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.     

Clients’ perceptions of delivery of veterinary services in peri-urban Ghana

A study was designed aimed at comparing the assessment of performance of animal health care delivery systems in peri-urban Ghana by livestock and poultry keepers in 4 locations. 889 respondents were interviewed using a questionnaire. A higher proportion of respondents in Location 1 met their needs for animal health by themselves, while in Location 3 these needs were met mainly by veterinarians. The mean distances to veterinary clinics, veterinary technicians or to purchase medicine were significantly higher in Location 1. Higher proportions in 3 locations perceived effectiveness of service delivery to be good. However, equity was poor in all 4 locations. Higher proportions in Locations 2, 3 and 4 said services were unaffordable. Client needs were perceived to have been met by higher proportions in Locations 3 and 4 but not in Locations 1 and 2. Staff attitude and technical competence were good in all 4 locations. The study concluded that the differences reported in the quality of service indicators in the 4 locations were not critical enough to recommend location-specific delivery systems.     

Promotion of Private Veterinary Practice in Ghana: Perceptions of Veterinarians and Veterinary Technicians

A study was designed to identify factors perceived by veterinarians and veterinary technicians as likely to promote private veterinary practice in Ghana. The participatory appraisal approach was used. The response rates were 88% (n = 90), 100% (n = 9) and 86% (n = 200) for government field veterinarians, private veterinarians and government veterinary technicians, respectively. Significant proportions of government field veterinarians (67%, n = 79), and veterinary technicians (64%, n = 167) were willing to go into private practice if the necessary push was given. Factors perceived as likely to motivate them to go into private practice included availability of capital to cover start-up costs; provision of a vehicle; prospect of higher income; availability of loans with low interest rates; availability of credit facilities from suppliers; stable macroeconomic environment with low interest and inflation rates; high pet, poultry and livestock populations at locations earmarked for private practice; leasing of vacant government premises for use as clinic and for accommodation; and enforcement of legislation on private practice, especially that against moonlighting by government veterinarians and technicians. These should be considered and used in the promotion of private veterinary practice in Ghana.     

Perceptions of Livestock Owners of Private Veterinary Practice in Ghana

Using the participatory appraisal approach, a study was designed to assess the perceptions of livestock owners on private delivery of veterinary services in two districts in the major livestock-producing area in Ghana. A significant proportion (74%, n = 180) were willing to patronize locally established veterinary practices. However, the respondents emphasized that the fees charged had to be reasonable and affordable. Factors identified as likely to discourage the use of the private provider included the inability of the provider to speak the local language; non-availability of credit facilities for services rendered by the provider; unreliability of personnel; poor interpersonal skills; lack of technical know-how; inability of the provider to make house calls or farm visits; and poor personal and work ethics. These findings provide information for prospective private veterinarians on the expectations of their clients and could be used in the preparation of veterinarians for private practice.     

Survey of mistakes made by recent veterinary graduates

To investigate the incidence and types of mistakes made in veterinary practice, and to assess the impact the mistakes had on the veterinarians involved, a questionnaire was sent in November 2002 to all the veterinary graduates of the Universities of Bristol, Edinburgh, Glasgow, London and Liverpool in 2001. One hundred and eight (27 per cent) of 402 questionnaires were returned completed; 87 of 106 respondents (82 per cent) worked frequently or always unsupervised and only 46 (43 per cent) could always rely on support from other veterinarians in the practice. Since starting work, 82 of 105 respondents (78 per cent) stated that they had made a mistake, defined as an erroneous act or omission resulting in a less than optimal or potentially adverse outcome for a patient and in many cases these mistakes had had a considerable emotional impact on the veterinarians involved. The survey highlights that a large number of recently graduated veterinarians work with little supervision and that many veterinarians beginning their year in practice do not always have access to assistance from other veterinary colleagues.     

Survey of the frequency and perceived stressfulness of ethical dilemmas encountered in UK veterinary practice

The scale of the ethical challenges faced by veterinary surgeons and their perceived stressful consequences were investigated via a short questionnaire, completed by 58 practising veterinary surgeons. Respondents were asked to report how frequently they faced ethical dilemmas, and to rate on a simple numerical scale (zero to 10) how stressful they found three common scenarios. Fifty seven per cent of respondents reported that they faced one to two dilemmas per week, while 34 per cent stated they typically faced three to five dilemmas per week. The three scenarios provided were all rated as highly stressful with 'client wishing to continue treatment despite poor animal welfare' rated as the most stressful (median 9). The female veterinary surgeons gave two of the scenarios significantly higher stress ratings than the male veterinary surgeons. Stress ratings were not influenced by number of years in practice (which ranged from one to more than 25 years). The results show that veterinary surgeons regularly face ethical dilemmas and that they find these stressful. This has implications for the wellbeing of veterinary surgeons and supports the case for increased provision of training and support, especially for those who entered the profession before undergraduate ethics teaching was widely available.     

