Promoting the Use of Ethnoveterinary Practices in Livestock Health Management in Masvingo Province, Zimbabwe

This study evaluated the contributions and potential of ethnoveterinary practices to livestock health management in Masvingo Province, Zimbabwe. Causes of non-adoption of ethnoveterinary practices were also determined, and recommendations for the way forward suggested. Both quantitative and qualitative research methods were used in the study. High costs and unavailability of pharmaceuticals, poor communication networks, and disintegrating government livestock health facilities were cited as some of the problems in livestock health management. Adoption of ethnoveterinary practices which are cheap, locally available, and sustainable is an alternative, especially in the face of climate change and variability. However, the respondents cited lack of documentation, inadequate diagnosis, and lack of knowledge of application rates or side effects of these practices as some of the challenges in using them. Ethnoveterinary practices are therefore mostly used in combination with pharmaceuticals rather than on their own. Scientific validation of indigenous medicinal plants is therefore important to increase their adoption in livestock health management. The knowledge of traditional healers, seasoned stockmen, hunters, and other experienced elderly people should be tapped to gather information on these practices so that it gets documented for the benefit of future generations

Biblical Principles to Guide Adventists on Political Involvement in Zimbabwe

Problem There is no harmony in the understanding of the momentous middle-of-the-road approach when it comes to political involvement. Some people are politically headstrong, while others are laid back. This standoff has left the church in a quandary about what to do concerning civic matters. The scarcity of a farsighted stratagem to help guide church members on citizenship issues might be the cause of the deadlock. Method To provide some framework, biblical principles and guidelines from the writings of Ellen G. White on political involvement were established. In addition to reviewing Adventist and other Christian authors on responsible citizenship, this examination also delineated some Jewish conceptions on the subject. Then, after a consideration of the political, cultural, and religious context of Harare, the specific context of Mount Pleasant Church was elucidated. Next, a strategy for political involvement was developed and implemented. Following this, a report on strategy implementation and recommendations were made, and a conclusion drafted. Results The Mount Pleasant Church understands and appreciates the historic apolitical Adventist stance. The members have been equipped with biblical guidelines on how they ought to relate to the state. A foundation was laid for the training of peacemakers to help bring about the much needed national healing and reconciliation. Conclusions Christians are not just citizens of the world to come, but of the all-encompassing kingdom of God. They have a divine mandate to stand with voice and vote against injustice. Their activism is supposed to be nonviolent and includes roles of advocacy, mediation, and reconciliation. While Christians are called upon to respect earthly government, there is room in their lives for civil disobedience when the requirements of the state conflict with those of God. There is room within the church for those feeling the call to occupy political office just as any other profession, provided they do not compromise biblical principles. Finally, there must be a clear demarcation between church and the state; the church has spiritual authority from God and must not depend on the government to fulfill its mission. On the other hand, the state should not use the church to advance its cause

Livestock Feeds and Feeding in Semi-Arid Areas of Southern Africa

Livestock production is the major source of rural livelihoods in semi-arid regions of Southern Africa. However, nutrition is the major limiting factor of livestock production in these areas characterised by declines in rangeland productivity due to the increases in drought frequency, deliberate overstocking by farmers, and climate change and variability. For instance, the grazing resource is strongly influenced by seasonality of rainfall. Poor-quality cereal crop residues are the main dry season supplementary feed source, yet the predominant crops such as sorghum and maize are deficient in protein and other essential nutrients. Additionally, although conventional supplements, fodder crops and agro by-products are an alternative dry season supplementary feed source; they are costly and not readily available. They are also mostly based on staple food crops such as maize, creating competition in use between humans and livestock. Therefore, indigenous browse species remain a significant source of abundant and persistent animal feeds. Other innovations with the potential to improve feed availability include straw ammoniation and silages, veld reinforcement and rehabilitation, and strategic destocking. However, they are not readily adopted by farmers. There is thus a need to promote technologies that improve livestock feeds and feeding for sustainable livelihoods

Challenges and Opportunities for ‘little brothers’ in the Tourism Sector Matrix: The Case of Local Communities around Great Zimbabwe National Monument.

