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Evaluation of participatory disease surveillance   for highly pathogenic avian influenza in Africa              and rinder...
ObjectiveParticipatory disease surveillance (PDS)    • Application of participatory approaches for disease surveillanceObj...
MethodsFramework : 5 Pillars, 34 Indicators   •   Relevance to national surveillance   •   Effectiveness for disease surve...
Results: RelevanceRelevance to meet national priorities   • Corroborated absence of disease   • Informed control programsT...
Results: EffectivenessSensitivity & PPV: Not quantified“Lots of data, little of it used”   • Field exposure led to actions...
Results: EfficiencyTimeliness: not quantified   • No effect on disease prevention & control   • PDS driven changes, action...
Results: Sustainability good newsOngoing uses   • Economic surveys (FMD Pakistan)   • AFENET annual surveys & outbreaks   ...
Results: Sustainability bad newsNot considered „institutionalized‟   • Evidence of use limited (new surveillance protocols...
Results: ImpactChanges & contributions outside surveillance   •   Universally positive   •   85% reported career or person...
What did we learn?Participatory approaches: appropriate as complementsConsistent with other data: not evidence of performa...
RecommendationsInvest in the evidence: Harness positive effects   • Survey tool as raison d’être   • Judicious & selected ...
International Livestock Research Institute                             Better lives through livestock                     ...
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Evaluation of participatory disease surveillance for highly pathogenic avian influenza in Africa and rinderpest in Pakistan

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Presented by H. Hannah, P. Pali, H. Rware, B. Bett, T. Randolph, D. Grace, J. Njuki, C. Pissang and E. Hisrich at the 13th conference of the International Society for Veterinary Epidemiology and Economics, Maastricht, the Netherlands, 20-24 August 2012.

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Evaluation of participatory disease surveillance for highly pathogenic avian influenza in Africa and rinderpest in Pakistan

  1. 1. Evaluation of participatory disease surveillance for highly pathogenic avian influenza in Africa and rinderpest in PakistanHannah H, Pali P, Rware H, Bett B, Randolph T, 13th conference of the InternationalGrace D, Njuki J, Pissang C and Hisrich E Society for Veterinary Epidemiology and 1International Livestock Research Institute, Kenya Economics, 20-24 August 2012Vétérinaires Sans Frontièrs, Belgium
  2. 2. ObjectiveParticipatory disease surveillance (PDS) • Application of participatory approaches for disease surveillanceObjective • Evaluate PDS as a surveillance tool within existing systems • Build evidence base of appropriate applications
  3. 3. MethodsFramework : 5 Pillars, 34 Indicators • Relevance to national surveillance • Effectiveness for disease surveillance and outbreak detection • Efficiency as a surveillance approach • Sustainability of PDS • ImpactCountry selection Nigeria Tanzania Benin, Togo Pakistan UgandaApproach • PE practitioners (n=74) & key informants (n=48) • Questionnaires & semi-structured interviews • Workshops: most significant changes, actions, decisions
  4. 4. Results: RelevanceRelevance to meet national priorities • Corroborated absence of disease • Informed control programsTool appropriateness: Non-commercial farmersUsefulness & purpose • Identification of priority diseases and challenges (surveys) • Improving farmer-vet relationships • Outbreak investigation
  5. 5. Results: EffectivenessSensitivity & PPV: Not quantified“Lots of data, little of it used” • Field exposure led to actionsData analysis & compatibility: Unit conflict • Integration, Reconciliation, Validation (Togo, Pakistan, PPR) • Qualitative challengesAcceptability: In complement
  6. 6. Results: EfficiencyTimeliness: not quantified • No effect on disease prevention & control • PDS driven changes, actions & decision not time sensitive PDS visits 60 Nigeria, Benin & Togo 200 50 HPAI outbreaks 180 No. of PDS visists 160 N of outbreaks 40 140 120 30 100 80 20 60 10 40 20 0 0 2007 2008 2009 2006 Month/YearCommunication flows: Upwards
  7. 7. Results: Sustainability good newsOngoing uses • Economic surveys (FMD Pakistan) • AFENET annual surveys & outbreaks • 32% of PE practitioners informally integrate into surveillanceTraining & veterinary curriculum • Graduate: formal (Nigeria, Tanzania) • Undergraduate: informal (Nigeria, Tanzania, Uganda, Pakistan) • In-service: sporadic (Uganda) • Post EDRSAIA: Nigeria, Uganda, Benin
  8. 8. Results: Sustainability bad newsNot considered „institutionalized‟ • Evidence of use limited (new surveillance protocols & strategies) • Sustainability road map not clearMissing pieces • Standard operating procedures for PDS visits • Standardized guidelines for data analysis • Mechanism to integrate data into existing systems • Legal framework • Scientific evidence and validation (Pakistan)
  9. 9. Results: ImpactChanges & contributions outside surveillance • Universally positive • 85% reported career or personal benefit • Veterinary service „mentality shift‟ & „coordination‟ • Field epidemiologists „investigate outbreaks better‟ • Professional skills improved – „change agents‟Participatory or extractive? • Participatory process poorly understood • Participation, empowerment, social capital lacking • Emphasized surveillance objectives Citizen Control Delegated Power Partnership Placation Consultation Informing Therapy Manipulation
  10. 10. What did we learn?Participatory approaches: appropriate as complementsConsistent with other data: not evidence of performanceCaptures community perspectives & improves relationshipsPositive attitude to PESurveillance data limitedLarge amounts of unused qualitative dataInformal use : significant elements lackingExtraction of data: inconsistent with participatory values
  11. 11. RecommendationsInvest in the evidence: Harness positive effects • Survey tool as raison d’être • Judicious & selected applicationsRecommendations • Validate data for common applications • Evaluate sensitivity, PPV & timeliness • Evaluate cost effectiveness • Build evidence base: evaluate & document applications • Develop Standard Procedures for data collection & analysis • Compare to passive surveillance, farmer field days, media • Align objectives : local priorities vs. surveillance outcomes
  12. 12. International Livestock Research Institute Better lives through livestock Animal agriculture to reduce poverty, hunger and environmental degradation in developing countriesAcknowledgement to all those who contributed advice, discussion and critique during framework development and at various points through the evaluation and are too numerous to list here. Thank you. ILRI www.ilri.org Thank you

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