Perceived importance and integration of the human-animal bond in private veterinary practice

OBJECTIVE: To determine perceptions of the human-animal bond (HAB) among veterinarians in private practice and evaluate how these veterinarians incorporate the HAB in their practices. DESIGN: Survey. SAMPLE POPULATION: 1,602 veterinarians in private practice in Washington state. PROCEDURE: Participants were contacted and asked to complete a survey. RESULTS: Response rate was 26% (415/1,602). Most respondents agreed that veterinarians will be more successful if they recognize and facilitate the HAB, that facilitating the HAB was important to their practices, that they actively evaluated the degree of bonding between clients and their animals, and that the bonding between a client and his or her animal affected the way they practiced medicine. However, > 50% of respondents did not train veterinary technicians and front office staff members in the HAB or encourage veterinary technicians or front office staff members to learn about the HAB. Fifty-one percent of respondents offered few or no HAB resources to clients. When asked to quantify the importance of 10 nontechnical skills associated with private veterinary practice, respondents ranked communication skills, ethical reasoning, and business management first, second, and third; the HAB was ranked fifth. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that for veterinarians in private practice in Washington state, there is a dichotomy between how important they consider the HAB to be in their practice and the degree to which they facilitate the HAB with regard to communication, training, and client resources. More research on the HAB is necessary to better understand what the HAB encompasses and its implications for private practitioners.     

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.     

Psychological well-being of Australian veterinarians

Objective   To use established psychological scales to measure levels of distress, anxiety and depression in veterinarians, and compare these levels between different veterinary subgroups and other professional groups.
Methods   A cohort of veterinarians was identified through contact with veterinary schools in Australia. Participants completed a self-reporting questionnaire that included queries about general health and demographics, psychological well-being, job-specific perceptions of health, dispositional characteristics and social support.
Results   Of the 2125 respondents who completed the psychological questionnaire, approximately one-third reported poor psychological health. Increasing age, increasing time in current job, increasing years since graduation and male gender was associated with fewer signs of distress, anxiety and depression. Compared with the general population, veterinarians experienced more negative emotions at work, but were similar to other professional groups.
Conclusions   Poor psychological health is common in the profession and professional veterinary bodies may wish to consider providing training in dealing with work-related distress, anxiety and depression.     

Treatment of canine lymphoma by veterinarians in first opinion practice in England

A survey of canine lymphoma treatment strategies by veterinarians in first opinion practice was undertaken by sending questionnaires to 1000 randomly selected, first opinion small animal veterinary practices throughout England. Completed replies were received from 382 veterinarians. Ninety-five per cent of respondents had diagnosed canine lymphoma in the preceding 12 months. Eighty-seven per cent of respondents treated at least 50 per cent of the cases of canine lymphoma they diagnosed. A multidrug combination of vincristine, cyclophosphamide and prednisolone (COP) was the treatment protocol most commonly used. A doxorubicin-based treatment protocol was used by 2 per cent of respondents to treat canine lymphoma initially. The study suggests that, despite several reports of improved survival times with doxorubicin-based protocols, most veterinarians in first opinion practice in England treat canine lymphoma with COP.     

Hawaii veterinarians' bioterrorism preparedness needs assessment survey

The purpose of this study was to assess the objective bioterrorism-related knowledge base and the perceived response readiness of veterinarians in Hawaii to a bioterrorism event, and also to identify variables associated with knowledge-based test performance. An anonymous survey instrument was mailed to all licensed veterinarians residing in Hawaii (N = 229) up to three times during June and July 2004, using numeric identifiers to track non-respondents. The response rate for deliverable surveys was 59% (125 of 212). Only 12% (15 of 123) of respondents reported having had prior training on bioterrorism. Forty-four percent (55 of 125) reported being able to identify a bioterrorism event in animal populations; however, only 17% (21 of 125) felt able to recognize a bioterrorism event in human populations. Only 16% (20 of 123) felt they were able to respond effectively to a bioterrorist attack. Over 90% (106 of 116) expressed their willingness to provide assistance to the state in its response to a bioterrorist event. Veterinarians scored a mean of 70% correct (5.6 out of 8 questions) on the objective knowledge-based questions. Additional bioterrorism preparedness training should be made available, both in the form of continuing educational offerings for practicing veterinarians and as a component of the curriculum in veterinary schools.     

