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Welcome to the Kenya One Health Conference



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Welcome to the Kenya One Health Conference

  1. 1. Welcome to the Kenya One Health Conference 8th December 2021 Lian Thomas
  2. 2. House Keeping • Please mute your mics when joining • Turn on video when speaking unless bandwidth issues • Please contribute your thoughts in the chat function • This session is being recorded and livestreamed • Join the conversation online by using #KOHC2021 and follow us on Twitter @Ohreca_ilri @ILRI
  3. 3. Visit: Kenya One Health Conference posters
  4. 4. Reflective session and reactions on Menti Dr Nicholas Bor
  5. 5. Thank you
  6. 6. Introduction to the policy and implementation session Dr Victor Yamo
  7. 7. Brucellosis control among agro-pastoralists in Tanzania: How to communicate risks effectively Ms. Caroline Mwihaki
  8. 8. Thank you
  9. 9. Foodborne disease outbreak in Kericho county Dr Donald Otieno, County Government Of Kericho
  10. 10. Food Borne Disease Outbreak, Kericho County, Kenya, August 2021 Donald Okello Otieno County Government Of Kericho 1/24/2022 Kenya One Health Conference December 6-8 2021 11
  11. 11. Background • Globally, Foodborne diseases are important cause of illness, death, and impaired socio-economic development (Mehlhorn, 2015) • There is no sufficient information on the global burden due to FBD • Bacteria is responsible for 2/3 of human food-borne diseases • Annually, (CDC) estimates that food borne diseases are responsible for • 76 million human illnesses • 325,000 hospitalizations • 5,000 deaths in the USA (Nyachuba, 2010) • In Kenya, under reporting, inadequate investigation of disease outbreaks, and inadequate diagnostic facilities suggests that FBD are more than what’s recorded by the MOH (Ombui, Kagiko and Arimi, 2001) 1/24/2022 Kenya One Health Conference December 6-8 2021 12
  12. 12. Introduction 1/2 • On Monday 23rd August 2021: ⁻ County Disease Surveillance and Response team notified by hospital clinician ⁻ A total of 35 patients with symptoms of diarrhoea, vomiting and headache • A 38 year-old male died while on treatment • 5 patients were admitted in the hospital • 29 patients were discharged at outpatient unit • Same evening, two national media did broadcast on the outbreak 1/24/2022 Kenya One Health Conference December 6-8 2021 13
  13. 13. Introduction 2/2 • On Tuesday 24th August - The department of health constituted an interdisciplinary team to establish the existence of a possible zoonotic food borne disease outbreak - A sick goat had been home slaughtered, and meat sold out locally • The team included: - Human Clinical and laboratory staff - Public health team - Veterinary public health and livestock disease surveillance - Regional veterinary investigation laboratory - Community health workers 1/24/2022 Kenya One Health Conference December 6-8 2021 14
  14. 14. Objectives Main objective • To describe the food borne disease outbreak and risk factors Specific objective • To determine the magnitude, and characterize the disease outbreak in person, place and time • To identify the cause and risk factors for the disease • To Implement preventive and control measures 1/24/2022 Kenya One Health Conference December 6-8 2021 15
  15. 15. Methods • Outbreak Site: Soliat ward, Soin/Sigowet sub county, Kericho county • Investigation Period : 23rd to 31st August 2021 • Study design: retrospective cohort epidemiological study • Case definition: any person of any age who ate the goat meat, slaughtered on the 20th August 2021, in Soliat ward • Active case search was done • Structured questionnaire used to collect data • Data variables: Case socio-demographic, clinical and exposure factors • Laboratory: Human samples collected • Human sample analysis: standard culture and molecular typing for pathogenic enterics 1/24/2022 Kenya One Health Conference December 6-8 2021 16
  16. 16. Data Management • Data Collected by trained enumerators • Data entered, cleaned and analysed using Microsoft Excel and Epi Info • Continuous data were analyzed by measures of central tendency and dispersion, reported as mean, median • Discrete data analyzed by frequency of counts and proportions and presented in tables and graphs • Relative risk (RR) computed on variables 1/24/2022 Kenya One Health Conference December 6-8 2021 17
