Perceptions of veterinarians regarding privatization of veterinary services delivery in Ghana and Jamaica

There are on-going reforms in the delivery of veterinary services in many developing countries, with privatization of certain veterinary activities as one of the approaches. In Jamaica, with the support of veterinarians, clinical aspects of veterinary services were privatized in 1992. In contrast, Ghanaian veterinarians are generally wary of the government's on-going privatization process. The objective of this study was to find out if perceptions of the veterinarians from these two countries on certain issues of privatization were sufficiently different to explain the willingness or reluctance to go into private practice.

The response proportions for predominantly self-administered questionnaires were 83% (121/145) and 92% (35/38) for Ghana and Jamaica, respectively. There was a very good (92%) agreement in the perceptions of veterinarians in Ghana and Jamaica on a battery of 24 responses pertaining to privatization of veterinary services. Generally, the perceptions of the veterinarians in Ghana and Jamaica were similar even though the predominant delivery systems for animal health services were different. Therefore, reasons other than those examined in this study may explain the differences in willingness to go into private practice. The need to account for these other reasons is discussed.     

Perceived Constraints to Privatization of Delivery of Veterinary Services in Ghana

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

Needs, difficulties, and possible approaches to providing quality clinical veterinary education with the aim of improving standards of companion animal medicine in sri lanka

Companion animal medicine has now gained prominence in Sri Lanka as a result of an increased public interest in pets; however, veterinary education has not kept pace with current developments. The main constraints faced by the veterinary education system are those common to all university education in Sri Lanka. Changes in the current system, though important, depend heavily on political will and vision, which are not forthcoming in the near future. It is therefore both necessary and important that the private sector provide the impetus to improve standards of veterinary medicine in Sri Lanka. The immediate focus should be on improving the skills of practitioners through clinically based continuing education programs. Later, more specialized and intensive programs may be initiated. Interaction and sharing of knowledge with more developed countries are critical in leading the way to improved standards of companion animal medicine in Sri Lanka.     

Financing the Delivery of Public-Sector Animal Health Services in Jamaica: Pre- and Post-Privatization

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

Perceived constraints to private veterinary practice in India

We used an exploratory study in two districts of West Bengal State, India to find out the constraints of private veterinary practice. Privatization of veterinary services is being seen as an alternative to government-sponsored veterinary services to livestock. In December 2000 to February 2001, 50 private veterinary practitioners were interviewed from the districts. Their opinion was that weak regulations about competition from illegal practitioners and the use of veterinary drugs, competition by animal-health technicians (who are likely to charge less than veterinarians), absence of efficient diagnostic-laboratory support, and lack of commercial livestock farming were the main constraints faced.     

International programs and veterinary public health in the Americas—Success, challenges, and possibilities

The veterinary public health (VPH) program at the Pan American Health Organization (PAHO) began in 1949 when an arrangement with the newly founded World Health Organization made PAHO its Regional Office for the Americas to serve as the specialized health agency both for the Organization of American States and the United Nations. It started as a Section of Veterinary Medicine to help eradicate rabies on both sides of the US-Mexico border, and PAHO grew to be the biggest VPH program in the world. By providing a political and technical base, PAHO assisted its member states to organize and develop their national VPH programs and activities, and it provides technical cooperation and works with their national counterparts to solve national and local problems.In the 1980s and 1990s, PAHO concentrated that cooperation on several, specific needs: the elimination of dog-transmitted human rabies, hemispheric eradication of foot-and-mouth disease (FMD), regional action planning for food safety, control/eradication of bovine tuberculosis and brucellosis, and surveillance and prevention of emerging zoonoses and food-borne diseases. The Pan American centers developed a number of diagnostic antigens and a continental system for the surveillance of FMD and vesicular diseases, using geographic quadrant technology to augment sensitivity, analyze data, and make decisions. Another visible accomplishment is the elimination of hydatidosis in the endemic countries and regions of the southern cone.In addition, the VPH program of PAHO pioneered the mobilization of the private sector to participate in official programs. Nevertheless, privatization of animal and human health services has had a negative effect on human resources and infrastructure by weakening essential epidemiological functions in some countries.Today, there is a need for closer coordination between veterinary medicine and medical services. Practically all potential bioterrorism agents are zoonoses, and it is cost-effective to control them at the veterinary level, providing the first line of defense. The opportunities for VPH are boundless, but the challenge is to be able to apply the plethora of available research results and knowledge. What we will need is a new breed of veterinarians who will lead and provide us with a vision, like those we honored in 2005 at the Schwabe Symposium Honoring the Lifetime Achievements of Dr. James H. Steele: veterinarians in public health who will be in the forefront of policy setting, decision-making, and allocation of resources, and veterinarians who will articulate and provide a strategic direction to our unique professional skills.     

