Improving women pastoralists’ access to animal health services: recommendations in Ethiopia and Kenya

What tangible steps can be taken to improve women pastoralists' access to Animal Health Services (AHS)? Providing evidence-based recommendations to answer this question drove a field-based study, by SPARC partner MarketShare Associates (MSA), exploring gender-inclusive approaches to AHS delivery in four pastoral communities in Oromia and Somali regions in Ethiopia and Isiolo and Samburu counties in Kenya. 

Our research focused on understanding the behavioural, normative, and social drivers that influence whether and how pastoralists – especially pastoralist women – interact with AHS. Our study, which is due to be published in November 2024, focused on understanding the behavioural, normative, and social drivers that influence whether and how pastoralists – especially pastoralist women – interact with AHS. Applying a systems lens, we examined how pastoralist men and women interact differently with AHS systems to determine ways in which AHS can be more responsive to gendered behavioural and normative factors. 

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In our first blog of the series, Bridging the gender gap in Animal Health Services as a resilience pathway: Insights from pastoralist communities in Ethiopia and Kenya,  we presented the findings of that study. Here we provide more details on the recommendations we made to improve women pastoralists' access to AHS. 

To make AHS more gender inclusive, we recommend:

• Closing the literacy and Animal Health (AH) information gap between pastoralist men and women. Pastoralist men possess the bulk of AH information and women often rely on their husbands to share this information with them. Pastoralist women also typically receive less education than pastoralist men, which limits their interaction with, and understanding of, written AH information - including diagnosis and dosage information. Women pastoralists also need to freely access information on where to seek AHS, and information that helps them negotiate for better prices of AHS. 
  
  Governments, AHS providers, Non-Governmental Organisations (NGOs) and other stakeholders could use more visual approaches and Information Education Communication (IEC) materials) when sharing AH information with pastoralist women. This could be achieved through community meetings or at weekly markets where women, and the rest of the community, tend to converge. Partnering with last-mile animal health service providers like agrovets in Kenya or private veterinary pharmacies (PVPs) in Ethiopia could be effective to ensure service providers are community-based.

• Bringing AHS and products closer to pastoralists through last-mile delivery is critical, especially for pastoralist women whose mobility, time, and financial constraints often prevent them from traveling to access AHS. This may call for more public-private partnerships, as has been trialed in pastoralist communities in Ethiopia with a vaccine delivery pilot[i], Gender Inclusive Vaccines to Empower Women (GIVE-Women)[ii],[iii], and more broadly through other vaccine distribution and delivery systems projects. 

• In Ethiopia, public-private partnerships are easier to develop, as the government-led AHS system and funds could be used to leverage similar initiatives with private players. While there are many trained community animal health workers (CAHWs) in the Ethiopian system, the sustainability of AHS through this model has been limited due in part to its lack of market orientation. This requires strengthened quality market linkages between CAHWs and PVPs, suppliers and veterinary professionals, and concerted collaboration between development stakeholders and private and government actors to implement the approved harmonised CAHW training manual and approach. These actors could also facilitate affordable financing for CAHWs to invest in start-up requirements and infrastructure such as alternative and cost-effective transportation.

  In Kenya, where the AHS sector is private sector-led, future development programming may be required to support the public arm of the public-private partnership to overcome constraints that private sector actors face, such as infrastructure and security gaps in drylands. This would make delivery not only plausible, but would also support the private sector to see a market opportunity to provide services. 

  Further exploration of the mobile AHS provision, which has been trialed specifically among pastoralists in the drylands in Kenya (and more broadly in India and Bangladesh), can support last-mile delivery of AHS. However, so far these models, such as the mobile veterinary clinics project in Kenya, have not proven financially sustainable with only modest willingness to pay for a full range of animal health services.

• Channelling investments to enable pastoralist women to access proactive preventative care. This begins with understanding the value of early investments in preventative healthcare for livestock to minimise any potential losses from delayed diagnoses and treatment. Contextualised and accessible information campaigns could resonate with and help communicate this to pastoralists. Information campaigns would require collaboration between government (with the overall incentive of improving livelihoods for constituents), communities (which have the most incentive to engage with information campaigns to protect animal health and livelihoods) and AHS providers (who could be critical actors in disseminating information). Campaigns delivered remotely (through radio, media or telecommunications) are most likely to reach female pastoralists due to the constraints already mentioned. 