  17. 17. Results 1/3 .Descriptive Findings • A total of 53 cases were line listed - Median age 27 years (IQR 21.5) - Females 29 (54.7%) • Median incubation period 15 hours (IQR 10.5) • A total of 14 (58%) of symptomatic cases sought medical care within a 1 day(0-1) (n=24) • Symptoms resolution period median 5.5 days (IQR 3) 1/24/2022 Kenya One Health Conference December 6-8 2021 18
  18. 18. 0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% 35.00% 1-5 6-10 11-15 21-25 26-30 31-35 36-40 41-45 46-50 51-55 61-65 PROPORTION % AGE GROUP IN YEARS proportion of FBD morbidity (age and sex) N=24 Female Male 1/24/2022 Kenya One Health Conference December 6-8 2021 19
  19. 19. Description of Symptoms among Outbreak Cases, Kericho County, August, 2021 (cases had multiple symptoms) n=24 symptoms cases proportion Headache 21 87.5% Fever 19 79.2% Abdominal pains 18 75.0% Diarrhea 17 70.8% Nausea 16 66.6% Fatigue 15 62.5% Vomiting 14 58.3% Dizziness 10 41.6% Confusion 4 16.7% Oral lesions 1 4.2% Sore throat 1 4.2% General body pains 1 4.2% Lost appetite 1 4.2% Skin hyper pigmentation 1 4.2% N=24 1/24/2022 Kenya One Health Conference December 6-8 2021 20
  20. 20. Results 2/3 .Bivariate Analysis Chi square (2x2 table) bivariate analysis. Disease outcome was determined by the development of clinical symptoms Disease outcome 95% CI Independent variables category total no. n=53 D(+) D(-) lower limit upper limit Relative Risk (RR) P. Value Gender male 24 16 8 1.26 4.65 2.41 0.0028 female 29 8 21 residence kipselton yes 5 5 0 1.51 3.51 2.3 0.0031 no 48 19 29 eating roasted meat yes 14 10 4 1.06 3.48 1.98 0.014 no 39 14 25 eating tripes (matumbo) yes 19 12 7 1.01 3.17 1.78 0.0299 no 34 12 22 1/24/2022 Kenya One Health Conference December 6-8 2021 21
  21. 21. Results 3/3 .Laboratory Tests Isolates Samples tested Percentage (%) Entero-toxigenic E. coli producing (ETEC LT/ST) 2 40 Shiga Toxin Producing E. coli 2 40 Entero-aggragative E. coli 2 40 Salmonella 2 40 Entero-pathogenic E. coli 1 20 Total Human sample 5 1/24/2022 Kenya One Health Conference December 6-8 2021 22
  22. 22. Discussion • The disease outbreak was a bacterial zoonosis caused by: - Pathogenic E. coli and Salmonella organisms in primary transmission • Progression of clinical symptoms, incubation periods and, convalescence periods, were consistent with the isolates clinical presentation • Children had the greatest burden of clinical disease due to low immunity • Males and residents of Kipselton village were high disease risk groups, due to their public health risk behaviors • People having eaten roasted meat, and tripes, were high disease risk due to more handling; and high infective dose of pathogens respectively • Health seeking duration was short due to severity of clinical symptoms 1/24/2022 Kenya One Health Conference December 6-8 2021 23
  23. 23. Limitations • Unavailability of samples from the slaughtered animal limited the interpretation of our findings • This was due to evidence (destruction) following apprehension occasioned by the death of a victim, and • Subsequent police arrest of the perpetrator; • Who doubled as a pastor; • Hence very influential in the community 1/24/2022 Kenya One Health Conference December 6-8 2021 24
  24. 24. Public Health Action and the Importance of Interdisciplinary Team Response • Detection of the disease out breaks • Verification of diagnosis and confirmation of disease outbreak • Case definition and case finding using line lists • Design of structured questionnaires • Tabulation and orientation of data in time, place and person • Formulation and test of hypothesis • Inter disciplinary epidemiologic consultation • Implementation control measures • Communication and dissemination of findings 1/24/2022 Kenya One Health Conference December 6-8 2021 25
  25. 25. Conclusion • Food borne disease outbreak caused by pathogenic E.coli and salmonella bacteria was rapidly managed showing the importance of having a coordinated county interdisciplinary One Health team • Public health risk behaviors in gender, and geographically defined groups; • Increased food handling; inadequate cooking time; played a major role in this food borne disease outbreak • Children bore the greatest health burden in this disease outbreak 1/24/2022 Kenya One Health Conference December 6-8 2021 26
