunitarios?La posibilidad real de permanencia de los Observatoriosdepende de en gran medida de la posibilidad que se le dé ala comunidad en su funcionamiento. Es importante resaltarque por el carácter participativo de los Observatorios, seinvolucren desde la fase de ambientalización del proyecto,líderes ciudadanos que han respaldado anteriormente lasocialización en las comunas. Igualmente, se requiere que enesta fase se definan los mecanismos de participación adecuadospara los distintos actores: gobierno, instituciones yciudadano.¿Se realizará la evaluación y seguimiento de losObservatorios?El funcionamiento de los Observatorios tiene que evaluarse,para ello se requiere de realizar el seguimiento con indicadoresde gestión. Esta es una fase definitiva para lospropósitos de los Observatorios. En este sentido, es necesariomantener actualizada la información sobre el municipio yrealizar el monitoreo permanente sobre su situación, al igualque registrar los cambios ocurridos con la ejecución del Plande Desarrollo Municipal y establecer indicadores que permitanun mejor control de los procesos de gestión que sepromueven y desarrollan con cooperación técnica institucionesdel orden local, nacional o internacional.El Reto: el funcionamiento permanente losObservatoriosEl funcionamiento de los Observatorios para el DesarrolloSostenible del municipio de Manizales, depende en granmedida de la forma como se dinamice hoy la participaciónciudadana y se capacite a la comunidad para la planificacióny el liderazgo en los programas y proyectos del Plan de DesarrolloMunicipal. En este sentido, es claro que en Manizales serequiere ampliar la capacidad del gobierno local y las institucionespara desarrollar los Observatorios como parte integralde una metodología que conduzca a involucrar a la totalidadde las instituciones del gobierno con la ciudadanía.Se requiere de la permanencia y cambios cualitativos enel largo plazo, los indicadores de sostenibilidad deberánrevelar o señalar si la calidad de vida en el municipio estamejorando o empeorando y si el gobierno municipal a travésde la implementación de programas y proyectos, se encuentraen el camino sostenible en cuanto el uso de los recursospara satisfacer equitativamente las demandas y deseos de lapoblación de hoy y del futuro. Por ello el Plan de Desarrollotiene la tarea de integrar programas y proyectos que beneficienlos aspectos económico, social y ambiental de maneramas equilibrada, para mejorar integralmente la calidad devida de la población.Es importante que se desarrollen paralelamente y deforma complementaria los procesos de capacitación comunitariapropuestos para el óptimo funcionamiento de losobservatorios e incluir el conjunto de herramientas técnicasque permitan agilizar el proceso de ajuste de indicadores parauna evaluación periódica eficaz y oportuna.Igualmente, la capacidad real del numero de Observatoriosque puede sostener el sistema, no solo desde el punto de vistatécnico, sino desde la capacidad de promover la participaciónciudadana. La importancia radicará en que sea accesible,entendible y posibilite la participación ciudadana en los objetivosdel corto y mediano plazo del Plan de Desarrollo. En unproceso de planificación permanente y más participativa sedebe realizar un control y seguimiento periódico sobre lasáreas críticas para definir con la participación de la comunidad,acciones integrales y concretas de actuación y planificación.ABOUT THE AUTHORLuz Estela Velásquez, IDEA: UniversidadNacional Manizales, Facultad de Arquitectura,‘El Cable’, Manizales, COLOMBIA.Email: bioluz@emtelsq.com.coBIBLIOGRAFIAVelásquez, L.S. (1998) ‘Agenda 21: a form ofjoint environmental management in Manizales,Colombia’. In D. Satterthwaite and J. Bicknell(Eds.), Environment and Urbanization: Sustainablecities revisited, Vol. 10, No. 2, London: IIED.70 October 2002Plan Sectorial Ambiental del Biomanizales:Bioplan 1997-2000. IDEA Universidad Nacionalde Colombia Sede Manizales – Municipio deManizales.Velásquez, L.S. (1997) ‘Sistema de Monitoreo,Seguimiento y Control de la actuación del Plande Desarrollo Manizales Calidad Siglo XXIAlcaldú de Manizales, Colombia’. DiscussionPaper. Proyecto gestión urbana en ciudadesintermedias seleccionadas de América Latina yel Caribe. Santiago de Chile: ComisiónEconómica para América Latina y el Caribe(CEPAL).Velásquez, L.S (2000) Estrategias e Instrumentosde Gestión Urbana para elDesarrollo Sostenible en América Latina y elCaribe. Observatorios para elDesarrollo Sostenible del Municipio deManizales – Colombia. Manizales: IDEA, CEPAL,United Nations, Municipio de Manizales.

