Abstract Pastoralists contribute to social, environmental, and economic well-being in the drylands of Northern Kenya. Pastoralism is also their way of life and how they manage their livelihoods. However, the marginalization of these communities, including the lack of basic infrastructure and services, compounded by the increasing threat of infectious disease and climate change, has led to the loss of livelihoods and poor health. One Health service delivery can improve pastoralists’ health and livelihoods. This case examines the development of the One Health policy in Turkana County, Kenya. The Turkana One Health Strategy (TOHS) is undergoing final approval. We discuss the contributions of the One Health Strategic Plan for the Prevention and Control of Zoonotic Diseases in Kenya, the One Health framework for integrated service delivery, and the Kimormor outreach model to this plan. We also describe recent One Health activities in Turkana and identify the benefits and limitations of each. One Health service delivery improved access to human health, animal health, and administrative services in rural, hard-to-reach areas in Turkana. Empowering communities to lead and take ownership of One Health activities is critical for implementation. One Health service delivery has some limitations, such as being resource and time intensive and being a relatively new concept in healthcare. Turkana County provides a valuable example of how One Health policy turns into practice through multilevel coordination structures, the support of public and private partners, and transdisciplinary research. It can act as a model for implementing One Health activities in Northern Kenya and other countries. Information © The Authors 2023

Given the recent emergence of Rift Valley Fever (RVF) in Rwanda and its profound impact on livelihoods and health, improving RVF prevention and control strategies is crucial. Vaccinating livestock is one of the most sustainable strategies to mitigate the impact of RVF on health and livelihoods. However, vaccine supply chain constraints severely limit the effectiveness of vaccination programs. In the human health sector, unmanned aerial vehicles, i.e., drones, are increasingly used to improve supply chains and last-mile vaccine delivery. We investigated perceptions of whether delivering RVF vaccines by drone in Rwanda might help to overcome logistical constraints in the vaccine supply chain. We conducted semi-structured interviews with stakeholders in the animal health sector and Zipline employees in Nyagatare District in the Eastern Province of Rwanda. We used content analysis to identify key themes. We found that stakeholders in the animal health sector and Zipline employees believe that drones could improve RVF vaccination in Nyagatare. The primary benefits study participants identified included decreased transportation time, improved cold chain maintenance, and cost savings.

Background. Traditionally, poultry is kept and reared by women in extensive production systems. In Kenya and most developing countries, smallholder poultry productivity is constrained by diseases such as Newcastle disease (ND), which is preventable via a vaccine, yet contributes to significant morbidity and mortality among flocks primarily owned and managed by women in villages. Objective. This study aimed to map the Newcastle disease vaccine value chain stakeholders and identify the barriers and opportunities for women's engagement along the Newcastle disease vaccine value chain. Methodology. Qualitative data were collected with 15 key informant interviews and four focus group discussions with a total of 42 poultry farmers in Machakos Town sub-county, Kenya. Results. The majority of the vaccine value chain consumers were women, and limited information was one of the root causes for not vaccinating their chickens. Vaccines were considered expensive and difficult to access as the production areas were remote from the agrovet shops that retail vaccines. Implication. The study showed that women farmers had no financial control to enable vaccine procurement. Conclusion. Based on the results the government using the Extension service providers should train smallholder farmers on how to use the ND vaccine. Furthermore, manufacturers of thermo-stable ND vaccines should furnish Agrovet shops with data to enable its adoption in remote areas where the cold chain is unreliable.

Most rural women smallholder farmers in Kenya generate income from the sale of small ruminant animals. However, diseases such as Contagious Caprine Pleuropneumonia (CCPP) prevent them from optimizing earnings. A crucial aspect for the control of CCPP is vaccination. In Kenya, CCPP vaccines are distributed through a government delivery mechanism. This study examines gaps and barriers that prevent women smallholder farmers from accessing CCPP vaccines. Qualitative data collection tools used were focus groups discussions, focus meals, jar voices and key informant interviews. Using outcome mapping (OM) methodology, critical partners and stakeholders in the CCPP vaccine value chain (CCPP-VVC) were identified to be the manufacturers, importers, distributors, agrovets, public and private veterinarians, local leaders, and farmers. Respondents highlighted the barriers to be limited access to vaccines due to cold chain problems, inadequate and late delivery of services, lack of information and training on vaccines, and financial constraints. Identified opportunities that can support women’s engagement in the CCPP-VVC are the Kenya Governments two-third gender rule, which requires that not more than two thirds of the members of elective or appointive bodies shall be of the same gender, and positive community perception of female veterinarians. We conclude that more resources and training should be made available to women farmers, and that gender perspectives on policy development related to livestock production and disease prevention are urgently needed to improve livestock productivity and increase agency for women.

