Veterinary services and the mental health of livestock farmers

Francis Sena Nuvey is a field epidemiologist and fully trained nurse who started as an MSc fellow with the Afrique One-African Science Partnership for Intervention Research Excellence (Afrique One-ASPIRE) at the University of Ghana. Afrique One-ASPIRE is one of the eleven Developing Excellence, Leadership and Training in Science in Africa (DELTAS Africa) programmes. DELTAS Africa funds Africa-based scientists to amplify the development of world-class research and scientific leadership on the continent while strengthening African institutions. It is implemented through the  Alliance for Accelerating Excellence in Science in Africa (AESA) platform, a funding, agenda-setting, programme management initiative of the African Academy of Sciences (AAS), the African Union Development Agency (AUDA-NEPAD), founding and funding global partners, and through a resolution of the summit of African Union Heads of Governments. DELTAS Africa is supported by Wellcome and the United Kingdom Foreign, Commonwealth and Development Office (FCDO, formerly DFID).

Summary

The negative effects of climate change, adverse events including water and pasture shortages, disease outbreaks, and conflicts with other land users have put a strain on farmers. This study showed how the poor health of animals and negative weather events leading to livestock losses, is closely linked with farmers’ mental wellbeing.

Background

Agriculture represents the mainstay of African economies, and livestock products are essential to the nutritional needs of the human population. In Ghana, although the livestock sector is a source of livelihood to about 50% of all households, it contributes only about 6% of Ghana’s economy. Cattle, sheep, goats and poultry are the main livestock kept by farmers, mostly free-range. In spite of the available arable agricultural land and high proportion of households raising livestock, Ghana is not self-sufficient in livestock and meat production. This creates a mismatch between the demand for livestock products and its domestic production. Demand that exceeds the domestic supply of meat and meat products is provided by meat imports and on the Sahelian transhumant livestock market that travels by foot into the country.

A major contributor to the low productivity of pastoral livestock farmers is the loss of animals to adverse events, the effect of which is amplified by a growing human population. Due to the negative effects of climate change, adverse events including water and pasture shortages, disease outbreaks, and conflicts with other land users have increased in frequency and intensity over the last decade. We hypothesize that these adverse events, linked to livestock farming, are potential sources for food insecurity and the psychosocial problems of farmers, such as depression and anxiety. These adverse events could lead to a total loss of livestock to farmers, which could result in trauma to them and their communities. Mental problems arise for farmers when these traumatic events and their sequelae remain unaddressed. Persistence of mental health issues may affect farmers’ normal, day-to-day functioning and their wellbeing, such as their motivation, outlook and self-resilience. Thus, the physical and mental wellbeing of individuals is an essential requirement for productivity.  

Although several strategies have been implemented to improve health services delivery and therefore productivity in the livestock sector, these strategies have so far been ineffective in achieving their objectives. Many such interventions appear to be narrow and sector-focused, which may explain their ineffectiveness. It is therefore essential that interventions for farmers are implemented using an integrated health risk analysis such as the One-Health approach, which has previously shown that the health of humans, animals and the environment are interdependent. However, no studies have evaluated if and whether the provision of health services for animals and the environment affects the mental health of livestock farmers in Ghana.    

Study organisation

This MSc research focused on identifying the adverse events affecting livestock farming in Ghana, and their effect on the mental wellbeing of farmers. The project was inspired by the increasing reports of conflicts between livestock farmers and other land users as well as the climate change-induced increase of water and pasture shortages in livestock-rearing areas, and the efforts by government to improve productivity in the livestock sector.

We adopted a mixed-method study design employing both quantitative and qualitative techniques to determine the adverse events farmers experienced in pursuit of their livelihoods and their mental health, as well as to describe the effect of losses on the mental health of farmers. Standardized tools were used to assess the depression, stress and anxiety levels of 287 farmers as dimensions of mental health.  Nineteen (19) cattle farmer leaders and five (5) veterinary officers performed in-depth interviews of farmers that provided valuable data to allow the meaningful interpretation of quantitative results. Mental health scores were generated for each livestock farmer and the influence of different adverse events on the mental health of farmers was evaluated.    