• In addition to or provided alongside information campaigns, encouraging AHS models that incentivise regular interaction with providers and demonstrate the financial benefits of preventative care could be effective for both pastoralists and providers. Prevention also needs to make financial sense for AHS providers, otherwise they too will have an incentive to delay providing services treatment as prices (and subsequent profit) at this later stage may be more lucrative than earlier preventative intervention. Examples include subscription models whereby animal health service providers regularly provide preventative care to pastoralist women through AHS payment schemes that charge lower but more frequent fees. 

• Making AHS more inclusive for women. AHS in pastoral areas are largely dominated by men; in patriarchal pastoral areas, women are not able to interact as freely with men outside their household, as men are. This limits the advice women receive from providers, such as consultations and medicine dosage information from agrovets or private veterinary pharmacies. 

  Increasing the number of women service providers would be one medium-term solution. The use of women agent models has been well documented in the broader agriculture space and was trialed in the Gender Inclusive Vaccines to Empower Women (GIVE-Women) project, with both pastoralist men and women showing a higher level of trust in women vaccinators, despite initial skepticism, especially from elderly community members. Still, regardless of gender, business models must be profitable to ensure longevity.  

  In the shorter term, it may be possible to facilitate mediated meetings or consultations between women pastoralists and male service providers. These could, for example, take place in the presence of community leaders to increase trust and enable women to speak freely with providers. Pastoralist groups, national and county governments and institutions, and other groups that organise consultative meetings with women pastoralists should consider their time burden and care work constraints. 

  There is opportunity for insight from work that explores digital solutions, such as digital financial and information services and mobile phone applications, for pastoralists. These hold potential to increase women’s access to important animal health information by allowing them to interact with providers remotely. 

  In the aftermath of Covid-19, several sectors adapted their service provision to avoid physical travel and interaction. For example, the human healthcare sector has promoted telehealth services rather than physical visits. It is worth exploring whether the same platforms could be adapted or replicated in the AHS sector. Programming for this must be mindful of the gender-gap in mobile phone access and ownership, with men as gatekeepers of mobile phones in some pastoral communities. For instance, a smartphone application in northern Kenya has supported disease documentation through community disease reporters and veterinary officers.

• Facilitating women’s uptake of innovative financial products, for example through bundled service models. Pastoralists face limited access to a wide range of services beyond veterinary care, such as financial and adjacent services. These include livestock insurance, health insurance, credit, agricultural services such as mechanisation, and inputs on credit for pastoralists who also practice agriculture. A bundled service provision model for pastoralists could increase pastoralists’, and especially women pastoralists’, access to the inputs and services they need by using a combined approach. 

  Through fostering trust and cooperation, connectivity, and information flows between market actors, such a model holds potential to improve both individual and system resilience. Bundling services could reduce the additional time burden women face to access services individually, thus making their access more efficient. This could be facilitated through women’s groups or cooperatives to make rural outreach easier and more attractive to private sector actors.

   

  SPARC will host a webinar in November 2024 to discuss these recommendations.

[i] Mekonnen, S (2023). Delivering Contagious Caprine Pleuropneumonia Vaccine through Public-Private Partnership (PPP) Franchise Business Model in Borena Zone, Oromia Regional State: A Pilot Project. Addis Ababa

[ii] Addis Abbaba University (2023). Best Practices on Adoption of new technologies and Systems by the beneficiary communities and local stakeholders. Addis Ababa. Prepared by Prof. Degefa Tolossa, Dr. Esubalew Abate, Prof. Feyera Senbeta, Prof. Getachew Terefe and Dr. Meskerem Abi

[] Fisseha, A (2023). Final Evaluation of A Livestock Vaccine Innovation Project Implemented by Vétérinaires Sans Frontières – Suisse (VSF-Suisse) and Vétérinaires Sans Frontières Germany (VSF-G)iii