Preventive livestock healthcare and veterinary paraprofessionals

Backgrounder

Introduction

In many countries across sub-Saharan Africa, it can be difficult for farmers to access animal health services. The overall number of veterinarians remains low, and they are more likely to be located in urban areas.

Unfortunately, there are also many untrained persons or “quacks” offering services and many illegal veterinary drugs available on the black market. “Quacks” and black market drugs are mostly ineffective and can be dangerous to livestock and human health.

It can be confusing for farmers to know who to turn to for animal health services—and to determine who is a reliable animal health service provider.

There are two main categories of animal health service providers:

• Veterinarians who have completed long studies (5-6 years at university): In many African countries, the total number of veterinarians is low, and they are mostly concentrated in urban areas. This can make it difficult for farmers to access services from veterinarians.
• Veterinary paraprofessionals (VPPs) who have undertaken a 2-4-year formal training (the duration and title varies depending on the country). VPPs are often also known as paravets. They tend to be more present in rural areas and fill this service gap.

Veterinary paraprofessionals can be distinguished from “quacks” in that:

• They have undertaken a formal training (2-4 years long depending on the country);
• They work under the supervision of and in collaboration with veterinarians. VPPs do not undertake tasks which are beyond their scope of work * (for example, surgeries such as C-section). Instead, they refer such cases to a veterinarian.

In many African countries, there is a professional body that is responsible for regulating the animal health profession. It is called a veterinary statutory body * (for example, Nigerian Veterinary Council, Ugandan Veterinary Board, and South African Veterinary Council).

Depending on the country’s legislation, VPPs may be required to register with the veterinary statutory body, or they may be regulated under the ministry of agriculture/livestock.

Community-based animal health workers are not the same as VPPs. There are CAHWs in many African countries who provide limited basic animal health services in remote areas. CAHWs are usually members of the community in which they work and have received a short training (usually of some weeks’ duration) enabling them to provide some basic animal health services, usually with training and inputs provided by an NGO.

For further information, please see documents 7, 8, 9, 12, 15, and 16.

Why is this subject important to listeners?

Because livestock farmers should know (that):

• Farmers will have more productive and healthy herds if they take specific measures to prevent their animals from getting sick. These preventive measures include vaccination, good nutrition, good housing and a clean environment, biosecurity measures, control of parasites, and improved reproduction.
• Overall, it is more cost-effective for a farmer to invest in prevention than to wait for their animals to get sick and then treat them, Vaccines, for example, cost a fraction of the cost of animals dying or of treatment when an animal when it gets sick.
• Farmers should source these services from qualified animal health professionals such as VPPs or veterinarians. They have formal qualifications and are trusted professionals who can provide advice and supply quality veterinary medicines.
• Many people who offer animal healthcare services are “quacks” rather than properly trained veterinary paraprofessionals. They may provide incorrect advice and sell illegal products which, although cheaper, may be harmful to both livestock and human health.

What is preventive healthcare?

• Preventive healthcare aims to keep animals as healthy and productive as possible.
• Prevention is about stopping problems before they happen—prevention is better than cure!
• Prevention includes all the steps that can be taken to stop infectious diseases (illnesses that can be spread from one animal to another) from affecting our livestock. This includes using vaccines to stop or reduce the effects of diseases such as Newcastle disease, foot and mouth disease, pestes des petits ruminants, lumpy skin disease, and many others.
• When using vaccines, it is important to use quality products that have been stored correctly and are carefully administered. Some vaccines need to be repeated at regular intervals. VPPs are qualified to provide guidance on which vaccines to use and when they should be used.
• Preventive healthcare also involves treating internal parasites (worms) and external parasites (such as ticks) effectively. It is possible for parasites to become resistant to veterinary drugs and VPPs can advise on ways to reduce the likelihood that resistance will develop by correctly applying appropriate products and using other measures such as grazing management.
• Preventive healthcare also involves taking biosecurity measures. These are actions that reduce the risk that animals will catch infectious diseases, and include managing contact between a farmers’ animals and animals belonging to other farmers, and reducing the number of visitors to areas where livestock are kept.
• Preventive healthcare goes beyond direct steps to prevent disease. It also involves taking actions to ensure that livestock are as healthy and productive as possible, such as improving nutrition and housing.
• Preventive healthcare also involves managing the reproduction and breeding of animals—from choosing the right breeds for a farmers’ situation to managing the intervals between each birth and dealing with infertility problems. Properly managed reproduction can have a big impact on productivity.
• With so many aspects to preventive healthcare, it can be challenging to keep track of everything. This is why it is important to make a plan of action. This documents the steps livestock keepers must take to prevent disease and improve the health of their animals and when they need to take them. It’s important to remember that farmers don’t need to do everything at once, and that even small steps can make a big difference!
• VPPs are ideally placed to work with livestock keepers to understand their farming system and both develop a herd or flock health plan and support them to implement that plan over time, making any adjustments necessary.

