Addressing governance challenges in the provision of animal health services: A review of the literature and empirical application transaction cost theory

Ilukor, John; Birner, Regina; Nielsen, Thea

doi:10.1016/j.prevetmed.2015.10.003

Cited by 17 publications

(17 citation statements)

References 54 publications

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“…Some of the strategies that can help achieve this—such as a correct pricing structure to ensure suitable margins, providing solution packages and provision of the right vaccine accessories—have been described elsewhere [13]. Empirical data indicate that CAHWs are desirable because they offer the needed care and attention that farmers want, are located close to the farmers, have lower transaction costs, and are likely to be trusted by the farmers [17]. This may not always be the case; for example, a survey in Ghana demonstrated that government paravets were preferred to CAHWs because limited training of the CAHWs led to them having higher costs and poor performance [18].…”

Section: Potential Strategies To Increase Vaccine Adoption By Shfs Anmentioning

confidence: 99%

Strategies to increase adoption of animal vaccines by smallholder farmers with focus on neglected diseases and marginalized populations

et al. 2019

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BackgroundMost smallholder farmers (SHFs) and marginalized populations (MPs) in Africa, Asia, and Latin America depend on livestock for their livelihoods. However, significant numbers of these animals do not achieve their potential, die due to disease, or transmit zoonotic diseases. Existing vaccines could prevent and control some of these diseases, but frequently the vaccines do not reach SHFs, especially MPs, making it necessary for specific vaccine adoption strategies.Principal findingsSeveral strategies that have the potential to increase the adoption of animal vaccines by SHFs and MPs have been identified depending on the type of vaccines involved. The strategies differed depending on whether the vaccines were aimed at diseases that cause economic losses, government-controlled diseases, or neglected diseases. The adoption of vaccines for neglected diseases presents a major challenge, because they are mostly for zoonotic diseases that produce few or no clinical signs in the animals, making it more difficult for the farmers to appreciate the value of the vaccines.Strategies can be aimed at increasing the availability of quality vaccines, so that they are produced in sufficient quantity, or aimed at increasing access and demand by SHFs and/or MPs. Some of the strategies to increase vaccine adoption might not provide a definite solution but might facilitate vaccine uptake by decreasing barriers. These strategies are varied and include technical considerations, policy components, involvement by the private sector (local and international), and innovation.ConclusionsSeveral strategies with the potential to reduce livestock morbidity and mortality, or prevent zoonoses in SHFs communities and MPs through vaccination, require the involvement of donors and international organisations to stimulate and facilitate sustainable adoption. This is especially the case for neglected zoonotic diseases. Support for national and regional vaccine manufacturers is also required, especially for vaccines against diseases of interest only in the developing world and public goods.

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Section: Potential Strategies To Increase Vaccine Adoption By Shfs Anmentioning

confidence: 99%

Strategies to increase adoption of animal vaccines by smallholder farmers with focus on neglected diseases and marginalized populations

et al. 2019

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“…However, in the 1980s, under pressure from the World Bank, most developing countries adopted structural adjustment programs (SAPs) taking a market approach as the preferred means of providing services whilst at the same time reducing state expenditure. Impacts of the SAPs have been extensively analyzed and discussed in several international forums and publications in the decades following the reform, analyzing the consequences of the subsequent drastic shift of responsibility from the public to the private sector, including in the veterinary drug deliveries and veterinary services ( 30 , 48 , 52 ).…”

Section: Resultsmentioning

confidence: 99%

“…The number of public veterinary services has not been fully offset by the private sector, particularly with regards to the distribution of veterinary drugs in rural areas. These reductions have led to many failures in the supply of veterinary drugs and services ( 48 , 49 ). Gehring et al ( 58 ) indicate that in some villages in South Africa, the nearest accessible outlet for veterinary drugs was between 10 and 30 km.…”

Section: Resultsmentioning

confidence: 99%

Access to Veterinary Drugs in Sub-Saharan Africa: Roadblocks and Current Solutions