Opinions and practices of veterinarians and dairy farmers towards herd health management in the UK

The objective was to compare farm veterinary surgeons' and dairy farmers' opinions on herd health plans and herd health and production management with the aim of discovering and better understanding the differences. Two comparable questionnaires, one for farm veterinarians and one for dairy farmers, were distributed throughout the UK. While listing the 'major roles' of the veterinarian on the farm, veterinarians considered 'optimising milk production', 'decreasing overall cost' and 'being an independent adviser' as important roles, but these were not seem to be perceived as such by the farmers. In addition, when presenting themselves to clients, veterinarians seemed to favour the 'friend of the farmer' approach; a much smaller proportion of farmers seemed to prefer this approach. The majority of farm respondents (98 of 121; 81 per cent) valued the discussions with their veterinarian, and it was apparent from the relatively small proportion of veterinarians instigating a discussion on farm (33 of 125; 26 per cent) that there is the opportunity for a more proactive approach from veterinarians. The study underlines that 'demonstrating cost-effectiveness' is still a main concern for veterinarians and farmers and identifies areas that can be improved by more training and effective communication.     

Antimicrobial labelling in Australia: a threat to antimicrobial stewardship?

Antimicrobial resistance is a public health emergency, placing veterinary antimicrobial use under growing scrutiny. Antimicrobial stewardship, through appropriate use of antimicrobials, is a response to this threat. The need for antimicrobial stewardship in Australian veterinary practices has had limited investigation. A 2016 survey undertaken to investigate antimicrobial usage patterns by Australian veterinarians found that antimicrobial dose rates were varied and often inappropriate. Doses of procaine penicillin in horses and cattle were often low, with 68% and 90% of respondents, respectively, reporting doses that were unlikely to result in plasma concentrations above minimum inhibitory concentrations for common equine and bovine pathogens. Frequency of penicillin administration was also often inappropriate. Gentamicin doses in horses were largely appropriate (89% of dose rates appropriate), but 9% of respondents reported twice daily dosing. Amoxycillin and amoxycillin‐clavulanate were administered at the appropriate doses, or above, to dogs and cats by 54% and 70% of respondents, respectively. Here, we explore the potential reasons for inappropriate antimicrobial dose regimens and report that antimicrobial labels often recommend incorrect dose rates and thus may be contributing to poor prescribing practices. Changes to legislation are needed to ensure that antimicrobial drug labels are regularly updated to reflect the dose needed to effectively and safely treat common veterinary pathogens. This will be especially true if changes in legislation restrict antimicrobial use by veterinarians to the uses and doses specified on the label, thus hampering the current momentum towards improved antimicrobial stewardship.     

Potential barriers to veterinary student access to counselling and other support systems: perceptions of staff and students at a UK veterinary school

Considerable evidence suggests that veterinary surgeons' mental health is often poorer than comparable populations and that the incidence of suicide is higher among veterinary surgeons than the general public. Veterinary students also appear to suffer from high levels of anxiety and stress, and may possess inadequate coping strategies when faced with adversity. Veterinary students may find it difficult to access central university support systems due to their heavy workload and geographical isolation on some veterinary campuses. A previous study of University of Edinburgh fourth-year veterinary students found that support services located several miles from the main veterinary campus was a barrier to students accessing counselling services. Consequently, a pilot project was initiated, which provided a counselling service at the University of Edinburgh's rural Easter Bush veterinary campus one afternoon a week during 2010. As part of the evaluation of this service, web-based questionnaires were delivered via e-mail to all veterinary staff and students towards the end of the 12-month pilot period to evaluate perceptions of barriers to student counselling and to investigate student-valued support services. Questionnaire responses were received from 35 per cent of veterinary students and 52 per cent of staff. Stigmatisation of being unable to cope was a potent inhibitor of seeking support within the veterinary environment, but counselling was perceived as valuable by the majority of staff and students. Provision of an on-site counselling service was considered important for increasing ease of access; however, students viewed friends and family as their most important support mechanism. Workload was cited as the main cause of veterinary student stress. The majority of staff and student respondents perceived veterinary students as having an increased need for counselling support compared with other students.     

Attitudes of veterinarians to undergraduate education in genetics and the use of genetics in veterinary occupations

A questionnaire regarding attitudes to undergraduate education in genetics and the subsequent use of that education was sent to 1000 veterinarians registered in New South Wales. Three hundred replies to the questionnaire were received and analysed. No significant difference in the perceived adequacy of courses at the four universities involved in teaching veterinary science was observed. Opinions on adequacy of education in genetics were not affected by age, sex or years since graduation. The major reason cited for lack of adequacy was that undergraduate genetics courses were not practical. Only 17 respondents stated that they were never approached for information on genetics or animal breeding, while 76 were approached more than 20 times annually for information. Eighty-three respondents claimed to deal with more than 20 cases annually that required some knowledge of genetics. The results of the questionnaire highlight the importance of genetics instruction in undergraduate veterinary education. The questionnaire responses also provide insight into how working veterinarians consider that courses in genetics could be improved.     

