Improving Village Animal Health Worker participation in national disease surveillance systems: A case study from Cambodia

Abstract

Para‐veterinary systems have arisen in numerous developing countries to address the low capacity of national veterinary services in meeting livestock health demands of mainly smallholder farmers. In Cambodia, the village animal health worker (VAHW) system was established in the early 1990s, involving short training programmes to equip VAHWs to provide basic animal health services for smallholder farmers, particularly the vaccination of cattle for haemorrhagic septicaemia (HS). However, there are increasing expectations that VAHWs provide village level disease surveillance information to the national veterinary services, despite their low‐level disease diagnostic skills. To identify opportunities to improve the disease reporting system in Cambodia, a closed‐ended cross‐sectional study of VAHWs (n = 80) from two provinces was conducted in 2015, examining their contact frequency with district and provincial animal health authorities. Ordinal logistic regression was used to determine factors associated with increased frequency of VAHW contact with the district animal health authorities responsible for national disease reporting. Positive associations between income generated from VAHW activities (p = .01) and the frequency of visiting farmers (p < .0001), with more frequent contacts with district animal health authorities, were identified. High levels of inappropriate use of antibiotics, with almost 90% of VAHW reporting they use antibiotics to treat FMD‐affected animals, were reported. Although further research to increase the rates of reporting at the smallholder farmer and VAHW levels is required, increased emphasis on complying with the World Organisation for Animal Health's competency guidelines for veterinary paraprofessionals may be required if they are expected to contribute to national animal disease surveillance systems.

Contributions of village animal health workers to foot-and-mouth disease control in Cambodia

“…The majority of VAHWs provided their animal health services to large ruminants rather than pigs or poultry, and these findings were similar to the previous reports from Cambodia (Bhandari et al, 2011;MacPhillamy et al, 2019;Stratton et al, 2015) and northern Malawi (Huttner, Leidl, Jere, & Pfeiffer, 2000). It should be noted that although VAHWs may wish to provide animal health services to poultry, farmers generally do not think it worthwhile spending money for low-value village poultry.…”

“…This is consistent with a previous study from 2008 that identified most VAHWs (66%) from 19 provinces earned less than 40% of their household income from animal health and vaccination services (Stratton et al, 2015). However, a 2015 survey of VAHWs from Takeo and Tbong Khmum provinces identified that although incomes from VAHW activities were also generally low with monthly incomes predominantly within the USD 48.80 -USD 97.50 income bracket (38%), 62% of VAHW earning over USD 97.50/month had over 10 years of VAHW experience, and there also appeared to be a strong association between income generating activities and frequency of contact with district animal health authorities (MacPhillamy et al, 2019).…”

“…Para-veterinarians are considered crucial in providing front-line veterinary care and advice to smallholder farmers in countries with under-resourced national veterinary services, although often these individuals undergo basic training with minimal monitoring and evaluation of performance and knowledge levels (MacPhillamy et al, 2021). The para-veterinarians in Cambodia are the Village Animal Health Workers (VAHW) system that was established in early 1990, involving the selection of a local livestock-interested farmer to receive some training in basic village-level animal health services provision for smallholder farmers, particularly the vaccination of cattle for haemorrhagic septicaemia (HS) in rural communities (MacPhillamy et al, 2019). Similar approaches have been adopted and implemented in many developing countries, including Afghanistan (Leyland, 1993), Kenya (Blakeway, 1993;Mugunieri, Irungu, & Omiti, 2004), Ethiopia (Admassu et al, 2005) and Nepal (Moktan, Mitchelhill, & Joshi, 1990) and have shared similar purposes and goals.…”

“…A cross-sectional survey of VAHWs (n=445) from 19 provinces in Cambodia in 2008, used 'guided group interviews', to examine the roles of VAHWs and found they had good contact with farmers, with 61.5% making more than one farm visit daily, yet incomes from these services were low (Stratton et al, 2015). In 2015, a closed-ended cross-sectional study of VAHWs (n=80) from two provinces (Takeo and Tbong Khmum provinces) found positive associations between income generated from VAHW activities (p = .01) and the frequency of visiting farmers (p < .0001), although almost 90% of VAHW reported that they use antibiotics to treat FMD affected animals (MacPhillamy et al, 2019), potentially contributing to antimicrobial resistance risks (AMR).…”

<p>Managing Welfare and Antimicrobial-Resistance Issues in Treating Foot-and-Mouth Disease Lesions: A New Therapeutic Approach</p>

“…In a recent report from neighboring Cambodia, almost 90% of surveyed village animal health workers from two provinces admitted that they used antibiotics to treat FMD-affected animals. 12 In addition to antibiotics, affected animals may be treated with mild disinfectants, occasionally anti-inflammatory drugs, and in many rural communities in Laos, lesions may be treated with traditional therapies, including application of lemon juice or the scraping of lesions with the bark of trees. 3,7 In other countries, anecdotal reports include the use of soda-ash solution for washing the lesions and application of honey and various astringent substances (PW, personal observations).…”