Are government veterinary paraprofessionals serving the poor? The perceptions of smallholder livestock farmers in Western Kenya

The liberalization of clinical veterinary services in Kenya introduced new service providers into the animal health service sector. This study examines the perceptions of livestock farmers regarding these service providers and analyses the factors that influence their choice of alternative service providers in Kakamega County. The empirical analysis shows that private animal health assistants were perceived to provide better services than alternative providers because they are more accessible and offer services on credit. Results from a multinomial logit model reveal that more educated, wealthier, and older farmers are more likely to use government services. The study concludes that it is imperative to better target the poor and to integrate private service providers into government animal health programs.

     

The Perceived Value of Passive Animal Health Surveillance: The Case of Highly Pathogenic Avian Influenza in Vietnam

Economic evaluations are critical for the assessment of the efficiency and sustainability of animal health surveillance systems and the improvement of their efficiency. Methods identifying and quantifying costs and benefits incurred by public and private actors of passive surveillance systems (i.e. actors of veterinary authorities and private actors who may report clinical signs) are needed. This study presents the evaluation of perceived costs and benefits of highly pathogenic avian influenza (HPAI) passive surveillance in Vietnam. Surveys based on participatory epidemiology methods were conducted in three provinces in Vietnam to collect data on costs and benefits resulting from the reporting of HPAI suspicions to veterinary authorities. A quantitative tool based on stated preference methods and participatory techniques was developed and applied to assess the non‐monetary costs and benefits. The study showed that poultry farmers are facing several options regarding the management of HPAI suspicions, besides reporting the following: treatment, sale or destruction of animals. The option of reporting was associated with uncertain outcome and transaction costs. Besides, actors anticipated the release of health information to cause a drop of markets prices. This cost was relevant at all levels, including farmers, veterinary authorities and private actors of the upstream sector (feed, chicks and medicine supply). One benefit associated with passive surveillance was the intervention of public services to clean farms and the environment to limit the disease spread. Private actors of the poultry sector valued information on HPAI suspicions (perceived as a non‐monetary benefit) which was mainly obtained from other private actors and media.     

International programs and veterinary public health in the Americas--success, challenges, and possibilities

The veterinary public health (VPH) program at the Pan American Health Organization (PAHO) began in 1949 when an arrangement with the newly founded World Health Organization made PAHO its Regional Office for the Americas to serve as the specialized health agency both for the Organization of American States and the United Nations. It started as a Section of Veterinary Medicine to help eradicate rabies on both sides of the US-Mexico border, and PAHO grew to be the biggest VPH program in the world. By providing a political and technical base, PAHO assisted its member states to organize and develop their national VPH programs and activities, and it provides technical cooperation and works with their national counterparts to solve national and local problems. In the 1980s and 1990s, PAHO concentrated that cooperation on several, specific needs: the elimination of dog-transmitted human rabies, hemispheric eradication of foot-and-mouth disease (FMD), regional action planning for food safety, control/eradication of bovine tuberculosis and brucellosis, and surveillance and prevention of emerging zoonoses and food-borne diseases. The Pan American centers developed a number of diagnostic antigens and a continental system for the surveillance of FMD and vesicular diseases, using geographic quadrant technology to augment sensitivity, analyze data, and make decisions. Another visible accomplishment is the elimination of hydatidosis in the endemic countries and regions of the southern cone. In addition, the VPH program of PAHO pioneered the mobilization of the private sector to participate in official programs. Nevertheless, privatization of animal and human health services has had a negative effect on human resources and infrastructure by weakening essential epidemiological functions in some countries. Today, there is a need for closer coordination between veterinary medicine and medical services. Practically all potential bioterrorism agents are zoonoses, and it is cost-effective to control them at the veterinary level, providing the first line of defense. The opportunities for VPH are boundless, but the challenge is to be able to apply the plethora of available research results and knowledge. What we will need is a new breed of veterinarians who will lead and provide us with a vision, like those we honored in 2005 at the Schwabe Symposium Honoring the Lifetime Achievements of Dr. James H. Steele: veterinarians in public health who will be in the forefront of policy setting, decision-making, and allocation of resources, and veterinarians who will articulate and provide a strategic direction to our unique professional skills.     