Livestock diseases are a major barrier to productivity for both male and female livestock keepers in Africa. In Kenya, two of the most devastating livestock diseases are Newcastle Disease (ND) in poultry and Contagious Caprine Pleuropneumonia (CCPP) in goats. Female livestock keepers tend to own more small ruminants (goats, sheep, etc.) and poultry and their livelihoods are adversely affected if their herds are not vaccinated against these diseases. Livestock farming has gender specific challenges and opportunities, with implications for the empowerment of women smallholder farmers, their household well-being, food security, and livelihoods. There is a need to estimate the level to which women benefit personally, socially, and economically from keeping livestock, yet there are very few studies that can measure if livestock production does in fact empower women smallholder livestock farmers. This study was done to examine linkages between women's empowerment and access and control over livestock products and vaccines. The Women Empowerment in Livestock Index (WELI) tool, which was customized to include questions on livestock vaccine access, was used to capture baseline data on empowerment scores for women in Machakos county, Kenya, prior to implementation of animal health and vaccine test models. In total, 400 participants were surveyed in two wards of Machakos County, Kola and Kalama, which were purposively selected. Women's empowerment was mapped to three domains (3DE): intrinsic agency (power within), instrumental agency (power to), and collective agency (power with) measured against adequacy in 13 indicators. Our results indicate that the household structure (female headed or dual headed household), age of respondents and number of members in a household influence the adequacy score. Work balance was the most significant negative contributor to women's disempowerment. Women contributed the most to livestock productive activities and attained adequacy in this area compared to men, directly impacting the WELI score. Women smallholder livestock farmers report low CCPP and ND vaccination rates, minimal knowledge on livestock diseases, a lack of access to cold chain storage and rarely visited veterinarians. The WELI score was 0.81 indicating a high level of empowerment for women in this community compared to men leading us to conclude that the overall WELI score was not an accurate indicator of women's empowerment in Machakos County. However, the decomposability of the index allows us to disaggregate the drivers of change and to examine how individual indicators contribute to disempowerment.

The Government of Rwanda reported an outbreak of Rift Valley fever (RVF) in the Eastern Province in 2018. To respond to the outbreak, vaccination and education campaigns about the disease were carried out. Because RVF cases continue to be detected in Rwanda and the disease impacts livelihoods and health, accurate knowledge and communication are imperative. The objectives of this study were to evaluate knowledge and risk perceptions of RVF transmission among livestock farmers in Nyagatare District, Eastern Province, Rwanda, and to compare RVF knowledge, risk perceptions, and farming practices between male and female livestock farmers. This cross-sectional, quantitative study was conducted in selected sectors of Nyagatare District in the Eastern Province of Rwanda in June 2019. A 34-question survey was used to ask about demographics, livestock ownership, risk perceptions about zoonotic diseases and livestock management, RVF knowledge, preferred communication sources and information sharing strategies, and protective strategies for RVF mitigation while working with livestock. Livestock farmers were interviewed at three milk collection centers, two village meeting points, a farm cooperative meeting, and during door-to-door visits in villages. In total, 123 livestock farmers were interviewed. The survey found that most livestock farmers lacked knowledge about epizootic and zoonotic transmission of RVF, more male livestock farmers were familiar with RVF and risk mitigation strategies, and female livestock farmers are not viewed as reliable sources of information. Additionally, most livestock farmers had not vaccinated their animals against RVF despite past vaccination campaigns. Radio was the most popular communication channel. These findings show that RVF knowledge and information sharing are inadequate among livestock farmers in Eastern Province. Therefore, vaccination and education campaigns may need to be reevaluated within the context of these trends in order to prepare for future RVF outbreaks.

