The slow road to community and private sector participation
Veterinary medicine in developing countries has changed over the last 25 years. Fiscal crisis and structural adjustment in the 1980s meant that highly subsidised, state-led animal health services could not survive.
The transition from state-led to private veterinary practices was faster than expected. With dramatically reduced state funds for pharmaceuticals, and the real value of their salaries in steep decline, veterinarians (vets) and other animal health practitioners quickly required producers to pay for services, often informally.
This has left several unresolved issues regarding the provision of veterinary services to poor livestock keepers. Studies in Africa and India demonstrate that:
- Poor people usually have better access to services when there are realistic charges. This is partly because animal health practitioners have a direct incentive to increase their work, but also because poor people lack the power or influence to access highly subsidised government services.
- Transport costs (both for practitioners and customers) are usually higher than professional veterinary fees.
- Access to veterinary care is a much bigger constraint than cost, especially in remote areas.
Vets and para-professionals
An important issue, which remains unresolved, is who should provide privatised services. The economic value of most smallholder production is too low to justify the fees of fully qualified vets; besides, they rarely want to live in the remote areas where some livestock keepers operate.
Research in Senegal and Uganda indicates that Community Animal Health Workers work best in supportive relationships with vets or near-professionals, who provide training, pharmaceuticals, oversight and help through referrals
In poor or remote areas, 'para-professionals' are usually the most economically viable option. Para-professionals range from 'near-professionals' with one to three years of college-based veterinary education, to Community Animal Health Workers (CAHWs), who may have less than six months training. Near-professionals usually work in areas of higher population density (especially with dairy animals); CAHWs tend to work in the less dense, poorest regions.
Our research in Senegal and Uganda indicates that CAHWs work best in supportive relationships with vets (or at least near-professionals), who provide training, pharmaceuticals, oversight and help through referrals. Without these referrals, vets feel that the integrity and survival of their profession is threatened and strive to keep legal recognition to themselves and near-professionals. This leaves poorer, more isolated livestock keepers without services.
Veterinary public goods
A further challenge concerns the funding of veterinary public goods. These goods include disease surveillance and control, and the certification of livestock and livestock products for human consumption and/or international trade. Poorer producers will not pay for these, because the benefits are indirect, but international regulations require state vets to supervise these activities.
For many public goods tasks, it makes economic sense for governments to contract private vets and near-professionals to supervise CAHWs to carry out the tasks. This approach, common in several developed countries (such as Sweden), benefits from the relative efficiency of the private sector. It also strengthens the viability of higher-end private practices, building useful relationships between them and CAHWs. This approach has rarely been used in developing countries, however; donors have tended to promote private vets, CAHWs and state services as independent, rather than as an integrated system.
The reform of veterinary care for poor people is still incomplete. The most beneficial approach would see state vets, private vets and para-professionals working together, which is also necessary for international trade.
David K. Leonard
Institute of Development Studies, University of Sussex, Falmer, BN1 9RE, UK
d.leonard@ids.ac.uk