Why should farmers be interested in prevention?

• Sick animals are not productive animals. They grow more slowly, are less likely to get pregnant, and produce less milk and eggs.
• Keeping animals which are not productive can be costly for farmers. Even if animals do not produce much milk or many eggs, farmers still have to pay for their feed and water, and shelter and treat them when they are sick.
• Preventive measures like vaccination minimize animal deaths and serious disease during outbreaks.
• Sick animals can infect people through contact or when people consume their meat or milk.
• Prevention costs less than treatment. There are many costs associated with having a sick animal which needs treatment:
  • lost production (decreased milk, eggs, fertility, etc.),
  • cost of the treatment itself (veterinary drugs, time of VPP),
  • cost of farmer’s time to administer treatment and support,
  • risk of disease spreading to rest of herd with further costs, and
  • in cases of treatment failure, the cost of death.
• For example:
• The cost of treating peste des petits ruminants in sheep and goats is four times higher than vaccination ($0.26 US vs. $1.06 US per animal).
• During an actual disease outbreak, the cost of treatment is much higher due to high mortality (70-80%). The cost of vaccination is $2.60 US for a herd of goats, whereas the cost of an outbreak could be up to $210 US.

Why should livestock keepers use a qualified animal health service provider’s services? (as opposed to vaccinating or treating animals themselves, or getting advice from someone selling veterinary medicines)

• Vets and VPPs can provide farmers with the services and advice needed to prevent livestock from getting sick, and to help increase farm productivity.
• Each farm is different and has different health risks: Vets and VPPs can provide tailored solutions for each farm.
• Many people offer services who are in fact not trained VPPs or vets, and are often called “quacks.” They may provide incorrect advice and sell illegal products.
• The market for illegal animal medicines is estimated at $1-2 billion US globally. These illegal drugs can be ineffective, leading to lack of recovery and spread of disease and poor animal welfare, and can even be toxic, causing death.
• Illegal animal medicines also pose a risk to human health because humans consume milk and food from animals. If a medicine is ineffective, it increases the risk of infecting humans through milk and meat. If the medicine is toxic, then humans could be intoxicated too if they drink milk or meat from a treated animal.
• Using illegal medicines also increases the development of antimicrobial resistance. * When disease-causing organisms such as bacteria or parasites become resistant to the drugs designed to treat them, the disease can be nearly impossible to treat, ending in the death of animals or humans.
• Vets and VPPs are qualified, experienced, trusted, and knowledgeable animal health service providers, recognized by the veterinary statutory body of their country.
• Thanks to their training, Vets and VPPs know how to dose medication. Farmer may be able to purchase medicine from a trader, but do not know if it is good quality medicine and whether they are giving the right dosage. If the dosage is too low, it may not be effective, and if if’s too high, it might be harmful/toxic. VPPs calculate the right dosage and apply it correctly for best treatment outcomes.
• Vets and VPPs supply quality veterinary and livestock inputs. They do not sell illegal veterinary medicines. They also ensure that veterinary products are stored correctly so that they remain effective (for example, many vaccines need to be kept cold).
• Vets and VPPs conduct on-farm visits. It is very important that people who offer treatments and advice have seen animals and how they are kept. By conducting on-farm visits, VPPs can provide more tailored and relevant livestock production advice than a pharmacist who simply sells veterinary drugs from a shop.

Key information about veterinary paraprofessionals

Who is a VPP?

• Not everyone can be a VPP: they have to complete a 2-3-year professional training at a recognized institute. In many countries, they also have to be registered with their veterinary statutory body.
• Uganda: VPPs hold a certificate or diploma in animal health and production at an institution recognized by the Ugandan Veterinary Board.
• Nigeria: VPPs have undertaken a 2-3 year course in animal health and production are either national diploma holders or higher national diploma holders (ND / HND). They are recognized by the Veterinary Council of Nigeria.
• After graduating, VPPs can take further training, which may enable them to provide additional services such as artificial insemination.
• VPPs work under the supervision / in collaboration with veterinarians.

Do all VPPs work for the government? What is the difference between a public and private sector VPP?