The present and future veterinary practitioners in the tropics

Summary

The tropical countries’ inability to maintain veterinary services in the realm of the state as well as the improved quality of privately provided animal health services are leading to a change in the role, and type, of veterinarians in most of the tropics. Although control of epizootics diseases will continue to be important, further attention has to be given to the equally important nutritional deficiencies and management related diseases. These changes will have implications for the position of veterinarians as well as for animal health related research and training. The present overproduction of veterinarians in some tropical and subtropical countries can not be absorbed in private practice, especially in view of the continuing role of animal health technicians and lay personnel in disease control.     

Educational preparedness of veterinarians for foreign animal diseases

Veterinary medical education in FADs has been and will continue to be critically important if veterinarians are expected to fulfill the profession's primary obligations to society--those of protecting our animals' health, conserving our animal resources, and promoting public health. It is imperative that curricula and instruction in veterinary schools and colleges provide the depth and breadth of knowledge and understanding necessary to prepare all veterinarians, including those in private practice, for their key role in defending against FADs. Development and implementation of governmental and military programs to diagnose, prevent, control, and eradicate FADs will require a dedicated cadre of public sector veterinarians who have a solid educational foundation in FADs and understand the contemporary issues and global challenges we face. Animal-related industries, associations, and organizations will increasingly rely on well-educated veterinarians to help guide them in ways that will protect animals, clientele, consumers, and trading partners from effects of FADs. Agencies and organizations concerned with conservation of animal resources will require veterinary expertise necessary to prevent FADs in a multitude of animal species, including marine animals, wildlife, endangered species, zoologic specimens, and important genetic lines as well as our domestic companion and livestock species. Species affected by FADs also include human beings for those disease agents with zoonotic potential; thus, veterinary education also plays a key role in public health.     

Investigation of public health issues by regional field disease investigation units

The conventional means of delivering animal health services to agricultural animal producers (private veterinary practitioners and state animal disease diagnostic laboratories) leave a gap where important regional disease problems are inefficiently addressed. This gap was successfully targeted by Dr. Clive Gay in the development of the Field Disease Investigation Unit (FDIU) for the northwestern region of the United States. The FDIU has also successfully targeted several zoonotic public health concerns and its success demonstrates the existence of a similar gap in the investigation and control of important public health issues including disseminated Salmonella clones and emergence of antimicrobial resistance.     

PVS评估与差距分析——现代公共管理理念在兽医体系能力建设中的实践探析

伴随全球化格局下世界政治经济社会自然环境发生的巨变,特别是“同一世界,同一健康”理念影响的深入,兽医工作的复杂程度显著增加。世界动物卫生组织（OIE）开展的兽医体系效能（PVs）评估和差距分析,意在帮助成员提升兽医体系能力,实现保护全球动物卫生、兽医公共卫生、生态环境,保障动物源性食品供给与安全,减少贫困的职责目标。本文通过解析PVS评估和差距分析方法中蕴含的现代公共管理理念、原理和方法,探讨应用时可能出现的干扰因素,提出了我国实行良好兽医管理、完善兽医体系、强健履职能力、保障兽医工作成效全面提升的措施建议。     

Financing the Delivery of Animal Health Services in Developing Countries: A Case Study of Ghana