  26. 26. Recommendation • Continuous public health education on food hygiene practices; and change of attitudes regarding public health risk behaviors • Anchoring the County One Health interdisciplinary teams on disease control policy; • Thereby giving it a formal institutional platform for efficient communication, coordination, and leadership 1/24/2022 Kenya One Health Conference December 6-8 2021 27
  27. 27. Acknowledgement • County Government of Kericho • Department of Health • Directorate of Veterinary Services • Walter Reed Project-Medical Research Institute, Kericho • Regional Veterinary Investigation Laboratory, Kericho • Kenya One Health Conference 2021 1/24/2022 Kenya One Health Conference December 6-8 2021 28
  28. 28. Reference • Mehlhorn, H. (2015) ‘Food-Borne Disease Burden Epidemiology Reference Group’, Encyclopedia of Parasitology, pp. 1–1. doi: 10.1007/978-3-642-27769-6_3884-1. • Nyachuba, D. G. (2010) ‘Foodborne illness: Is it on the rise?’, Nutrition Reviews, 68(5), pp. 257–269. doi: 10.1111/j.1753-4887.2010.00286.x. • Ombui, J. N., Kagiko, M. M. and Arimi, S. M. (2001) ‘Foodborne diseases in Kenya’, East African Medical Journal, pp. 40–44. doi: 10.4314/eamj.v78i1.9111. • MacDonald, P.D., 2011. Methods in field epidemiology. Jones & Bartlett Publishers. 1/24/2022 Kenya One Health Conference December 6-8 2021 29
  29. 29. THANK YOU Key informants interview at Soliat dispensary grounds Preparing for environmental sampling at the household where goat was slaughtered 1/24/2022 Kenya One Health Conference December 6-8 2021 30
  30. 30. Thank you
  31. 31. Assessing the importance of Rabies vaccination campaigns in influencing community knowledge and prevention of Rabies in Laikipia, Kenya Dr Christian Odinga
  32. 32. Assessing the importance of rabies vaccination campaigns at influencing community knowledge and prevention of rabies in Laikipia, Kenya Kenya One Health Conference Christian O. Odinga, Adam W. Ferguson, James M. Hassell, Dishon M. Muloi, Katherine E. L. Worsley-Tonks 8th December 2021
  33. 33. Introduction
  34. 34. Introduction Current Rabies situation ❑Poor surveillance and limited resources ❑World Health Organization target to eliminate rabies by 2030 ❑Collaboration across health sectors and more vaccination campaigns Hampson et al., 2015. PLOS NTD; Plan, Strategic. "for the Elimination of Human Rabies in Kenya 2014-2030."
  35. 35. The Laikipia Rabies Vaccination Campaign (LRVC) • Running for 7 Years (2015-2021) Dishon Muloi: Adam Ferguson; Dedan Ngatia
  36. 36. Study objective • Evaluate the impact of the Laikipia Rabies Vaccination Campaign (LRVC) on community knowledge about rabies and their attitude towards dog vaccination and rabies treatment
  37. 37. Approach ❑Cross-sectional study ❑March-Sep 2021 ❑28 stratified communities ❑Random dog-owning households ❑Semi-structured questionnaires Methods – Study design Example of questions and answers:
  38. 38. Methods – Three outcome variables of interest Scoring rabies knowledge • Transmission of rabies • Species affected • Typical signs in dogs • Knowledge about fatal nature of rabies • Knowledge of rabies control in animals • Knowledge of treatment options in exposed humans Treatment practices • Human health-seeking behavior • Wound washing after dog bite • Urgency of seeking medical treatment after dog bites 1. Adequate knowledge about rabies (Yes/No) 3. Dog Vaccination (Yes/No) 2. Adequate treatment practices (Yes/No)
  39. 39. Study participants 279 59% 196 41% 26% No formal education 40% up to primary school 34% Secondary school and above 13-83 Years, 35 Years 0-6 years, 5 years Years of vaccination Key predictor variable of interest: Vaccination years
  40. 40. 40% 60% Adequate Inadequate 60% of respondents had inadequate knowledge about rabies 37% • Infects animal and humans 24% • Animal reservoir (dog) 2.3% • Other infected mammals 75% • Rabies is fatal 69% • Typical sign in dogs 54% • Transmitted through Bites Preliminary findings Number of years LRVC attended communities did not significantly influence rabies knowledge, but owner education did