15Market scoping: methods tohelp people understand theirmarketing environmentGENERAL SECTIONby BEN BENNETTIntroductionIt is often difficult for rural people, and those who are tryingto assist them, to gain an overview of how the markets fortheir main products function. Markets are not transparent;participants in the marketing process are often reluctant toshare their knowledge for fear of being bypassed, andmarketing costs and losses are subsumed into the final price,in a way that prevents sound decision-making by producers.Efforts to improve the quality of agricultural extensionadvice at the level of individual farmers, farmer groups, andcooperatives in the Philippines and Namibia during the pastsix years have led to the development of a series of simpletools which allow the building of a local marketing picture.This picture then forms the basic tool for interactionbetween service providers (in our case, area team membersin the Philippines and agricultural extension officers inNamibia) and clients (rural households). This picture is thestarting point for a more in-depth consideration of marketingand business plans and strategies using participatorytools, which focus on individual households (see for exampleRoos and Mohatle, 1998).Defining the marketing environmentMarket scoping is a broad method of quickly and simplygathering information about a marketing system andpresenting it in an accessible and understandable way. It isnot meant to be exhaustive or comprehensive, but onlysuperficial and indicative. Market scoping focuses on identifyingsources of information, key players in the market, andthe main marketing issues that need to be addressed.Twobasic principles apply to market scoping:• information should be collected in a participatory way toencourage ownership of the results;• where possible, the information should be displayed graphically(i.e. maps and pictures) that can be updated from timeto time and which are accessible (i.e. can be pinned to thewall of the extension office).Marketing systems for individual commodities are consideredholistically. Thus, all the activities leading up to the saleand final consumption of a product are incorporated. Forexample, this can include preparation, transportation, transformation,storage, processing, packaging, storage, selling,and so on.The purposes of conducting a market scoping exercise are:• to draw together existing information on production, marketing,and consumption patterns in the area under study;• to determine the market information needs of the keyclient groups;• to prioritise interventions according to more market relatedcriteria; and,October 2002 71

Ben Bennett15GENERAL SECTION“Market scoping is a broad method ofquickly and simply gatheringinformation about a marketing systemand presenting it in an accessible andunderstandable way. Market scopingfocuses on identifying sources ofinformation, key players in the market,and the main marketing issues thatneed to be addressed”• to identify and classify marketing infrastructure and institutions.It was found in both the Philippines and Namibia thattraditional participatory rural appraisal (PRA) methods(ranking, seasonal calendars, mapping, transects, Venndiagrams, etc.) revealed a great deal of information aboutthe assets available to a given community and their relationshipto those assets. However, these methods reveal littleabout the potential for broadening and deepening livelihoodpossibilities through improved marketing. Discussions withextensionists revealed that, whilst often much was knownabout the production system of a particular crop, almostnothing was known about the dynamics of demand for thatproduct and its potential alternatives. Furthermore, it wasoften the case that considerable effort had been expended toenhance yields, through improved seeds, better tillagemethods, improved weed control etc. but that