Inadequate financing for the delivery of animal health services in many developing countries has been blamed for lack of efficiency and effectiveness of veterinary services. There are no reports of how the delivery of veterinary services in Ghana is financed. The aim of this paper is to provide information on the funding of veterinary services in Ghana to help in decision making on resource allocation.Various indicators and measures were used in assessing the adequacy of financing and resource allocation from 1990 to 1995. These measures were the veterinary budget as proportions of the national budget, GDP and AGDP; the proportions of the veterinary budget allocated to salaries; the ratios of salaries to non-staff expenditure and of non-staff expenditure to veterinary livestock units and technical staff; coefficient of efficacy; and R- ratio. These generally declined or worsened over the period, deviating from recommended norms where such norms exist. This confirmed the paucity of financing and resource allocation for the delivery of veterinary services. Revenue generation from cost recovery over the 1993–95 period was a potential source of funding, exceeding 100% of non-staff expenditure for 1993 and 1994. However, the revenue generated was not channelled back to veterinary services but went to the national coffers. This served as a disincentive.There is an urgent need to review how veterinary services are financed in Ghana, if the delivery of services is to improve in efficiency and effectiveness.     

Factors influencing choice of veterinary service provider by pastoralist in Kenya

This study analyzed the determinants for choice of animal health providers in a semiarid pastoral area with an aim of identifying specific attributes that could be targeted for intervention to enhance pastoralist access to quality veterinary services. The data were collected through administration of semi-structured questionnaires to 350 randomly selected household heads in different locations in Narok County of Kenya. Most of these respondents had no formal education (66.9 %), and most households were headed by men (88.9 %). The men were in control of sales (84.2 %), purchases (83.7 %), and treatment of sick cattle (70.3 %), while women were responsible for milking (83.8 %). Animal health services were delivered by drug stockists (87.76 %) and government veterinarians (12.24 %). The time spent while seeking animal health services and transport cost were specific attributes with impact on the probability of choice for service providers. Although distance covered to the preferred service provider was a significant attribute, it was inversely related to the probability of choice. The other factors including herd sizes, age and sex of household head, cost incurred per visit, level of education of household head, and the number of visits did not have significant impact on choices. These findings support commercialization of veterinary services in marginalized areas where the delivery of essential animal health services such as disease control programs are often viewed as a public good. In order to enhance delivery of veterinary services in these areas, it is proposed that public and private means are investigated to support qualified veterinarians and to strengthen the activities of untrained personnel operating drug outlets.     

Training the veterinary public health workforce: a review of educational opportunities in US veterinary schools

This article presents the results of an Internet-based review conducted in January and February 2003 to assess the educational opportunities available in veterinary public health, epidemiology, and preventive medicine at the 27 veterinary schools in the United States. Most professional veterinary curricula are designed to train students for careers as highly qualified private practitioners, although there is an increased need for veterinary perspectives and contributions in the public health sector. The future of veterinary public health relies on the opportunities available in education to teach and encourage students to pursue a career of public service. The results of this review indicate the availability of a wide variety of required courses, electives, and post-graduate training programs to veterinary students in the United States. Veterinary students are exposed to a median of 60 hours of public health, epidemiology, and preventive medicine in required stand-alone courses in these areas. Four veterinary schools also have required rotations for senior students in public health, preventive medicine, or population medicine. Contact time for required public health, epidemiology, and preventive medicine courses ranges from 30 to 150 contact hours. Advanced training was available in these subjects at 79% of the 27 schools. Greater collaboration between veterinary schools, schools of public health, and the professional public health community will increase exposure to and opportunities in public health to all future veterinarians.     

Veterinary medicine educational requirements to meet the needs of the US Agency for International Development

The US Agency for International Development (USAID) works within the overall purpose of US foreign assistance to improve the lives of the citizens of the developing world. Through partnerships with other agencies, organizations, and governments, and using its field offices around the world, USAID strives to develop local capacity and thus build sustainable development. Two specific USAID programs pertinent to veterinary medicine are global health and agriculture. In the area of global health, veterinarians can aid USAID's work to improve the quality, availability, and use of essential health services that specifically target maternal and child health, HIV/AIDS, family planning and reproductive health, infectious diseases, environmental health, nutrition, and other life-saving areas. The challenge of making the agricultural sector in a developing country more productive is a critical one for USAID and a clear area for input from the veterinary profession. Animal agriculture is the largest single sector of agricultural economies in most developing countries, and livestock remains a critical component of poverty alleviation. There are educational requirements that benefit anyone working at USAID and can be met prior to admittance to a DVM program, as part of a DVM curriculum, or in post-graduate training/employment, such as proficiency in a foreign language; environmental sciences background; familiarity with accounting and management techniques; expertise in foreign animal diseases, zoonotic diseases, epidemiology, food safety, and nutrition, as well as the application to human health of those areas; an advanced degree such as an MPH; and management experience. Appropriately trained veterinarians can make enormous contributions to USAID's global efforts to improve the health and agriculture sectors of developing nations.     