  41. 41. Word of mouth was the main source of information on rabies, and vaccination effort only 5%... N=477
  42. 42. …Respondents informed through word of mouth had inadequate knowledge about rabies 56% 44% 60% 40% 77% 33% 76% 24% 55% 45% 49% 61% adequate inadequate adequate inadequate adequate inadequate adequate inadequate adequate inadequate adequate inadequate experience healthcare professiona ls and in trainings media school and books vaccination efforts word of mouth Word of mouth Vaccination efforts School and books Media Health professional Experience N=477
  43. 43. Dog vaccination 27% 63% 0 100 200 300 400 no yes N=477 264 (87%) of 302 up to date 63% of the respondents had their dogs vaccinated against rabies Number of years LRVC attended communities did not significantly influence dog vaccination probability, but owner education and knowledge of rabies did
  44. 44. …Reasons for not vaccinating against rabies 14% of respondents believed their dogs did not need to be vaccinated
  45. 45. 4% practice wound hygiene 5% Showed urgency 2% vaccine 95% 5% 0 100 200 300 400 500 Hospital No hospital N=477 95% of respondents would go to hospital after a dog bite… …. But not all will know how and why they need to go Health-seeking behavior
  46. 46. Conclusions so far… Combine vaccination efforts with education ❑ Involve local elders in the planning process ❑ Carry out Focus Group Discussions and sensitization programs before the campaign and if an unexpected incidence occurs (e.g., CDV outbreak) ❑ Train local community representatives for constant monitoring of disease situation (Quick Response Team) Recommendations: • Number of vaccination years was not a significant predictor of rabies knowledge and dog vaccination, but education was • More efforts needed to improve human health-seeking behavior as a preventive measure
  47. 47. Next steps • Assess whether education campaign efforts need to target certain communities more than others • Liaise with community representatives to target education efforts and record dog bite cases • Estimate rabies burden in Laikipia based on dog bite data from hospitals “If everyone else is moving forward together then success takes care of itself” – Henry Ford
  48. 48. All study participants Andrea Lesurmat The LRVC team Peter Gathura Philip Kitala Acknowledgements
  49. 49. Thank you
  50. 50. Spatial predictive model of Anthrax across Kenya using a Bayesian approach Ms. Valentina Ndolo
  51. 51. Thank you
  52. 52. National Strategy for prevention and control of Anthrax in humans and animals in Kenya, 2021 – 2036 Dr Augusta Kivunzya
  53. 53. Augusta N. Kivunzya Kenya One Health Conference 6-9 Dec 2021 National Strategy for Prevention and Control of Anthrax in Humans and Animals in Kenya, 2021- 2036
  54. 54. Background • Anthrax is a zoonotic disease caused by Bacillus anthracis • In Kenya, anthrax is ranked as priority zoonotic disease • On average, >10 outbreaks annually in Kenya • Passive surveillance system – Considered underestimate • Prevention and Control efforts are currently uncoordinated at county level • Going either unreported or detected very late • Lack of a one health strategy for anthrax prevention and control • Noted by OIE PVS - 2018 & WHO JEE- 2017
  55. 55. Objective • Main objective to eliminate human anthrax and reduce the incidence of anthrax in animals to less than 1% of the 2020 baseline by 2036
  56. 56. National Anthrax Prevention and Control Strategy Road Map Consultative meeting • Key stakeholders and experts on Anthrax prevention and control • Multi-sectoral • Multi-disciplinary • Government and non-state agencies • Series of meeting • To review and validate preliminary drafts of the strategy
  57. 57. The Strategic Framework • Guiding principles • Anthrax prevention and control: • Requires a multi-sectoral & multi-disciplinary collaborative approach • Effectively reduces negative impact on public health and national economy • Involves breaking the cycle of infection • The community engagement is central in the prevention and control of Anthrax
