Browsing by Author "George, Janeth"

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Leveraging sub-national collaboration and influence for improving animal health surveillance and response: a stakeholder mapping in Tanzania
(Frontiers in Veterinary Science, 2021-12-13) George, Janeth; Häsler, Barbara; Komba, Erick V. G.; Sindato, Calvin; Rweyemamu, Mark; Kimera, Sharadhuli I.; Mlangwa, James E. D.
Animal health surveillance plays a vital role in ensuring public health, animal welfare, and sustainable food production by monitoring disease trends, early detecting (new) hazards, facilitating disease control and infection, and providing data for risk analysis. Good stakeholder collaboration across the sector can lead to better communication, better science and decision-making and more effective surveillance and response. An understanding of relevant stakeholders, their interests and their power can facilitate such collaboration. While information on key stakeholders in animal health surveillance is available at the national level in Tanzania, it is missing at the subnational level. The study aimed to explore the existing stakeholders’ collaborations and influences at the subnational level through stakeholder mapping and to determine potential leverage points for improving the national animal health surveillance system. A qualitative design was used, involving consultative workshops with government animal health practitioners in Sumbawanga, Sikonge and Kilombero districts of Tanzania from December 2020 to January 2021. Data were collected using an adapted USAID stakeholder collaboration mapping tool with the following steps: (i) Define the objective (ii) Identify all stakeholders (iii) Take stock of the current relationships (iv) Determine resource-based influence (v) Determine non-resource based influence and (vi) Review and revise the collaboration map. Forty-five stakeholders were identified in all three districts and grouped into four categories: private sector and non-government organizations (n = 16), government (n = 16), community (n = 9) and political leaders (n = 4). Animal health practitioners had a stronger relationship with community stakeholders as compared to other categories. The results also showed that most of the stakeholders have non-resource-based influence compared to resource-based influence. The private sector and non-government organizations have a relatively higher number of resource-based influential stakeholders, while political leaders have more non-resource-based influence. The mapping exercise demonstrated that the system could benefit from community mobilization and sensitization, resource mobilization and expanding the horizon of surveillance data sources. Some of the leverage points include integration of surveillance activities into animal health services, clear operational processes, constant engagement, coordination and incentivization of stakeholders. The diversity in the identified stakeholders across the districts suggests that collaborations are contextual and socially constructed.
Mechanisms and contextual factors affecting the implementation of animal health surveillance in Tanzania: a process evaluation
(Frontiers in Veterinary Science, 2022-01-13) George, Janeth; Häsler, Barbara; Komba, Erick V. G.; Rweyemamu, Mark; Kimera, Sharadhuli I.; Mlangwa, James E. D.
A strong animal health surveillance system is an essential determinant of the health of animal and human population. To ensure its functionality and performance, it needs to be evaluated regularly. Therefore, a process evaluation was conducted in this study to assess animal health surveillance processes, mechanisms and the contextual factors which facilitate or hinder uptake, implementation and sustainability of the system in Tanzania. A mixed-method study design was used to evaluate the national animal health surveillance system guided by a framework for process evaluation of complex interventions developed by Moore and others. The system was assessed against standard guidelines and procedures using the following attributes: fidelity, adherence, exposure, satisfaction, participation rate, recruitment and context. Quantitative and qualitative data were collected using a cross-sectional survey, key informant interviews, document review, site visits and non-participant observation. Data from questionnaires were downloaded, cleaned and analyzed in Microsoft TM Excel. Qualitative data were analyzed following deductive thematic and content analysis methods. Fidelity attribute showed that case identification is mainly based on clinical signs due to limited laboratory services for confirmation. Data collection was not well-coordinated and there were multiple disparate reporting channels. Adherence in terms of the proportion of reports submitted per month was only 61% of the target. District-level animal health officials spent an average of 60% of their weekly time on surveillance-related activities, but only 12% of them were satisfied with the surveillance system. Their dissatisfaction was caused by large area coverage with little to no facilitation, poor communication, and lack of a supporting system. The cost of surveillance data was found to be 1.4 times higher than the annual surveillance budget. The timeliness of the system ranged between 0 and 153 days from the observation date (median = 2 days, mean = 6 days). The study pointed out some deviations in animal health surveillance processes from the standard guidelines and their implication on the system’s performance. The system could be improved by developing a user-friendly unified reporting system, the active involvement of subnational level animal health officials, optimization of data sources and an increase in the horizon of the financing mechanism.
A systematic review on integration mechanisms in human and animal health surveillance systems with a view to addressing global health security threats
(BMC, 2020-06) George, Janeth; Häsler, Barbara; Mremi, Irene; Mboera, Leonard E. G; Rweyemamu, Mark; Mangwa, James
Background: Health surveillance is an important element of disease prevention, control, and management. During the past two decades, there have been several initiatives to integrate health surveillance systems using various mechanisms ranging from the integration of data sources to changing organizational structures and responses. The need for integration is caused by an increasing demand for joint data collection, use and preparedness for emerging infectious diseases.