Veterinary medical education in Iraq

Iraq is an agricultural country with a large population of animals: sheep, goats, cattle, water buffaloes, horses, donkeys, mules, and camels. In the 1980s, the successful poultry industry managed to produce enough table eggs and meat to satisfy the needs of the entire population; at one time, the thriving fish industry produced different types of fish for Iraqis' yearly fish consumption. There are four veterinary colleges in Iraq, which have been destroyed along with the veterinary services infrastructure. Understandably, improvements to the quality of veterinary education and services in Iraq will be reflected in a healthy and productive animal industry, better food quality and quantity, fewer zoonotic diseases, and more income-generating activities in rural areas. Thus, if undergraduate, graduate, and continuing education programs are improved, the veterinary medical profession will attract more competent students. This will satisfy the country's increased demand for competent veterinarians in both public and private sectors. Although Iraq has an estimated 5,000-7,000 veterinarians, there is a need for quality veterinary services and for more veterinarians. In addition, there is a need for the improvement of veterinary diagnostic facilities, as zoonotic diseases are always highly probable in this region. This article provides insight into the status of veterinary medical education and veterinary services in Iraq before and after the 1991 Gulf War and gives suggestions for improvement and implementation of new programs. Suggestions are also offered for improving veterinary diagnostic facilities and the quality of veterinary services. Improving diagnostic facilities and the quality of veterinary services will enhance animal health and production in Iraq and will also decrease the likelihood of disease transmission to and from Iraq. Threats of disease transmission and introduction into the country have been observed and reported by several international organizations.     

在“同一个健康”框架下,加强兽医与人医合作,有效监测和应对人畜共患病和新发传染病

新发传染病主要是人畜共患病,是世界经济和公共健康的沉重负担。这就要求加强检测、鉴别和监视传染病的能力方面投入。高致病禽流感H5N1、新甲型流感("猪流感")H1N1、非典型性肺炎、西尼罗河病毒、地方流行性狂犬病、布鲁氏菌病以及发展中国家暴发的其它人畜共患病及近期猪抗甲氧西林金黄色葡萄球菌,是人类、动物及其环境相互作用的典型范例。面临中国动物和人类常见的新发传染病坚持"同一个健康"战略,这就要求业已存在的兽医和人医及公共卫生机构的通力合作。人的疾病控制系统与动物疾病控制系统虽然都已经建立,但人畜共患病的暴发表明兽医机构和人医机构密切合作的重要性。在保证环境健康的同时,通过动物疾病和人类疾病监测系统的密切合作,中国就一定能够控制人畜共患病。以这种方式进行疾病预防、监测与应对,各层面及各动物生产部门间有效的兽医推广是加强和保持健康生态环境中人和动物健康的有效办法。中国还需大量努力才能达到从制度上保证预防和消灭疾病。透明而准确的人与动物疾病监督通常会产生经济且可持续的预防疾病方法。加拿大在兽医、公共健康、食品安全和人畜共患病预防方面所发挥的作用就是与中国农业部合作,促进必要的、可持续的兽医监督网络的建设。     

Veterinary public health: past success, new opportunities

Animal diseases are known to be the origin of many human diseases, and there are many examples from ancient civilizations of plagues that arose from animals, domesticated and wild. Records of attempts to control zoonoses are almost as old. The early focus on food-borne illness evolved into veterinary medicine's support of public health efforts. Key historical events, disease outbreaks, and individuals responsible for their control are reviewed and serve as a foundation for understanding the current and future efforts in veterinary public health. Animal medicine and veterinary public health have been intertwined since humans first began ministrations to their families and animals. In the United States, the veterinary medical profession has effectively eliminated those major problems of animal health that had serious public health ramifications. These lessons and experiences can serve as a model for other countries. Our past must also be a reminder that the battle for human and animal health is ongoing. New agents emerge to threaten human and animal populations. With knowledge of the past, coupled with new technologies and techniques, we must be vigilant and carry on.