  58. 58. Thematic areas, Stakeholders and Coordination Legend: • Coordination committee • Ministries County and Parastatals • Other Stakeholders • Thematic Area Acronyms NAPCC-National Anthrax Prevention and Control Committee CZC-County Zoonotic Committee SCZC-Sub county Zoonotic Committee CBO-Community Based Organisation WHO- World Health Organisation OIE-World Organization for Animal Health EAC-East Africa Community FAO-Food Agricultural Organization AFROHUM- Africa One Health University Network
  59. 59. Anthrax Prevention and Control Strategy Pillars Coordination, Collaboration and Partnership Resource mobilization Prevention and Control of Anthrax Conduct and Promote Operational and Applied Research Risk Communication Surveillance, Reporting Systems and Outbreak Response Anthrax Diagnostic Laboratory Capacity
  60. 60. Implementation of the Anthrax Elimination Strategy, 2021-2036 • It is a four phases (1- 4) • Each phase with set of activities synchronized to ensure synergy and leverage • Disease in animals will be progressively reduced • Disease eliminated in humans
  61. 61. Phase 1: Preparatory and Adoption Phase 2021- 2023 Development of guidelines and standard operating procedures Information, Education and Communication Prevention and Control Measures Promote and Co- ordinate Research Resource Mapping and Resource Mobilization Strengthen surveillance
  62. 62. Establishment of Anthrax Prevention and Control Committees Schematic diagram showing coordination structure of the Anthrax prevention and control strategy • Establishment of Anthrax Prevention and Control • Various levels • Drawn various organizations • To coordinate and oversee anthrax prevention and control activities • Advocacy and resource mobilization
  63. 63. Identification of High Risk and Low Risk Zones • High risk zones - counties reporting anthrax outbreaks in both human and animals in the last 5 years (2014 to 2019) • Anthrax outbreaks review and risk mapping data • Anthrax hot spot-(1-50km radius from an outbreak site) • Low risk areas - no reported Anthrax outbreak in the last 5 years will Spatial distribution of livestock anthrax outbreaks by counties in Kenya, 1957 to 2017 (Nderitu et al., 2021
  64. 64. Advocacy, communication and social mobilization Training human & animal personnel • Procurement and distribution of vaccines and lab commodities • Pre-positioning of the vaccines • Collating Anthrax outbreak data and feeding to national anthrax database • Assessments and economic cost analysis of the interventions • Outbreak investigations and response Impact assessment Vaccination & Sero- Surveys Inter-county & cross- border engagement Phase 2: Prioritized Implementation in High Risk Zones, 2024- 2027
  65. 65. Indicators to Move From Phase 2 to 3 Livestock vaccination -3 years consecutive High-risk zones Vaccination coverage 80% Laboratory confirmation of 80% of investigated anthrax outbreak Anthrax incidence reduced by 50% in human and livestock of the baseline Reduction of Anthrax cases: human- livestock- wildlife interface by 50% of the baseline
  66. 66. Phase 3: Implementation of Anthrax Prevention and Control Strategy in High & Low Risk Areas, 2028-2032 Implementation of the strategy countrywide • Aim;- sustaining the achievements of stage two • Apply lessons learnt to the other low risk zones Review and update of national anthrax risk map Advocacy, communication and social mobilization Heightened anthrax surveillance Sustaining livestock vaccinations Evaluation of effectiveness of programs/ interventions Inter-county, regional and International cross border engagements
  67. 67. Key indicators of success in phase 3 Reduction of Anthrax cases in humans & Anthrax incidences in livestock by 80% of baseline country wide Reduction of Anthrax cases at human-livestock- wildlife interface by 80% Country wide vaccination coverage of 80% of the susceptible animals
  68. 68. Phase 4: Elimination of Anthrax in Humans, 2033-2036 Defined by; Sustained surveillance in anthrax free areas Sustained elimination activities in areas reporting Anthrax cases Declared as anthrax free -Areas that do not report Anthrax outbreaks Sustained surveillance to detect new case Zero human Anthrax cases in two consecutive years