The economic margins of activities of a bovine practitioner on dairy farms

Because of lower margins and market liberalisation veterinarians and farmers are increasingly negotiating rates. Therefore, the margins of veterinarians are under pressure. In addition, the sales if drugs, performance of operations or giving of advice are more and more separated. These developments give veterinarians uncertainty about the profitability of their activities for dairy farmers. Not much is known about margins on veterinary activities on dairy farms. Moreover, it is interesting to see how much margins of the bovine practitioner differ between veterinary practises and dairy farms. In this study, invoices for bovine activities of 14 veterinary practises were combined with milk production registration data of the dairy farms of these practices. This way, the gross margin per bovine practitioner could be studied for the different veterinary practise. Moreover the relation between gross margin and specification of the veterinary practise could be studied. Finally, the gross margin per dairy farm and the factors that influenced this gross margin were studied. The most important result was the observation that the gross margin per bovine practitioner was dependent on the number of dairy farms per practitioner, the margin on drugs and the region of the veterinary practise. The size of the veterinary practise, the share of the dairy farming within the practise and the source of the gross margin (drugs, time or operations) did not influence the gross margin. Variables that explained the gross margin per dairy farm were, amongst others, the number of dairy cows, the milk production level of the farms and participation in PIR-DAP (a system to support the veterinarians herd health and management program). There is no relation of gross margin per dairy farm and the veterinary practise or region.     

Prevalence of occupational exposures and protective practices in Australian female veterinarians

OBJECTIVE: To identify the prevalence of exposure to potentially harmful occupational hazards in Australian female veterinarians and to report factors associated with prevalence of occupational hazards in this profession. DESIGN: National cross-sectional survey of a cohort population. PROCEDURE: A self-administered questionnaire was mailed to 5748 veterinarians (males and females) graduating from Australian veterinary schools from 1960 to 2000. This paper reports the prevalence of occupational exposures in 1197 female veterinarians in their current job including radiation, anaesthetic gases, pesticides and long working hours. Comparisons were undertaken between respondents by practice type and decades of graduation. Multivariate logistic regression was undertaken to predict the risk for exposure to occupational hazards in female veterinarians by age, type of practice, graduation year and number of hours worked. RESULTS: The response rate for females was 59%. We found that age under 30 years, small and mixed animal practice, graduation year after 1990, and working more than 45 hours per week were all associated with greater exposure to putative risk factors. Mixed animal practitioners worked more than 45 hours per week (53%) and reported the highest exposure to anaesthetic gases (94%) and pesticides (54%). Twenty two percent of those who were exposed to anaesthetic gases did not have waste anaesthetic gas scavenging systems. Small animal practitioners reported they took more X-rays (90%). While taking X-rays, 56% of respondents reported physically restraining animals, and only one in five of respondents used film holders and lead screens. CONCLUSIONS: The high prevalence of potentially harmful exposures among female veterinarians and lack of use of protective equipment at work needs to be considered in developing and planning the safety of veterinary work.     

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.     

Intentional misuse of veterinary medications in human suicide

Many veterinary medications can be lethal in human overdose. This review aims to educate practicing veterinarians about the most common medications used by humans in intentional overdose. Strategies to mitigate the risk posed by these medications are discussed, and the risk factors that predispose a person to suicide are reviewed. Synthesis of the published cases will allow veterinarians to easily identify high‐risk medications and to take steps to prevent their misuse by at‐risk patients or staff.     

Rabies preexposure vaccination among veterinarians and at-risk staff

OBJECTIVE: To measure rabies preexposure vaccination rate and identify factors potentially associated with lack of vaccination among veterinarians and at-risk staff. DESIGN: Cross-sectional survey. STUDY POPULATION: At-risk veterinary medical association (VMA) members, their staff members, and animal shelter and wildlife rehabilitation center personnel located in a California county. PROCEDURE: A questionnaire was mailed to VMA members and managers of animal shelters and wildlife rehabilitation centers. Respondents were requested to provide data on vaccination history and potential factors associated with vaccination status for themselves and their at-risk staff members. Vaccinated and unvaccinated individuals were compared by use of univariate and logistic regression analyses to identify factors associated with vaccination status. RESULTS: Fifty-eight percent (79/137) of persons who received questionnaires responded; 74 were eligible for the study. Respondents provided data for 47.6% (219/460) of their staff members. The vaccination rate was greater among respondents (85.1 %) than among their staff members (17.5%). Among staff members, age and duration of employment were significantly associated with vaccination status. CONCLUSIONS AND CLINICAL RELEVANCE: A large proportion of at-risk staff members working in veterinary clinics, animal shelters, and wildlife rehabilitation centers in the study area did not receive rabies preexposure vaccination per the Centers for Disease Control and Prevention's published recommendations of the Advisory Committee on Immunization Practices (ACIP). The cost of the preexposure vaccine series may be a barrier, particularly for young employees who are commonly short-term, part-time, or volunteer workers. Efforts are needed to increase awareness of the ACIP recommendations and to increase access to vaccination through agencies such as public health clinics.