A systems approach for designing an integrated animal health surveillance system in Tanzania
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Date
2022
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Sokoine University of Agriculture
Abstract
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.
Description
Thesis
Keywords
Systems approach, Integrated animal health, Animal health surveillance, Infectious livestock diseases, Tanzania