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

Abstract

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.

Reaching for the low hanging fruits: One health benefits of joint crop–livestock services for small-scale farmers

“…The survey demonstrated a large unmet demand for advice on livestock in the selected countries. This agrees with the findings of the Platform for Agricultural Risk Management (PARM), which identified livestock pests and diseases among the most severe agricultural risks in Uganda [16], yet animal health services are understaffed, particularly in remote areas, and of insufficient quality [17]. Only few queries were on zoonoses in our survey, despite that endemic zoonotic diseases (such as leptospirosis, cysticercosis, tuberculosis, rabies, leishmaniasis, brucellosis) are estimated to cause more than 2.2 million human deaths globally and 2.4 billion cases of illness annually, and disproportionately affecting the poor in the Global South [18].…”

Supply Chain and Delivery of Antimicrobial Drugs in Smallholder Livestock Production Systems in Uganda

“…This is exacerbated by the fact that in most African countries such as Uganda, there inappropriate limited diagnostic facilities including antimicrobial sensitivity testing ( 10 ). Previous studies in Uganda by Dione et al ( 17 ) and Ilukor and Birner ( 18 ) reported that incorrect diagnosis, under-dosing and overdosing and wrong drug administration routes, poor handling and storage of drugs were common practice among farm households and service providers in pig and cattle production systems, respectively. In fact, service providers were found not to be able to prescribe correct drugs for treatment of specific cattle diseases ( 18 ).…”

“…Previous studies in Uganda by Dione et al ( 17 ) and Ilukor and Birner ( 18 ) reported that incorrect diagnosis, under-dosing and overdosing and wrong drug administration routes, poor handling and storage of drugs were common practice among farm households and service providers in pig and cattle production systems, respectively. In fact, service providers were found not to be able to prescribe correct drugs for treatment of specific cattle diseases ( 18 ). Although the link between stakeholder practices and AMR is still weak, according to Ayukekbong et al ( 10 ), the lack of appropriate quality control regulations as reported in the distribution of veterinary of drugs including antimicrobials could be a contributing factor to the misuse of antimicrobials; consequently, any imprudent practice along drug supply chain may fuel the emergence of resistance.…”

‘Don’t Put the Cart before the Mule!’ Challenging Assumptions Regarding Health-Related Treatment Practices of Working Equid Owners in Northern India

“…Ilukor and Birner [ 38 ] ascertained that ‘livestock farmers who have no skills or training in veterinary science are not able to measure the quality of services being offered’ [ 38 ] (p.1) and, as a result, this inability to assess service quality might negatively impact upon their willingness to pay a fee to see them. This might lead to highly qualified practitioners being forced to accept low prices within certain markets, ultimately nudging them out of such areas altogether.…”