In an extensive literature review, the author develops policy
recommendations to facilitate scaling up community-based animal health
systems to the national level. Noting that human and animal health
services in rural areas have much in common, and that an extensive
literature studies policy regarding primary healthcare for humans
exists, she surveys that literature for observations and conclusions
applicable to policy analysis of primary animal healthcare.
She notes differences in the history and development of the two delivery
systems. The push for human health services came with a worldwide
initiative agreed at a high level in 1978. Health for All was set out as
a moral imperative, and programmes have been strongly top-down. Delivery
of animal health services, by contrast, has been viewed mainly in terms
of economic development, and community-based systems have been cobbled
together bottom-up, with NGOs taking the lead.
As a result, community animal health workers are not integrated into
national systems, and how they are trained and monitored varies even
within districts. More broadly, the author details regional differences
in community-based animal healthcare initiatives. Whereas in Asia there
is considerable government involvement, private practitioners hold much
more sway in East Africa. Although the literature is sparse on West
Africa and Latin America, professional acceptance of community health
workers appears to be high in both regions.
The core of the paper is devoted to elaborating six criteria for
assessing community-based animal health systems, which the author adapts
from studies on primary healthcare systems for humans. She argues that
the criteria - equity, efficiency, accessibility of services, quality of
services, human resources and financial resources - must be addressed
when scaling-up community-based programmes.
The author recommends that policymakers clearly state their national
animal health objectives and encourage dialogue between NGOs and
existing national structures to allow better coordination of efforts and
more equitable and consistent delivery of animal health services in
rural areas. She adds that bringing community animal health workers into
institutional frameworks - and agreeing a standard training curriculum -
would improve equity in the distribution of benefits.
A three page executive summary is also available in addition to this
PPLPI, FAO, Rome, Italy, vii+31 pp.