in some casesthe benefits accruing from such improvements were beinglost because of post-harvest losses. The most poorly understoodof these losses was where the product had notachieved the hoped for market price. Usually this phenomenais ascribed to unfair practices by middlemen, a view universallyheld by those unaware of the way the market operates.In discussions of the problems constraining development, oneof the most common highly ranked issues is that of inadequateprices. Broadly speaking, it was to allow this issue to beunderstood in a participatory way, that some of the methodsdescribed in this article were developed.What is needed to understand the immediatemarketing environment?To describe the marketing microenvironment for a given area,a two-stage approach was adopted. The first, a process ofmarket mapping, involved preparing a resource map for thetarget area, which specifically focused on marketing,markets, and marketing resources. Secondly, the team useda number of methods, to narrow down the focus of inquiryonto a limited number of key marketable products, and tothen understand those commodities in depth.Market mappingInvitees to the market scoping workshop were requested tobring with them any maps of their immediate areas. In bothNamibia and the Philippines, even the most isolated areasmanaged to find maps from their local government departmentof works. These maps were stuck to tables withmasking tape and a layer of tracing paper fixed firmly overthe top. Participants then traced the basic elements of themap onto the tracing paper and this formed the master mapfor each area under consideration.Having created a master map, groups of participants (allextensionists in Namibia, but including key informants suchas heads of cooperatives and non-governmental organisations(NGOs), local government workers, and marketmanagers in the Philippines) then added to this map as muchmarket related information as possible. This could include:roads and their seasonality of use (access to markets is oftenconstrained by impassable roads); formal and informalmarkets (and which days they occurred on); formal and informalabattoirs; grain processing locations; sites of conglomerationsof middlemen, such as ports, key bridges, andprocessing plants; and so on. The volume of informationincluded on such a map is only constrained by the knowledgeof the participants.It was found in the Philippines that the volume of informationwas too much for a single sheet, so a series of plasticoverlays were created illustrating different types of marketinfrastructure such as cattle, coconuts, maize, fish, etc. TheFilipino map also included areas of production, which allowedsimple analysis of the relationship between production andmarketing/processing to take place, often revealing keybottlenecks to market development.In many cases, it was found that the process of creatingthe market map led to a new understanding of the overallmarket dynamics in a given area, and particularly the relationshipbetween market access constraints and price. In thePhilippines, this information was used to target communitymarket information delivery, so that prices for the sameproduct in two markets (which were easy to get to from thetarget area) could be given to allow producers to deliver tothe market with the highest price.As a follow-up activity to the creation of a market map,a series of market watches were then conducted. Theseconsisted of a small team visiting a market in their area from72 October 2002