Study outcomes

Description of the baseline situation of farmers

The findings revealed that livestock are kept mostly in remote areas to minimize conflicts over water and pasture resources with other land users. Most livestock owners are increasing the employment of herdsmen to feed and water their animals using a free-range system. The major adverse events leading to livestock losses were found to be cyclical animal disease outbreaks on farms, pasture shortages, animal theft and conflicts with other land users. In times of adversity, nine out of 10 farmers reported losing on average about 15% of their livestock herds each year. More than 90% of farmers lost animals due to diseases, with devastating effects on productivity.  

Performance of veterinary services

Veterinary services were not adapted to meet the demands of livestock farmers, with limited access to veterinary resources in the zones studied, especially those in remote geographical areas. Difficulty accessing drugs and vaccines at veterinary posts also limits the delivery of services to farmers. These resource constraints lead to the proliferation of unqualified practitioners and sale of fake veterinary drugs. Study results showed that existing state veterinarians do not have sufficient logistic capacity or discretionary funds to support the supply chain of drugs and consumables to deliver veterinary services.

Due to epidemics and the poor provision of veterinary services, the incidence of mortality of livestock due to pneumonia and foot and mouth disease has increased. As a result, farmers resort to treating livestock themselves with unproven drugs and without veterinary advice, which leads to more livestock losses. These increased losses reduce herd productivity and the income of farmers, leading to increased stress, depression and anxiety in affected farmers. Some farmers also resort to selling diseased animals in markets in the hope of recovering their losses, thereby threatening the public health.

Linking animal disease and the health of farmers

Findings revealed that infectious diseases, like pneumonia and foot and mouth disease, are recorded in more than 90% of farms. The related physical and mental health consequences to farmers that affect productivity had been less well-documented. The majority of livestock farmers (60%) reported depression, stress and anxiety related to the loss of their animals. Some 31% of farmers in the study reported physical health issues that can be attributed to farming practices, including musculoskeletal and cardiovascular illnesses.

Lessons

Options in managing animal health

For the first time, research revealed that animal diseases are a major problem for livestock production in Ghana and that their control depends mainly on access to good veterinary services, including the maintenance of an adequate ratio of veterinarians to the livestock population. In addition, the training of community veterinary workers supports professional veterinary personnel to achieve adequate geographic coverage of veterinary services. In an era of privatization of livestock services, the registration and licensing of veterinary drug dealers is crucial in order to assure the quality of veterinary drugs. Additionally, meat inspection must be promoted to ensure that meat entering the food chain is safe for consumption.

Promoting an integrated health system to achieve good mental health

These findings illustrate that the poor health of livestock and subsequent losses of animals negatively affects the physical and mental health of farmers. Thus, to manage the health of farmers, physicians and other healthcare providers must routinely consider the social and ecological environment of the patient to identify the root causes of psychological problems to inform treatment plans. This multifaceted approach will improve health for humans, animals and the environment. Thus, to address challenges confronting livestock farmers, strategies to improve the productivity and profitability of farming must be holistic.  

Impact

This study has shown that the health of livestock farmers, their animals and the environment are interdependent. The study has created awareness of the importance of veterinary services and their effect on herd productivity and the health of livestock farmers. Recommendations for addressing these challenges have been shared with the key stakeholders through a policy brief and community meetings with farmers. Following a successful engagement with key stakeholders about emerging mental health problems, a follow-up study has been designed to be implemented though a PhD program to assess the cost-effectiveness of proposed veterinary interventions.

Nurse training positioned Nuvey to further acquire the requisite skills and competencies to become an independent public health researcher. After completing his masters training, Nuvey published two papers from this research in peer-reviewed, open access journals. This research was also a factor in the selection of Nuvey for the Swiss Government Scholarship for Foreign Scholars and to pursue his doctoral studies in the Swiss Tropical Institute for Public Health at the University of Basel. His goal is to use his research to impact public health.