• In many countries VPPs can work in the public (government) or private sector. This depends on the legislation of the country. (It’s important to check with the appropriate authorities on what the situation is in your country.)
• Generally, public sector VPPs are often more involved in disease surveillance, extension services, vaccination campaigns, and public health campaigns. Private sector VPPs can provide farmers with primary animal health care services: vaccination, advice on livestock production and health, treatment of some conditions, development of herd health plans, sales of veterinary products and livestock feed, and other services.
• Private sector VPPs charge a fee for their services.
• Public and private sector VPPs often work together, for example, during mass vaccination campaigns or disease outbreaks.
• If a private sector VPP suspects an outbreak, they may involve public sector veterinary services for further diagnostics.

Gender aspects of VPPs

• In many countries, there are fewer women VPP graduates and thus fewer women VPPs providing animal health services to livestock keepers. However, women VPPs can be key service providers within their communities, and in particular for outreach to women farmers.
• Women VPPs often face discriminatory attitudes and local traditions that make it harder for them to work. Interviews conducted with farmers and VPPs found that in some communities:
• Livestock keepers prefer men VPPs and have a perception that women VPPs cannot restrain large animals.
• Livestock keepers pay men VPPs more than women VPPs for the same work.
• Women VPPs reported sexual harassment by men farmers.
• In South Africa, some communities do not allow women to enter livestock enclosures called
• Where patriarchal norms are strongly enforced, women VPPs may not be listened to by community leaders/farmers.

However, it is important for farmers to understand that:

• Women VPPs have the same training as men VPPs.
• Women VPPs are competent and can provide expert advice to farmers.
• Women VPPs can safely handle and restrain large animals. Farmers can also support VPPs with sufficient animal handling infrastructure (race *, pen, or crush *) and assist in restraint during clinical examinations.
• Women VPPs are professional and committed to their work; they can be trusted by farmers.
• Women VPPs should be treated with respect and should not be subjected to sexual harassment.
• Women VPPs are just at competent as men VPPs and therefore should be paid the same amount for the same services.
• In African countries where seclusion norms prevent women from mixing with men (like parts of Nigeria), women VPPs can reach out to women livestock keepers and offer animal health services to them.

For further information, please see documents 5 and 14.

Women farmers and livestock

• Small-scale farmers generally operate family farms, and all members of the household are often involved in livestock keeping and care. Women and men may carry out different but complementary livestock management activities; their roles depend on traditional practices and social norms.
• For example, in some communities, women are more likely to keep chickens and small ruminants and men to keep cattle. Also, within the household, men and women might look after the same animals but be responsible for different tasks. For example, men might be responsible for feeding cattle and women for milking.
• Actively involving both men and women in matters related to providing animal health care ensures successful outcomes.
• Two-thirds of the world’s 600 million low-income livestock keepers are rural women. However rural women have less access to knowledge and training—an FAO survey found that, globally, women farmers received only 5% of all agricultural extension services.
• While all communities are different, in many small-scale farming families, men are traditionally seen as the head of the household and are therefore more likely to make decisions, control income, participate in training, and talk to veterinarians or VPPs.
• Given women’s important roles in livestock production, it is important to enable them to receive advice and training so that they can also benefit from improved livestock health and productivity.
• Men should be encouraged to enable their wives to join trainings and take part in discussions when a VPP visits.
• If women have better access to knowledge and to VPPs, their animals will be healthier and more productive, which will benefit the whole family—and community, as it will decrease the risk of infectious diseases spreading.
• Women typically must balance their livestock activities with household work such as cooking meals. Women’s dual roles may put them at greater risk for zoonotic diseases. Zoonotic diseases are diseases that can be passed from livestock to humans, through contact with animals or consumption of raw meat and milk. It is therefore even more important that women have access to information on preventive healthcare.

For further information, please see documents 2, 3, and 14.

Definitions

Antimicrobial resistance: When disease-causing organisms such as bacteria or parasites become resistant to the drugs designed to treat them, the disease can be nearly impossible to treat, ending in the death of animals or humans.

Biosecurity: Measures to reduce the risk that animals catch infectious diseases.

Cattle crush: Strongly built close-fitting stall that can hold cattle still so that the animals can be safely examined or treated.

Cattle race: A narrow corridor built for cattle that separates them from the rest of the herd so that the animals can be restrained for medical care or other procedures.

National veterinary statutory body: Professional body responsible for regulating the animal health profession.

Scope of work: Tasks and activities that a VPP may undertake according to their level of training and as defined by the veterinary statutory body.

Zoonotic disease: Disease that can spread from animals to humans and vice versa.