Determinants of referrals from paraprofessionals to veterinarians in Uganda and Kenya

Ilukor, John; Nielsen, Thea; Birner, Regina

doi:10.1016/j.prevetmed.2014.02.009

Cited by 8 publications

(10 citation statements)

References 38 publications

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“…As revealed by farmers during the feedback meeting, they would go back to the same paraprofessionals even when the previous outcome was negative because they knew them and would always want to give them the benefit of the doubt. The third reason could be a language problem which limits non-educated paraprofessionals to interact with veterinarians since most of the veterinarians especially is pastoral areas are not from same ethnic background [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…The slow pace by which farmers were updating their beliefs about non veterinary trained service providers was because these paraprofessionals are known to farmers while veterinarians were not known to farmers. Improving relations between paraprofessionals and veterinarians, therefore, is a key to improving quality of veterinary services [ 9 ]. However, this depends on farmers’ ability to “punish” service providers who provide poor quality services by shifting to quality service providers.…”

Section: Discussionmentioning

confidence: 99%

“…The dominance of the veterinary paraprofessionals in the provision of veterinary services, although useful in reducing costs and increasing access, has been linked to the decline in the quality of veterinary services [ 5 , 6 ]. Improving relationship between veterinarians and paraprofessionals is seen as an important approach towards improving the quality of clinical veterinary services [ 7 – 9 ]. In addition, the economic literature on the provision of animal health services emphasizes that if farmers had information about the quality of service offered, they would be able to update their beliefs and more readily seek services of veterinarians who offer quality services.…”

Section: Introductionmentioning

confidence: 99%

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Measuring the quality of clinical veterinary services for Cattle: an application of a role play experiment in rural Uganda

Ilukor

Birner

2014

BMC Research Notes

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BackgroundThe dominance of veterinary paraprofessionals in the animal health markets has been linked to the decline in quality of veterinary services. This study uses a role play experiment to analyze how the interaction of farmers and service providers influences the quality and the demand for clinical services for cattle. The quality of clinical services was measured by scoring the accuracy of the service provider prescribing the appropriate drug for selected cattle diseases.MethodsThe game was played in four rounds. Farmers were given “animal medical card” with the name of the disease written on it both in English and the local language in each round. Service providers were asked to write the clinical signs, and prescribe the drugs.ResultsThe results show that the ability to identify the signs of different diseases and the accuracy of prescriptions by veterinarians is not significantly different from that of paraprofessionals trained in veterinary science. However, the ability of service providers who are not trained in veterinary medicine to perform these tasks is significantly lower than that of service providers trained in veterinary science. The continued interaction between paraprofessionals and veterinarians gradually leads to an improvement in the ability of paraprofessionals trained in general agriculture and social sciences to perform these tasks. This was not the case for paraprofessionals with no formal training or education. Farmers do not easily change their beliefs about paraprofessionals, even if they receive information on their inability to diagnose diseases correctly and prescribe the correct drugs. Belief updating depends not only on the outcome of the previous round, but also on the gender of the farmer and the livestock production system.ConclusionThis paper argues that the slow pace in which farmers update their beliefs about paraprofessionals limits paraprofessionals’ willingness to learn or consult with veterinarians. However, the use of “animal health cards” (records of diagnoses and treatments) could induce paraprofessionals to provide services of better quality clinical services for cattle and enable farmers to measure the quality of these services.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Measuring the quality of clinical veterinary services for Cattle: an application of a role play experiment in rural Uganda

Ilukor

Birner

2014

BMC Research Notes

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“…The major barriers to implementing telemedicine in developing countries are interstate licensing issues, confidentiality concerns, broadband and internet connectivity, and potential ethical issues and cost effectiveness (Devi et al, 2015). In developing countries in Africa, telemedicine conducted with smartphone-based technology has been used to increase referrals from paraprofessionals to veterinarians in countries like Kenya and Uganda (Ilukor et al, 2014). Many countries rely on paraprofessionals, defined by the World Organisation for Animal Health (OIE) (2019) as: a person who, for the purposes of the Terrestrial Code, is authorised by the veterinary statutory body to carry out certain designated tasks (dependent upon the category of veterinary paraprofessional) in a territory, and delegated to them under the responsibility and direction of a veterinarian.…”

Section: Telemedicine and Its Role In Global Healthmentioning

confidence: 99%

“…Because of potentially detrimental impacts on animal disease, public health, and the overuse of antimicrobials by paraprofessionals operating without veterinary oversight, the OIE recommends strengthening the bond between paraprofessionals and veterinarians (Ilukor et al, 2014;and OIE, 2019). With this improved bond, expectations include more appropriate pharmaceutical prescriptions, improved diagnoses, more accurate disease surveillance, and better adherence to veterinary care standards.…”

Section: Telemedicine and Its Role In Global Healthmentioning

confidence: 99%

Veterinary Telemedicine: A literature review

Teller¹,

Moberly

2020

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As telemedicine becomes more mainstream in the veterinary profession, it is important to understand when and how to utilise it successfully, and its potential downsides. This literature review supports the use of veterinary telemedicine for teleconsultations, and using wearable and mobile health (mHealth) devices for monitoring animal health. Data supporting the provision of virtual care directly to a client within an established veterinarian-client-patient relationship (VCPR) is more limited, and some of what we know comes from paediatric medicine on the human side. As we have learned from human health care providers, we must be aware there could be a tendency to overprescribe antimicrobials in a virtual visit compared to an in-person visit. Data have also shown telemedicine can be just as effective in diagnosing respiratory disease when compared to traditional visits to a doctor’s office or hospital. Telemedicine is especially effective in areas where access to care is limited, whether because of geography, finances, or lack of resources. Overall, veterinary telemedicine and telehealth can provide positive results.

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Are government veterinary paraprofessionals serving the poor? The perceptions of smallholder livestock farmers in Western Kenya

K’Oloo

Ilukor

Mockshell

et al. 2014

Trop Anim Health Prod

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The liberalization of clinical veterinary services in Kenya introduced new service providers into the animal health service sector. This study examines the perceptions of livestock farmers regarding these service providers and analyses the factors that influence their choice of alternative service providers in Kakamega County. The empirical analysis shows that private animal health assistants were perceived to provide better services than alternative providers because they are more accessible and offer services on credit. Results from a multinomial logit model reveal that more educated, wealthier, and older farmers are more likely to use government services. The study concludes that it is imperative to better target the poor and to integrate private service providers into government animal health programs.

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Determinants of referrals from paraprofessionals to veterinarians in Uganda and Kenya

Cited by 8 publications

References 38 publications

Measuring the quality of clinical veterinary services for Cattle: an application of a role play experiment in rural Uganda

Measuring the quality of clinical veterinary services for Cattle: an application of a role play experiment in rural Uganda

Veterinary Telemedicine: A literature review

Are government veterinary paraprofessionals serving the poor? The perceptions of smallholder livestock farmers in Western Kenya

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