Pro-poor tourism seeks to improve opportunities and earnings of the socio-economically disadvantaged communities. This research explored ways in which poor and often marginalized local communities around the Great Zimbabwe National Monument can benefit through pro-poor tourism. The study adopted a mixed methods research framework. Research methods included key informant interviews, a questionnaire survey, participant observations and desktop research. The research findings indicate that local communities are deriving economic, social, cultural and environmental benefits from the tourism economic sub-sector. The benefits accruing to these local communities are derived from selling artefacts, handicrafts, agricultural produce and fruits to tourists as well as often lowly paid wage employment in hotels and lodges. There are also spill-over benefits as improved transport and communication services as the area is linked by an all-weather tarred road from Masvingo City and partial cellular network provision respectively. Moreover, some of the villagers are also involved in fishing in Lake Mutirikwi and its feeder rivers. However, accrual of the stated benefits remains unsatisfactory due to a plethora of factors including poor participation by the local villagers in community-based tourism projects as a result of lack of entrepreneurial skills, technical knowhow, capital and linkages to the mainstream tourism market. The study recommends a multistakeholder approach in building the capacity of local communities in terms of tourism product development and linkages with the mainstream tourism market. This maximization of benefits will enable the local villagers to play a stewardship role towards cultural and biophysical resources found in their area thereby contributing to employment and sustainable tourism development

Informing Balanced Investment in Services and Health Systems: A Case Study of Priority Setting for Tuberculosis Interventions in South Africa.

OBJECTIVES: Health systems face nonfinancial constraints that can influence the opportunity cost of interventions. Empirical methods to explore their impact, however, are underdeveloped. We develop a conceptual framework for defining health system constraints and empirical estimation methods that rely on routine data. We then present an empirical approach for incorporating nonfinancial constraints in cost-effectiveness models of health benefit packages for the health sector. METHODS: We illustrate the application of this approach through a case study of defining a package of services for tuberculosis case-finding in South Africa. An economic model combining transmission model outputs with unit costs was developed to examine the cost-effectiveness of alternative screening and diagnostic algorithms. Constraints were operationalized as restrictions on achievable coverage based on: (1) financial resources; (2) human resources; and (3) policy constraints around diagnostics purchasing. Cost-effectiveness of the interventions was assessed under one "unconstrained" and several "constrained" scenarios. For the unconstrained scenario, incremental cost-effectiveness ratios were estimated with and without the costs of "relaxing" constraints. RESULTS: We find substantial differences in incremental cost-effectiveness ratios across scenarios, leading to variations in the decision rules for prioritizing interventions. In constrained scenarios, the limiting factor for most interventions was not financial, but rather the availability of human resources. CONCLUSIONS: We find that optimal prioritization among different tuberculosis control strategies in South Africa is influenced by whether and how constraints are taken into consideration. We thus demonstrate both the importance and feasibility of considering nonfinancial constraints in health sector resource allocation models

The patient costs of care for those with TB and HIV: a cross-sectional study from South Africa.

BACKGROUND: This study describes the post-diagnosis care-seeking costs incurred by people living with TB and/or HIV and their households, in order to identify the potential benefits of integrated care. METHODS: We conducted a cross-sectional study with 454 participants with TB or HIV or both in public primary health care clinics in Ekurhuleni North Sub-District, South Africa. We collected information on visits to health facilities, direct and indirect costs for participants and for their guardians and caregivers. We define 'integration' as receipt of both TB and HIV services at the same facility, on the same day. Costs were presented and compared across participants with TB/HIV, TB-only and HIV-only. Costs exceeding 10% of participant income were considered catastrophic. RESULTS: Participants with both TB and HIV faced a greater economic burden (US$74/month) than those with TB-only (US$68/month) or HIV-only (US$40/month). On average, people with TB/HIV made 18.4 visits to health facilities, more than TB-only participants or HIV-only participants who made 16 and 5.1 visits, respectively. However, people with TB/HIV had fewer standalone TB (10.9) and HIV (2.2) visits than those with TB-only (14.5) or HIV-only (4.4). Although people with TB/HIV had access to 'integrated' services, their time loss was substantially higher than for other participants. Overall, 55% of participants encountered catastrophic costs. Access to official social protection schemes was minimal. CONCLUSIONS: People with TB/HIV in South Africa are at high risk of catastrophic costs. To some extent, integration of services reduces the number of standalone TB and HIV of visits to the health facility. It is however unlikely that catastrophic costs can be averted by service integration alone. Our results point to the need for timely social protection, particularly for HIV-positive people starting TB treatment

Use of Indigenous Knowledge Systems for Managing Cattle Health in Zimbabwe: Challenges and Opportunities

Cattle play a pivotal role especially for the rural farmer by providing milk, draught power, meat and serving as an indication of wealth among other roles. Research and development of cattle production especially in communal areas can be a sustainable way to improve the livelihoods of the rural population. Major constraints to communal cattle production include high prevalence of diseases, limited forage and poor marketing linkages. For reasons that include; lack of veterinary clinics and extension services, high costs of drugs and potency of the ethnoveterinary medicines, many farmers have resorted to the use of their indigenous knowledge systems (IKS) in the management of cattle diseases. Generally, these practices are cheap, locally available, and sustainable especially in times of climate change and variability. One of the challenges in the use of (IKS) is the lack of scientific evidence on their efficacy and the lack of precise dosages, which could lead to toxicity. There is need therefore for documentation, research and scientific validation of IKS to increase their sustainable use and adoption in livestock health management

Empirical estimation of resource constraints for use in model-based economic evaluation: an example of TB services in South Africa.