Snakebite envenomation (SBE) is a neglected One Health issue that overwhelmingly affects people living in rural and impoverished regions of Africa and Asia. Information on SBE is scarce in Rwanda; thus, our objectives were to 1) describe the demographics of SBE patients seeking hospital care, 2) evaluate physician adherence to national treatment guidelines, and 3) assess availability of snake antivenom at hospitals in Rwanda. To achieve these goals, we obtained national data on animal bites/stings and visited every district and provincial hospital in Rwanda to obtain physical records of SBE patients treated in 2017 and 2018. Hospital pharmacies were assessed for antivenom availability. We identified snakes as the second leading cause of animal bites, after dogs, among patients who sought hospital care in 2017 and 2018. Of 363 SBE patients, the highest number of cases occurred among children (< 18 years; 32%) and young adults (18-30 years; 33%), females (61%), farmers (82%), and those living in Eastern Province (37%). Overall, physician adherence to treatment guidelines was 63%. Prescriptions of vitamin K and antivenom were low (4% and 13%, respectively), and only 8% of hospital pharmacies had antivenom in stock throughout the study period. The antivenom stocked was an Indian generic suited for Asian snakes. This minimum estimate of hospitalization cases does not include individuals who died in communities or sought care outside the formal sector. Our study highlights the need to map incidence, risk factors, and patient experiences to mitigate human-snake conflicts and improve patient outcomes.

Most capacity building efforts to investigate and counter emerging infectious diseases have focused on supporting public health agencies. However, to improve the understanding of the epidemiology, and outcome of diseases, aid in their detection and treatment and increase public participation in prevention and control, gender roles must be considered. Gender plays a significant role in shaping infectious disease response. In the most recent Ebola Outbreak in the West African region, glaring gender disparities were apparent as Ebola spread through nations decimating families. Policy implementers, practitioners and researchers were slow to recognize the gender implications, ask why, and build responses accordingly. A report that examined the avian influenza crisis in South East Asia in 2008 concluded that women were clearly in the frontline defense against the disease both as caretakers of the poultry and the families, and yet strategies to combat avian influenza did not consider their roles and potential contribution to the prevention and response. Makerere University, Uganda with the support of Tufts University developed a Gender, One Health and Infectious Disease short course that allows public health specialists to address gender gaps, and explore how gender, the realm of emerging pandemic threats and One Health intersect and how policies can be developed and/or implemented to address those gaps. The week long short course targets in service personnel in multiple disciplines, the private sector, faculty and students from OHCEA institutions and Africa. The course themes apply gender analysis tools to disease surveillance, response, and control and address gender sensitive emergency response planning.

Sporadic anthrax outbreaks have occurred in and around Uganda's Queen Elizabeth National Park (QENP) for years, affecting wildlife, domestic animals, and humans. Reported outbreaks (2004–2005 and 2010) in QENP collectively killed over 500 wild animals and over 400 domestic animals. A 2011 outbreak in Sheema district temporarily froze local markets while killing two humans and seven bovines. One Health is multidisciplinary at its core, yet studies sometimes focus on the effects of animals on human health to the detriment of investigating the surrounding ecological and cultural contexts. Participatory methods connect problems – such as disease – to their context. A multidisciplinary team used participatory epidemiology and conventional structured questionnaires to investigate the impacts of anthrax on human livelihoods and the related perceptions of conservation, public health, and veterinary health efforts in the QENP area. Proximities to previous anthrax outbreaks and to QENP were treated as risk factors in the collection and evaluation of data. Participants' feedback indicates that anthrax prevalence may be greater than officially reported. Community member perceptions about anthrax and other diseases appear to be more closely related to their proximity to QENP than their proximity to anthrax outbreaks. Neither risk factor had a strong effect on knowledge of disease, nor any effect on behaviors associated with disease response or control. Instead, participants reported that social pressures, the economics of poverty, and the lack of health and veterinary infrastructure highly influenced responses to disease. The complex connections between the social needs and the economic context of these communities seem to be undermining current anthrax control and education measures. This livelihood-based decision-making may be unlikely to respond to educational intervention alone. This study provides a strong base for further research and for improvements in effective disease control.