  69. 69. Monitoring and Evaluation Routine monitoring, periodic assessment and evaluation At all level Internal monitoring Measure progress and assess the achievement of the program in line with the strategy Led by zoonotic disease unit - Verifiable indicators External evaluation Independent To assess the progress and identify modification
  70. 70. Acknowledgement
  71. 71. Thank you
  72. 72. Reflective session and reactions on Menti Dr Nicholas Bor
  73. 73. Highlights on ILRI’s Impact book Prof Grace Delia
  74. 74. 78 • The first evidence-based global estimates of the many scientific, economic, policy and capacity development impacts of livestock research in and for developing countries. • Four main sections: • Animal Genetics, Production and Human Health • Primary Production • Tropical Livestock Systems and Policies • Future of Livestock Research Edited by John McIntire and Delia Grace Chapters related to One Health • Control of Pathogenesis in Animal African Trypanosomiasis: A search for answers at ILRAD, ILCA and ILRI 1975-2018 • Tsetse and trypanosomiasis control in West Africa, Uganda, and Ethiopia: ILRI’s role in the field • Impact assessment of immunology and immunoparasitology research at ILRAD and ILRI • Transboundary Animal Diseases • Zoonoses • Food Safety and Nutrition
  75. 75. The first global syntheses on the impacts of zoonotic diseases, led by ILRI, estimated that in the least-developed countries, 20% of human sickness and death was due to zoonoses or diseases that had recently jumped species from animals to people. Zoonoses sicken several billion people each year and kill millions, mostly in low- and middle-income countries (this was pre-Covid 19 estimates). The World Bank has estimated that emerging zoonoses cost around US$7 billion a year. Some zoonoses are considered neglected, classical or endemic, and others as new or emerging. Many zoonoses, both neglected and emerging, are food-borne; this chapter focuses on zoonoses that are not transmitted primarily through food. ‘Zoonotic’ diseases, transmissible between humans and animals, ➤ make up around 60% of all human infectious diseases and 75% of emerging human infectious diseases Zoonoses research ➤ estimated that diseases transmitted from animals, including livestock, sicken several billion people each year and kill millions, mostly in lower income countries Veterinary and One Health approaches ➤ estimated the burden and risk factors for neglected as well as emerging zoonoses, identified their drivers and developed strategies for reducing those risks
  76. 76. ‘Is our food safe?’ is a fundamental concern of consumers, especially as populations urbanize and food systems develop. Food safety science – drawing on health, agriculture, technology, marketing and psychology – emerged as a separate discipline in the latter half of the last century. Food safety is relevant to domestic and international markets and involves private and public sectors as well as civil society. Recent evidence suggests that the health burden of food-borne disease (FBD) is comparable to that of three major diseases – malaria, human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) and tuberculosis. Most of the unsafe food health burden is due to contaminated fresh foods purchased from informal markets, and livestock products – milk, meat, offal and eggs – are especially risky. As our understanding of the importance of FBD, and its complicated links with livestock development, has increased, so too has research conducted by ILRI and other research organizations in this area. Veterinary epidemiologists ➤ elevated the importance of food safety and food safety science in low-to middle-income countries, where the health burden of food-borne disease is (shockingly) comparable to that of malaria, HIV/AIDS and tuberculosis. Veterinary epidemiologists ➤ determined that the unsafe food health burden in developing countries is due largely to contaminated fresh foods purchased from informal markets, with livestock products–milk, meat, offal and eggs–as especially risky. Veterinary epidemiologists ➤ focused on food safety in the ‘informal markets’ of developing countries, becoming the lead researchers globally in this emerging area.
