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

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• Refresher training to 32 CAHWs. • Small business planning and management training to five private veterinary practitioners, being three veterinarians and two CAHWs. • The private practitioners were mobilized to revitalize their veterinary business using funds from their own sources, including loan stock collected from the Vet Agro Company. • The project covered part of the cost of pharmacy renovation. The overall approach used by VSF Suisse was to support a reliable drug supply system, mainly by facilitating business agreements signed between the Vet Agro Company and the private veterinary pharmacies; this was done in Isiolo in May 2008. VSF Suisse also acted as collateral for a portion of the loan provided by Vet Agro Company to the pharmacies, being 35 to 45% of the loan. Similarly, VSF Suisse facilitated the signing of agreements between the CAHWs and private veterinary pharmacies. Consequently, at the time of this assessment in August 2009 the Takaba and Wargudud veterinary pharmacies were using the Vet Agro Company in Nairobi for inputs while the CAHW were using drugs from the local pharmacies. The local pharmacies were selling drugs at a price that included the CAHW service charge to individual customers. By August 2009 some key achievements in terms of pharmacy development had been achieved. The pharmacies received credit from Vet Agro Company based on the business agreements signed in Isiolo. Figure 3 shows the value of the stock collected from Vet Agro Company by the pharmacies (supported by the VSF Suisse/ELMT project) between May 2008 and July 2009. Figure 3. Private pharmacies stock replenishment performance 300,000.00 Total value of drugs (Ksh) 250,000.00 200,000.00 150,000.00 100,000.00 50,000.00 Total sales Total collection Outstanding 0.00 Takaba Wargudud Garbatula Laisamis Wajir Location of Pharmacies Figure 4 shows the sources of drugs used by six CAHWs involved in this assessment, before and after the revitalization of the pharmacies. Their higher preference for the price (affordability) offered by the pharmacies was explained in terms of transportation costs and other personal expenses such as food and accommodation which were incurred when visiting more distant sources in Mandera and Nairobi. Table 1 presents CAHW preferences for different antibiotics which were available from the pharmacies. On average, the CAHW veterinary stock turnover rates increased from 19.5% before the revitalization of the pharmacies to 80.5% at the time of the assessment (a 61% increase). It was noticeable that the CAHWs interviewed prioritized the skill gained from the trainings and the social respect from their communities relative to the financial benefits gained from their services. With regards to economic benefits, the CAHWs very much disapproved of the competition from warejis (drugs circulated by black‐market dealers) and ordinary shops selling cheap, low quality drugs. 6
Figure 4. CAHW preferences for veterinary drug suppliers 70 Median score (n=4 CAHWs) 60 50 40 30 20 10 Accessibility Affordability Quality Availability 0 Dukan Local pharmacies Private pharmacies Mandera Private pharmacies Moyale Veterinary suppliers Nairobi Note for Figure 4 Dukan – multi‐purpose local shops selling veterinary medicines, usually in small quantities and without licenses or technical training. Table 1. CAHW preferences for antibiotics Item Penstrep 20% Oxytetracycline 10% Tylosin Oxytetracycline 20% LA Deseptoprim tablet Average preference Unit price (Ksh) Gross profit per unit score (%) Purchase Sell Ksh % profit 27 20 20 27 7 286 120 540 286 8 350 160 600 350 10 64 40 60 64 2 22.4 33.3 11.1 22.4 25 3.2 Number of CAHW treatments and income The project hired two veterinary paraprofessionals (a veterinary assistant and a livestock technician) to collect monthly treatment and disease outbreak reports forms from each CAHW and transfer them to the Nairobi office. The monitoring reports indicated that CAHW treatment figures were collected regularly from the 32 CAHWs throughout the project period. While these figures are summarized below it should be noted that the number of treatments are not related to the livestock population or disease prevalence, and therefore, provide only limited evidence of impact. • The monthly treatment reports for the period September 2008 to July 2009 indicated that more than 51,000 animals were treated for various diseases by the 32 CAHWs who reported to VSF Suisse; each CAHW treated around 177 cases per month. • The number of animals treated in June and July 2009 was low compared with previous months and this was explained in terms of drought. Specifically, livestock migrated to Ethiopia and Somalia and because herders spent a lot of money on water for the remaining livestock (within the drought‐affected area), they had less to spend on veterinary care. • Incomplete financial records from the project were available but showed an average monthly profit per CAHW of Ksh2,520 (US$35). 3.3 Disease reporting by CAHWs The VSF Suisse/ELMT project started an animal disease surveillance system based on CAHW reports. In the system the CAHWs were responsible for collecting information on outbreaks of diseases listed 7
Page 1 and 2: Impact Assessment of the Community
Page 3 and 4: Abbreviations CAH CAHW CBPP CCPP CF
Page 5 and 6: • CAHWs also provided supportive
Page 7 and 8: 1. Introduction 1.1 Private veterin
Page 9 and 10: 2.2 Data collection The data collec
Page 11: Within time and resource limits, th
Page 15 and 16: herds these changes were not statis
Page 17 and 18: 3.5 Areas for improvement Table 6 d
Page 19 and 20: 4.2 Impact assessment findings The
Page 21 and 22: assessment agree with earlier studi
Page 23 and 24: With regards to the CAH disease rep
Page 25 and 26: diseases, NSD and PPR can all be pr
Page 27: Annex 2. Mortality and case fatalit

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

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