BACKGROUND: Evidence on the relative costs and effects of interventions that do not consider 'real-world' constraints on implementation may be misleading. However, in many low- and middle-income countries, time and data scarcity mean that incorporating health system constraints in priority setting can be challenging. METHODS: We developed a 'proof of concept' method to empirically estimate health system constraints for inclusion in model-based economic evaluations, using intensified case-finding strategies (ICF) for tuberculosis (TB) in South Africa as an example. As part of a strategic planning process, we quantified the resources (fiscal and human) needed to scale up different ICF strategies (cough triage and WHO symptom screening). We identified and characterised three constraints through discussions with local stakeholders: (1) financial constraint: potential maximum increase in public TB financing available for new TB interventions; (2) human resource constraint: maximum current and future capacity among public sector nurses that could be dedicated to TB services; and (3) diagnostic supplies constraint: maximum ratio of Xpert MTB/RIF tests to TB notifications. We assessed the impact of these constraints on the costs of different ICF strategies. RESULTS: It would not be possible to reach the target coverage of ICF (as defined by policy makers) without addressing financial, human resource and diagnostic supplies constraints. The costs of addressing human resource constraints is substantial, increasing total TB programme costs during the period 2016-2035 by between 7% and 37% compared to assuming the expansion of ICF is unconstrained, depending on the ICF strategy chosen. CONCLUSIONS: Failure to include the costs of relaxing constraints may provide misleading estimates of costs, and therefore cost-effectiveness. In turn, these could impact the local relevance and credibility of analyses, thereby increasing the risk of sub-optimal investments

Exploring equity in health and poverty impacts of control measures for SARS-CoV-2 in six countries

Background: Policy makers need to be rapidly informed about the potential equity consequences of different COVID-19 strategies, alongside their broader health and economic impacts. While there are complex models to inform both potential health and macro-economic impact, there are few tools available to rapidly assess potential equity impacts of interventions.Methods: We created an economic model to simulate the impact of lockdown measures in Pakistan, Georgia, Chile, UK, the Philippines and South Africa. We consider impact of lockdown in terms of ability to socially distance, and income loss during lockdown, and tested the impact of assumptions on social protection coverage in a scenario analysis.Results: In all examined countries, socioeconomic status (SES) quintiles 1-3 were disproportionately more likely to experience income loss (70% of people) and inability to socially distance (68% of people) than higher SES quintiles. Improving social protection increased the percentage of the workforce able to socially distance from 48% (33%-60%) to 66% (44%-71%). We estimate the cost of this social protection would be equivalent to an average of 0.6% gross domestic product (0.1% Pakistan-1.1% Chile).Conclusions: We illustrate the potential for using publicly available data to rapidly assess the equity implications of social protection and non-pharmaceutical intervention policy. Social protection is likely to mitigate inequitable health and economic impacts of lockdown. Although social protection is usually targeted to the poorest, middle quintiles will likely also need support as they are most likely to suffer income losses and are disproportionately more exposed

Estimating Cost Functions for Resource Allocation Using Transmission Models: A Case Study of Tuberculosis Case Finding in South Africa.

OBJECTIVE: Cost functions linked to transmission dynamic models are commonly used to estimate the resources required for infectious disease policies. We present a conceptual and empirical approach for estimating these functions, allowing for nonconstant marginal costs. We aim to expand on the current approach which commonly assumes linearity of cost over scale. METHODS: We propose a theoretical framework adapted from the field of transport economics. We specify joint functions of production of services within a disease-specific program. We expand these functions to include qualitative insights of program expansion patterns. We present the difference in incremental total costs between an approach assuming constant unit costs and alternative approaches that assume economies of scale, scope and homogeneous or heterogeneous facility recruitment into the programme during scale-up. We illustrate the framework's application in tuberculosis, using secondary data from the literature and routine reporting systems in South Africa. RESULTS: Economies of capacity and scope substantially change cost estimates over time. Cost data requirements for the proposed approach included standardized and disaggregated unit costs (for a limited number of outputs) and information on the facilities network available to the program. CONCLUSIONS: The defined functional form will determine the magnitude and shape of costs when outputs and coverage are increasing. This in turn will impact resource allocation decisions. Infectious diseases modelers and economists should use transparent and empirically based cost models for analyses that inform resource allocation decisions. This framework describes a general approach for developing these models