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Presented by Jeffrey Mariner at the 13th International Society for Veterinary Epidemiology and Economics (ISVEE) Conference Maastricht, The Netherlands, 20–24 August 2012.
Citation preview
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!