Market scoping: methods to help people understand their marketing environment15Box 1: Commodity rankingCommodityCriteria1 2 3 4 5 6 7 8 9 10 11 12Total RankMelon seeds ✓✓✓ ✓✓ ✓✓ ✓✓ ✓✓ ✓✓✓ ✓✓✓ ✓✓✓ ✓✓✓ 23 4thJackal berries ✓✓ ✓✓✓ ✓✓ ✓✓✓ ✓✓ ✓✓✓ ✓✓ 17 8thChillies ✓✓✓ ✓✓ ✓✓✓ ✓✓✓ ✓✓✓ ✓✓✓ ✓✓✓ ✓✓✓ ✓✓✓ 26 1stLocal spinach ✓✓ ✓✓ ✓✓✓ ✓✓✓ ✓✓ ✓✓✓ ✓✓ ✓✓✓ ✓✓✓ 23 4thPear millet ✓✓✓ ✓✓✓ ✓✓✓ ✓✓ ✓✓ ✓✓✓ ✓ ✓✓✓ ✓✓✓ ✓ 24 3rdBaskets ✓✓ ✓✓ ✓✓ ✓✓ ✓ ✓✓ ✓✓ ✓✓ ✓✓ 17 8thThatching grass ✓✓ ✓✓ ✓✓ ✓✓ ✓✓ ✓✓✓ ✓ ✓✓ ✓✓ 18 7thGrain storage basket ✓✓✓ ✓✓ ✓✓✓ ✓✓ ✓ ✓✓ ✓✓ ✓✓ 17 8thMilk ✓✓ ✓✓ ✓✓ ✓✓ ✓✓ ✓✓ ✓✓ ✓✓✓ ✓ 18 7thCattle ✓✓✓ ✓✓✓ ✓✓✓ ✓✓✓ ✓✓ ✓ ✓✓✓ ✓✓✓ ✓ 21 5thGoats ✓✓✓ ✓✓ ✓✓✓ ✓✓✓ ✓✓✓ ✓✓ ✓✓ ✓✓✓ ✓✓ ✓ 24 3rdBraai meat ✓✓✓ ✓✓✓ ✓✓ ✓✓ ✓✓✓ ✓✓✓ ✓✓ 18 7thChicken ✓✓ ✓✓ ✓✓ ✓ ✓ ✓ ✓✓✓ ✓✓ ✓✓ ✓ 18 7thSorghum beverage ✓✓ ✓✓ ✓✓✓ ✓✓ ✓✓ ✓✓ ✓✓ ✓✓ ✓ 18 7thMarula juice ✓✓ ✓✓✓ ✓✓ ✓✓ ✓✓ ✓✓ ✓✓ ✓✓ 17 8thMarula kernel ✓ ✓✓ ✓✓ ✓ ✓✓ ✓✓ ✓✓ ✓ ✓✓ ✓✓ ✓✓ 19 6thSpinach cake ✓✓ ✓✓ ✓✓✓ ✓ ✓ ✓✓ ✓✓ ✓✓ ✓✓ 17 8thFlour (millet, sorghum) ✓✓✓ ✓✓✓ ✓✓✓ ✓ ✓✓ ✓✓ ✓✓✓ ✓✓ ✓✓✓ ✓✓✓ 25 2ndMillet-based soft drink ✓✓✓ ✓✓ ✓✓ ✓✓ ✓✓ ✓✓✓ ✓✓ ✓✓ ✓ 19 6thProcessed palm fronds ✓✓ ✓ ✓✓✓ ✓ ✓ ✓✓✓ ✓✓ ✓✓ ✓✓ 17 8thGENERAL SECTIONvery early in the day and then following the progress of productsarriving and then being sold. This revealed to participantsthe prices of products arriving and leaving the market, themarketing costs involved, and importantly, the type ofconsumer involved and some of the consumer’s needs.Marketing systems analysisA marketing system is the sum of all activities leading to thesale and final consumption of a product, and may includeactivities such as preparation, transport, processing, packaging,storage, and selling. All these factors are influenced notonly by the nature of the product, but also by social andcultural factors which can fall outside the influence of theproduct or the market. For example, in Namibia the sale ofcattle is largely unrelated to market price, but rather relatedto social or physical need. Thus, to understand how marketingsystems operate in such areas, broader concepts thansimple marketing economics need to be applied.Prioritising key commodities – commodity rankingExperience in both the Philippines and Namibia showed thatrural households see value in an enormous number of naturallyavailable products. This breadth of items often came as asurprise to the extension workers involved, who are trained toconcentrate on commodities of strategic importance (usuallythe key food grain plus livestock). If non-agricultural goods areincluded (i.e. non-timber forestry products such as baskets andfirewood), the list of commodities can become extremely long.One group in Namibia, a country ostensibly without great agriculturalor livelihood diversity, identified 60 marketedcommodities in their area, far more than they expected. In thePhilippines, this could run to well over 100 items.The commodity ranking exercise consists of three stages.First, participants list all the commodities they can think ofthat might be marketed or which have value. The group thenbrainstorm a set of criteria by which to rank the commodities.Examples of these criteria include: important for food security,profitability, drought tolerance, seasonal advantages,beneficial to women, requiring little labour, traditionallyimportant, etc. Participants then score the commodities on ascale of one to three (three being the most important) andthe scores are totalled 1 (see Box 1).1 The author recognises the potential statistical pitfalls of ranking provided bysuch a method (see Fielding et al, 1998), however the purpose is only to limit thescope of further research to a manageable level. Commodities not selected forfurther research in the first round will be considered later.October 2002 73