  77. 77. 81 ILRI impact book contacts and links For further information, please contact: ▪ Animal genetics—Steve Kemp: ▪ Feeds and forages—Michael Peters: ▪ Climate and rangelands—Polly Ericksen: ▪ Animal and human health—Hung Nguyen: ▪ Policies, institutions and livelihoods—Isabelle Baltenweck: Visit ILRI’s impact book landing page: Download ILRI’s impact book: Follow: @ILRI on Twitter Search: #45YearsOfImpact & #WhyLivestockMatter
  78. 78. Thank you
  79. 79. Keynote: Experiences and lessons from development and implementation of One Health policies in Africa Dr Mark Nanyingi (FAO, University of Liverpool)
  80. 80. Recap on learnings from the conference Dr Lian Thomas and Dr Bernard Bett
  81. 81. #KOHC2021 Organizing Committee
  82. 82. #KOHC2021 Special mention
  83. 83. Thank you
  84. 84. Panel discussion: How One Health research can be translated into policy and practice in Kenya Panelists: Dr Harry Oyas (DVS), Dr Ngere Philip (MoH), Dr. John Mumbo (NEMA), Mr Anthony Odhiambo (CCM) and Dr Mark Nanyingi (FAO)
  85. 85. ONE HEALTH Implementation, Lessons learnt, Good practices and Challenges Mr Anthony Odhiambo, Comitato Collaborazione Medica (CCM)
  86. 86. 91 ONE HEALTH Implementation, Lessons learnt, Good practices and Challenges
  87. 87. OH Milestones 92 CCM promotes the Right to Health for all, strengthening the national and regional health systems of the countries where we operate Tested first One Medicine project in 2005 by strengthened existing health services through introduction new service provision models 10yrs later, elaborated the objectives from the lesions learnt and conducted an operational research to test the feasibility, effectiveness and sustainability of the One Health approach Implementation of evidence-based/ context-specific OH interventions in the region
  88. 88. OH Intervention 93 ONEHEALTH: Multidisciplinary approachtofosterthehealthand resilienceofpastoralcommunities innorthernKenya(OHP) OneHealthforHumans,Environment,AnimalsandLivelihoods (HEAL) BuildingDroughtResilienceinIsioloCountythroughSustainable Livelihoods
  89. 89. 94 ONE HEALTH Multidisciplinary approach to foster the health and resilience of pastoral communities in northern Kenya (OHP)
  90. 90. Context Description 95 Drivers and Rationale Risk of zoonotic diseases spillover Poor access to animal and human health services Financial vulnerabilities (healthcare costs) Climate change Water for Animals and Humans Address illiteracy (adult education) Animal health services (diseases) Human health services Access to livestock markets Drought and famine Community needs
  91. 91. Context Description 96 Community network
  92. 92. OHP Experience/ Achievement Change In Social Behavior Increased level of awareness of zoonotic diseases: (54.4% among interviewees aware of OHP) Improved Hygiene and sanitation: (Overall, 87.1% boil water, 92% wash hands before/after touching animal, 63.2% clean milking equipment using traditional methods) Improved waste management: (54.7% had a form of latrine in their household and 55.7% burn waste as a method of disposal) Use of veterinary drugs: (54.1% treat their animals with drugs that they have or buy treatment and 69.3% buy the drugs from vet shops) Capacity Building: (One Health training sessions targeting 37 CDRs, 40 CHVs, 258 HHAs,20 traditional/religious leaders) Active Diseases Surveillance: (239 animal zoonosis identified-49% Brucellosis, 15% Rabies, 6% Anthrax, and 506 human zoonosis identified- 50% Brucellosis, 9% Rabies, 1% Kalazar) Integrated Human and Animal Health Service Outreaches: (192 missions conducted, 15,539 people and 4,680 animals reached) Community-based weather monitoring & DSS: (1 automatic and 8 manual weather stations installed) OH Stakeholder Coordination Mechanism: (2 county technical working groups/ One Health Units established) Direct Interventions
  93. 93. Lesions Learnt Active stakeholders engagement in designing, planning and execution; and sometimes delegation to promote a sense of ownership Shift from event-based response to establishing patterns of diseases to inform early preventive interventions like vaccination, deworming, de-risking etc. This may in the long run prove to be cost effective and sustainable Always consider areas with a diverse ethnic, religious, and social perspectives to ensure for greater impact and outcome All aspects of the problem (human, animal and environmental) should be translated to scientific questions Stakeholder mapping and needs assessment exercise to identify core focus areas of synergies
  94. 94. Good Practices Building local capacities to ensure sustainability Context-specific human and animal health services Robust surveillance that informs planning & decision Use of locally relevant structures as entry points for OH interventions Locally adapted infographics for information dissemination Solid anthropologica l evidence Flexible OH budgets for any emergency that may arise
  95. 95. Challenges Lack of animal health historical data to support in the proper design of animal health services High demands and needs to be addressed on the ground against limited resources available Missing stakeholders contribution in the design and implementation of the mobile unit delayed integration of services Covid-19 pandemic had to realign funds for emergency response and delayed implementation
  96. 96. Acknowledgement
  97. 97. Thank you
  98. 98. Closing remarks Dr Jimmy Smith, Director General ILRI
  99. 99. END of conference Thank you for attending