Update on the Participatory Epidemiology Network for Animal and Public Health (PENAPH)

Update on the

Participatory Epidemiology Network for Animal and Public Health (PENAPH)

c/o ILRI, P. O. Box 30709, Nairobi, 00100 Kenya; phone: +254-20 422 3000; fax:+ 254-20 422 3001; email:ilri-kenya@cgiar.org

Jeffrey C. Mariner - PENAPH Coordinator

13th International Society for Veterinary Epidemiology and

Economics (ISVEE) Conference

Maastricht, The Netherlands, 20–24 August 2012

c/o ILRI, P. O. Box 30709, Nairobi, 00100 Kenya; phone: +254-20 422 3000; fax:+ 254-20 422 3001; email:ilri-kenya@cgiar.org

Jeffrey Mariner - International Livestock Research Institute (ILRI)

Cyrille Pissang - Vétérinaires sans Frontières – Belgium (VSF-B)

Robert Allport - UN Food and Agriculture Organization (FAO)

Baba Soumare - Interafrican Bureau for Animal Resources (AU-IBAR)

Susanne Munstermann - World Organisation for Animal Health (OIE)

Parmley Jane - Veterinarians without Borders – Canada (VSF-C)

Dirk Pfeiffer - Royal Veterinary College, United Kingdom (RVC)

Peter Bloland - US Centers for Disease Control (US-CDC)

Monday Busuulwa - African Field Epidemiology Network (AFENET)

Overview of the presentation

• Definition and Brief History of PE

• Participatory Epidemiology (PE)

• Applications of PE

• Participatory Disease Surveillance (PDS)

• Attributes of PE/PDS Programs

• Participatory Epidemiology Network for Animal and

Public Health (PENAPH)

• First PE Technical Workshop, Chiang Mai, Dec 11-13,

2012

Participatory Epidemiology

The use of participatory rural appraisal

techniques to collect epidemiological

knowledge and intelligence

Participatory Rural Appraisal

(PRA)

• Qualitative intelligence

gathering process

• Key informants

• Iterative

• Problem-solving

• Decision-making

• Best-bet scenarios

Participation

• The empowerment of people to find solutions to their own development challenges

• Both an attitude and philosophy

– Learning

– Discovery

– Flexibility

• A response to past failures

Origins of PE

• NGO and development experts enter into animal health programmes – Climate of innovation

– Needs assessments and program design using PRA

– New insights

• Conventional science sceptical – Anecdotal vs. qualitative inquiry

– Difficult to publish

– Results of PE applications changed perceptions

• Widely practiced technique – Not a panacea

– Fit-to-purpose

Existing Veterinary Knowledge

• Traditional terms and

case definitions

• Clinical presentation

• Pathology

• Vectors

• Reservoirs

• Epidemiologic

features

Tools

• Secondary sources

• Direct observation

• Semi-structured interviews

– Checklists vs. questionnaires

– Open-ended questions

• Discovery

• Non-leading

– Probing

• Visualization - mapping

• Scoring - piling

• Key diagnostics

Applications of PE

• Needs Assessments – Priorities

– Entry points

• Participatory Epi Research – Basic epi studies

– Disease modelling

– Risk assessment

• Impact Assessment – Epidemiological

– Livelihoods

– Well-being

• Strategy and Policy Reform – More direct link between

decision-makers and the livestock owners

Applications of PE

• Community-based Disease Reporting

• Participatory Disease Surveillance – Case finding

– Disease freedom

– Community assessments • RP, FMD, PPR

• RVF,CSF, HPAI

– Fit-to-purpose

Young girl presenting her pet chicken to culling team during a mass

cull, Indramayu District January 2006. Photo by Peter Roeder.

Entry Points and Incentives

Participatory Disease

Surveillance

• Targeted surveillance done by professionals

• Risk-based

• Highly sensitive – Traditional information

networks

– Extended time frame

• Specificity – Validation

– Cross-checking

– Diagnostic testing

Photo: C. Pissang Tchangaï, VSF-B

Example from

participatory mapping

from Indonesia

Integrating PDS into surveillance

• Surveillance assessment and plan

• Surveillance fit-to-purpose

• Define objectives – National priorities

• Optimal balance of attributes – Sensitivity, timeliness, etc.