Ben Bennett15GENERAL SECTIONDuring evaluation of this method with participants it wasagreed that, in order to make the process not too demanding,the number of criteria should not be more than ten, andif possible, no more than 50 commodity items should beincluded. Experience also suggests that time spent properlydefining the criteria and the meaning of the scores attachedto each criterion will be repaid later as this will mean fewerarguments over the group ranking decision.The purpose of commodity ranking is two fold. Firstly, itreveals the large number of economically and socially importantcommodities in a given area. Secondly, the processallows a large group to agree on the commodities that willget greater attention in the market scoping process.Commodity system and chain analysisHaving narrowed the focus of commodities to be investigated,the teams then applied two further methods to buildinga more in-depth picture of marketing problems andpotential for each commodity. First, the group conducted acommodity chain analysis using a simple table (see Box 2).This takes a single commodity and breaks down all theactions from production to marketing. In Namibia, wherethere are relatively simple marketing systems, few middlemenand little processing, these chains were short. In thePhilippines, the opposite was often the case.Having listed all the stages of marketing and processing,more information can be added, such as the gender differentiationof the activity (is the activity done by men, women,or children?). This part of the exercise is particularly useful asit allows the correct targeting of interventions. If, for example,it is found that women take the product to market, trainingin marketing for men is pointless. For each stage, the groupthen discussed losses and problems. These problems thenwent on to become the focus of future interventions.Groups agreed that the commodity chain analysis wasvery useful in revealing problems that were hitherto hiddento them. However, they all preferred to conduct the exercisein larger, rather than small groups (i.e. they did not want tobe split up into groups considering individual commodities).Using commodity chain analysis to develop seasonalcalendarsFor each commodity, the group prepared a seasonal calendarshowing when in the season the activities identified occurred(see Box 3). They were also asked to indicate when during theseason the best prices would be achieved for each commodity.This information can then be used to discuss with farmersproduction strategies that maximise seasonal price advantage.Box 2: Commodity chain analysisCommodity ChilliesM/F/Ch Losses ProblemsActivities toproduce andSowing (seed pot) F/Ch Xmarket the Transplant F/Ch XcommodityWatering Ch 0Harvesting F/Ch XXX Breaking of chilliesDrying F/Ch XXX Insects; moisturePackaging F/Ch XTransporting M/F/Ch 0Selling F XXStealing at theselling pointsM: male F: female Ch: children 0: no losses X: small lossesXX: average losses XXX: high lossesIn Namibia, we discovered a problem with this approachin that the timing of marketing varies according to the onsetof the rains. Therefore a system was needed to understandthe relationship between the time of planting and the otheractivities involved in producing and marketing. The result wasthe development of the ‘Bennett’s Wheel’ concept (see Box4). This consists of two wheels, divided into 12 equal parts torepresent months. On the larger wheel the months aremarked, and on the smaller wheel the critical activities. Thetwo wheels are then joined at the centre point so that thesmaller wheel can rotate. The extensionists/farmer can thenset a sowing time for the month of rain arrival and predictthe time when the product will be marketed.The group decided on an additional sophistication to thewheel, which involved putting an indicator of the price possibilityon the larger wheel and then reading this off througha hole cut next to the ‘selling’ segment of the smaller wheel.This allowed the user to consider adjusting planting time onthe basis of potential market price.ConclusionIn areas where the focus of attention has been production andproductivity of rural activities, market scoping can be veryuseful for broadening the horizons of rural service providers. Itis clearly important for extensionists to understand the immediatemarketing environment for those commodities that theyare recommending to farmers, and upon which they are askedto indicate research and investment priorities. Market scopingis a starting point for a much more market-oriented approachto farming and livelihoods systems analysis.74 October 2002