2022

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BackgroundAccess to veterinary drugs for livestock has become a major issue over the last decade. Analysis has tended to focus on the demand for these products, while studies looking at the drivers behind their use generally focus on farmer behavior and interactions between veterinarians and farmers. However, the use of drugs also depends on structural factors that determine the functioning of the drug supply chain and farmers' access to the drugs. This article presents an overview of the factors that limit access to veterinary drugs in sub-Saharan Africa (SSA) as well as the international policy tools and arrangements that claim to improve it.MethodsWe have conducted a scoping review of the scientific and grey literature as well as the publicly-available data from both the animal health industry and international organizations. We aimed to gather information on the veterinary drugs market in SSA as well as on the international norms, recommendations, guidelines, and initiatives that impact SSA farmers' access to these drugs.FindingsWe highlight numerous barriers to veterinary drug access in SSA. The SSA market is highly dependent on imports, yet the region attracts little attention from the international companies capable of exporting to it. It suffers from a high level of fragmentation and weak distribution infrastructures and services, and is driven by the multiplication of private non-professional actors playing a growing role in the veterinary drug supply chain. The distribution system is increasingly dualized, with on the one hand the public sector (supported by development organizations) supplying small scale farmers in rural areas, but with limited and irregular means; and on the other side a private sector largely unregulated which supplies commercial and industrial farming systems. Different innovations have been developed at the international and regional levels to try to reduce barriers, such as homogenizing national legislations, donations, and vaccine banks. Alongside decades-old inter-state cooperation, many new forms of public-private partnerships and other hybrid forums continue to emerge, signaling the private sector's increasing influence in global governance.ConclusionsPolicies on animal health would be bolstered by a better understanding of the drivers behind and the components of access to veterinary drugs in different regional and national contexts. Inequalities in drug access need to be addressed and a market-driven approach adopted in order to strengthen our understanding of what determines veterinary drug use at the farm level. Policies should balance the interests of the various stakeholders, being careful not to reinforce bias toward certain diseases deemed “interesting” and neglect others that could prove to be highly important for veterinary public health.

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“…Analysing production costs and transaction costs, and characteristics yields the overall total cost of the service. 13 …”

Section: Introductionmentioning

confidence: 99%

Institutional Arrangements for Providing HIV and AIDS Services in Uganda: A Transaction Cost Economics Analysis

Khanakwa

Mbonigaba

2022

Health�Serv�Insights

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Transaction cost economics (TCE) theory predicts that features of institutional arrangements determine the intensity of their governance instruments. Consequently, institutional features link to transaction costs, but the linkages have received little attention in the public health literature. This study sought to address this gap. It examined the governance features of institutional arrangements and their transaction cost implications for providing HIV prevention and social support services in Uganda. The analysis was based on 4 proposed TCE governance instruments: administrative controls, adaptation, incentives and contract laws. These governance instruments were assessed in 3 modes of delivery( institutional arrangments) for HIV and AIDS Services in Uganda: Contracting-Out – the case of DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe); a Public-Non-Governmental Organisation (NGO) partnership – the case of the CHAI (Community-led HIV/AIDS Initiative); and direct Public Sector Delivery. These assessed delivery modes follow Williamson’s TCE framework of 3 institutional arrangements to deliver goods and services, notably market, hybrid (partnership) and internal (hierarchy) delivery, with related governance features. Within this framework, the discriminating alignment hypothesis guided the analysis. According to the hypothesis, the delivery modes of goods and services result in smaller transaction costs when their governance features are as predicted by TCE. The hypothesis was assessed by analysing, with qualitative methods, the differences in HIV and AIDS services characteristics across the 3 arrangements and their differences with theory prediction, and hence the difference in transaction cost implications. The study found that the delivery arrangements that minimised cost are those whose HIV and AIDS services were aligned with the TCE theory prediction. The aligned ‘public-NGO partnership’ arrangement (CHAI) had fewer sources of transactional costs than the misaligned arrangements – ‘contracting-out’ (DREAMS) and ‘public sector’. The analysis revealed that the DREAMS and public sector delivery models suffered some flaws in efficiencies. DREAMS had high administrative controls, high-powered tangible incentive intensity and intensive monitoring mechanisms for performance adaptation due to the lack of ‘trust’ on the part of the financing agency, contrary to the TCE prediction. In contrast with the TCE prediction, low administrative controls in the public sector arose from the failure to invest in performance monitoring systems. The high-powered incentive intensity and low administrative controls observed in the CHAI arrangement primarily stemmed from the reliance on informal institutions (trust, social expectations and reputation) rather than principal-agent arms-length sanctions. These results suggest that the level of transaction costs is associated with features of institutional arrangements. The valuable insights from TCE could contribute to policymaking during the design of institutional arrangements to efficiently deliver HIV and AIDS services.

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Addressing governance challenges in the provision of animal health services: A review of the literature and empirical application transaction cost theory

Cited by 17 publications

References 54 publications

Strategies to increase adoption of animal vaccines by smallholder farmers with focus on neglected diseases and marginalized populations

Strategies to increase adoption of animal vaccines by smallholder farmers with focus on neglected diseases and marginalized populations

Access to Veterinary Drugs in Sub-Saharan Africa: Roadblocks and Current Solutions

Institutional Arrangements for Providing HIV and AIDS Services in Uganda: A Transaction Cost Economics Analysis

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