A systems approach for designing an integrated animal health surveillance system in Tanzania
(Sokoine University of Agriculture, 2022) George, Janeth
Animal health surveillance plays a vital role in ensuring public health, animal welfare, and sustainable food production by monitoring disease trends, early detecting (new) hazards, facilitating disease control, and providing data for risk analysis. However, Tanzania's animal health surveillance system is currently not adequately equipped to address ever-increasing infectious diseases particularly emerging and re-emerging ones due to several inefficiencies, including fragmented data sources and their processing, delays in detection and underreporting. Lack of an efficient animal health surveillance system prevents the country from effective prevention and control of potential outbreaks and the spread of infectious livestock diseases resulting in high disease burden to the livestock keepers and the national economy. One of the solutions to such limitations could be to develop an integrated animal health surveillance system that is cost-effective by leveraging the existing technologies. The aim of the study was to develop integrative solutions for improving animal health system in Tanzania using a systems approach. The thesis integrates multiple research methods that give perspectives on various aspects of animal health surveillance systems. The study involved systematic review, extensive field investigation, and systems integration. The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) 2015 checklist. Peer-reviewed articles obtained from five databases and eligible articles were assessed for quality using QualSyst Tool. The final list of articles was then synthesized thematically. Field investigations were organized into two phases: Phase I was conducted in Ngorongoro, Kibaha and Kongwa districts, focusing on the situational analysis of the existing animal health and related systems and process evaluation of the current national animal health surveillance system. Phase II involved Kilombero, Sikonge and Sumbawanga districts focusing on subnational level stakeholder mapping for the animal health surveillance system. Various data collection techniques were deployed during field data collection, including documentary reviews, cross-sectional surveys, key informants' interviews, non-participant observation, and stakeholders' workshops. The final part of the research was the development of a prototype of an interoperable animal health surveillance system in Tanzania. It was developed using Hypertext Processor (PHP) version 7.4 (Laravel framework), Python version 3.8.0 and MySQL database. Three animal health information systems: FAO EMPRES Global Animal Disease Information System (EMPRES-i), Sistema Informativo di Laboratorio (SILAB) and AfyaData were linked to the central data repository through Application Programming Interfaces (APIs). The findings of the study are presented in five scientific papers. The first three papers in this thesis focus on gaining an in-depth understanding of the appropriate integration mechanisms in health surveillance systems, animal health surveillance situation, and contextual factors that influence the performance of the systems. The last two papers focus on operationalizing the integrated animal health surveillance system in Tanzania by looking into stakeholders’ collaboration and prototype of the proposed integration. A systematic review (Paper 1) reveals that integration in health surveillance systems is a relatively new concept which picked pace in the 2010s. There were very few integrated systems in animal health surveillance compared to human health. The common integration mechanisms were interoperability and semantic consistency. The results in paper 2 shows a lot of commonalities in the data sources in terms of relevant surveillance variables and area coverage but diverse in quality. However, despite the richness of the data sources for animal health surveillance, very few of them were being used actively and are fragmented. Paper 3 confirms that the performance of animal health surveillance is attributed to several interconnected factors which need to be analyzed and addressed holistically. More specifically, it reveals deviations in the implementation of surveillance from core principles and guidelines. Most identified challenges were systemic hence need systemic solutions and very little financial commitment to surveillance activities and its effect spilt over every component. Paper 4 demonstrates the importance of animal health stakeholder mapping, especially at the sub-national level, and how stakeholders’ collaboration can be leveraged to improve the efficiency of the system in early disease detection and response. The study established that community-level stakeholders had the strongest relationship with government animal health practitioners compared to other stakeholder categories. Meanwhile, the private sector had more resource-based influential stakeholders, while political leaders had more non-resource-based influence. Paper 5 presents a generic prototype of an interoperable animal health surveillance system in Tanzania, the Wanyama heAlth suRveillaNce (WARN). The prototype has demonstrated the possibility of having an integrated multi- data source animal health surveillance system through the interoperability of existing animal health information systems. This research confirms the complexities of the animal health surveillance systems and that their analyses require systems lens and integrative solutions. The final output of this thesis is the prototype. Its generic and flexible architectural features make it adaptable hence can be used beyond Tanzania with provision for data integration from other surveillance systems. Therefore this should be considered in the future to experiment on how we can move from single- to multi-sectoral health surveillance systems in the direction of One Health approach.
Towards an integrated animal health surveillance system in Tanzania: making better use of existing and potential data sources for early warning surveillance
(BMC Veterinary Research, 2021) George, Janeth; Häsler, Barbara; Komba, Erick; Sindato, Calvin; Rweyemamu, Mark; Mlangwa, James
Background: Effective animal health surveillance systems require reliable, high-quality, and timely data for decision making. In Tanzania, the animal health surveillance system has been relying on a few data sources, which suffer from delays in reporting, underreporting, and high cost of data collection and transmission. The integration of data from multiple sources can enhance early detection and response to animal diseases and facilitate the early control of outbreaks. This study aimed to identify and assess existing and potential data sources for the animal health surveillance system in Tanzania and how they can be better used for early warning surveillance. The study used a mixed-method design to identify and assess data sources. Data were collected through document reviews, internet search, cross-sectional survey, key informant interviews, site visits, and non-participant observation. The assessment was done using pre-defined criteria. Results: A total of 13 data sources were identified and assessed. Most surveillance data came from livestock farmers, slaughter facilities, and livestock markets; while animal dip sites were the least used sources. Commercial farms and veterinary shops, electronic surveillance tools like AfyaData and Event Mobile Application (EMA-i) and information systems such as the Tanzania National Livestock Identification and Traceability System (TANLITS) and Agricultural Routine Data System (ARDS) show potential to generate relevant data for the national animal health surveillance system. The common variables found across most sources were: the name of the place (12/13), animal type/species (12/13), syndromes (10/13) and number of affected animals (8/13). The majority of the sources had good surveillance data contents and were accessible with medium to maximum spatial coverage. However, there was significant variation in terms of data frequency, accuracy and cost. There were limited integration and coordination of data flow from the identified sources with minimum to non-existing automated data entry and transmission. Conclusion: The study demonstrated how the available data sources have great potential for early warning surveillance in Tanzania. Both existing and potential data sources had complementary strengths and weaknesses; a multi-source surveillance system would be best placed to harness these different strengths.