Market scoping: methods to help people understand their marketing environment15Box 3: Commodity chain analysisCHILLIES Month Month Month Month Month Month Month Month Month Month Month MonthSowing (seed pot)TransplantWateringHarvestingDryingPackagingGENERAL SECTIONTransportingSellingBox 4: ‘Bennett’s Wheel’ – flexible seasonal calendars.Large wheelNovemberDecemberSmall wheelOctoberSeptember$$$$$$$$$JanuaryFebruarySowingTransplantWateringWateringAugustJuly$$$$$$AprilMarchWateringHarvestingDryingPackagingTransportingSellingJuneMayABOUT THE AUTHORBen Bennett, P.O. Box 40624, Ausspannplatz,Windhoek, Namibia.Email: divplan@mweb.com.naBen is a Principle Scientist with the NaturalResources Institute,University of Greenwich, UK, currently onsecondment as team leader of theEU funded Namibian Agricultural SupportServices Project (NASSP).ACKNOWLEDGEMENTSThe author is indebted to the staff and beneficiariesof the EU Small Island Support ServicesProgramme (SMISLE) in the Philippines and theMinistry of Agriculture, Water and Rural Development,Namibia. Pepa Dumon, MiguelLoureiro, and Marion Palmer made significantcontributions to the evolution of thisapproach.REFERENCESRoos, M. & Mohatle, M. (1998) ‘Investigatinglocal markets using PRA’. In A. Jeans (Ed) PLANotes 33, pp.45–53. London: IIED.Fielding, J., Riley, J. & Ayejola, B. (1998) ‘Ranksare statistics: some advice for their interpretation’.In A. Jeans (Ed) PLA Notes 33, pp.35–39.London: IIED.October 2002 75

Tips for trainersby JOHN NEWSTROM and EDWARD SCANNELLTIPS FOR TRAINERSHopes and fears – introductionand icebreakingObjectiveTo allow participants to express,share, and reduce the misconceptionsthey may have brought with them toa training programme.MaterialFlipcharts or notepaperTime25 minutesProcedureIn some workshops, participants maycome from a large geographical area,may know very little about theproposed programme, may not knoweach other, or may not know what isexpected of them. In these cases, itmay be appropriate to create a forumfor exchanging and discussing somepreconceptions.1. Divide the participants intosmall groups of 4–6 people. Give aflipchart or notepaper to each group.2. Have each group selectsomeone to record the information.Ask them to respond quickly to thequestion. ‘What fears, concerns, orpreconceived notions did you havebefore coming here today?’3. After gathering responsesquickly, ask the reporters to presenttheir lists to the entire group. This willpresent excellent opportunities forthe trainer to empathise with traineeneeds, as well as provide reassuranceby using the items to indicate howthe seminar does/does not relate tothose concerns.CommentsUse the following questions to helpin the debriefing.1. ‘What were some of the fears,concerns, or preconceived notionsexpressed in each group?’ Pastexamples include the following:• ‘Will I be the oldest (youngest)person?’• ‘Will I be the only man (woman)?’• ‘Will I act appropriately at my firstprofessional seminar?’• ‘I am sure everyone will be moreexperienced than I am.’• ‘What will I get out of theprogramme?’• ‘What kind of questions should Iask?’• ‘What will the room/programme/trainers, etc. be like?’• ‘Will we receive the promised perdiem?’2. ‘What can I/we the trainer(s)do to reduce your concerns?’Possibilities include explaining thedress ‘code’, defining all acronymsused, having copies of anyoverheads to be used, speakingslowly, and so on.● Source: John Newstrom and EdwardScannell (1980)● Taken from: Pretty J.N., Guijt I.,Thompson J. and Scoones I. (1995)Participatory Learning and Action, aTrainer’s Guide. London: IIED SustainableAgriculture and Rural LivelihoodsProgramme, IIED.76 October 2002