• Optimal mix of activities

Attributes of PE/PDS Programs

– Flexible approach that allows for discovery

– Practitioners are problem-solvers and not enumerators

– Strength of the approach lies in its flexible and qualitative nature

– Orients and complements, but does not replace structured and quantitative methods

– Information from diverse sources and methods

– Analyzed in an iterative process referred to as triangulation

– Integrates daignostic testing and quantitative methods when appropriate to objectives

Lessons

• Use PE/PDS for its strengths

– Flexibility and discovery vs. standardization

• Institutionalization

– Organizations and rules of the game

– What is the objective?

• An accepted problem solving tool or a

• Structured routine to fill databases?

• Invest in expert teams

– Focus on quality not quantity of personnel

Appropriate Combinations of

Complimentary Techniques

• Participatory approaches

• Diagnostic testing

• Analytical methods

Persistence as a Function of Initial Herd Immunity

0

1 00

200

300

400

500

600

700

800

0 20000 40000 60000 80000 1 00000 1 20000 1 40000 1 60000 1 80000 200000

Initial Number Recovered (Immune)

Le

ng

th o

f O

utb

re

ak

(D

ays

)

PENAPH Participatory Epidemiology Network for

Animal and Public Health

c/o ILRI, P. O. Box 30709, Nairobi, 00100 Kenya; phone: +254-20 422 3000; fax:+ 254-20 422 3001; email:ilri-kenya@cgiar.org

• Building Surveillance Capacity

• Good Practice Guidelines

• Certification of Training

• Research, Policy and Advocacy

• Pro-Poor and One Health Focus

• Knowledge Exchange

PENAPH Participatory Epidemiology Network for

Animal and Public Health

c/o ILRI, P. O. Box 30709, Nairobi, 00100 Kenya; phone: +254-20 422 3000; fax:+ 254-20 422 3001; email:ilri-kenya@cgiar.org

• Nine Core Partners

- Action-oriented

- Decisions by consensus

• Practitioners, Trainers and Organizations

- Key stakeholders

- Over 300 members to date

• Linkages with Regional and National Organizations

PENAPH Activities

c/o ILRI, P. O. Box 30709, Nairobi, 00100 Kenya; phone: +254-20 422 3000; fax:+ 254-20 422 3001; email:ilri-kenya@cgiar.org

•Capacity building

• Institutional approach

•Development of standards – policy briefs

•Action research

•Project development

•PENAPH website and virtual community of practice

www.penaph.net

•Policy dialogue and advocacy

PENAPH Certification

c/o ILRI, P. O. Box 30709, Nairobi, 00100 Kenya; phone: +254-20 422 3000; fax:+ 254-20 422 3001; email:ilri-kenya@cgiar.org

• Practitioners

- Practical Intro training

- Field practice

- Refresher

• Trainers

- Experienced practitioners

- Training on training

- Mentored training experience

• Master Trainers

• Policy Brief

PENAPH Capacity Building

c/o ILRI, P. O. Box 30709, Nairobi, 00100 Kenya; phone: +254-20 422 3000; fax:+ 254-20 422 3001; email:ilri-kenya@cgiar.org

• International training of trainers

- Geographically diverse

- English, French, etc.

• Training support

2 projects

• Regional Networks

4 projects

• Mentoring process

3 projects

• Certification

First Technical Workshop

Chiang Mai Dec 11-13

c/o ILRI, P. O. Box 30709, Nairobi, 00100 Kenya; phone: +254-20 422 3000; fax:+ 254-20 422 3001; email:ilri-kenya@cgiar.org

• Presentation of papers and discussion

forums

– 55 abstracts submitted

• Forums

– Incorporating participation in epi and

surveillance

– Methods for evaluation

– Information at www.penaph.net

Conclusion

• Participatory epidemiology is an accepted tool for addressing animal health issues that compliments more structured or quantitative approaches

• Combining PE with more conventional approaches can add value and strength

• Guidelines rather than rules

• Appropriate training is essential for quality results

• Don’t cut corners.

Thank you!