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:[email protected]
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:[email protected]
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:[email protected]
• 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:[email protected]
• 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:[email protected]
•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:[email protected]
• 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:[email protected]
• 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:[email protected]
• 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!