A food systems approach and qualitative system dynamics model to reveal policy issues within the commercial broiler chicken system in South Africa.

Global broiler production and consumption levels continue to rise. South Africa's broiler system is dominated by commercial production and formal retail trade, with competition from cheap imports. Local broiler policies have narrow, production-driven, short-term aims for industry growth and national food security. However, these have unintended consequences that undermine the system's future sustainability. Using a food systems approach, this study developed a qualitative system dynamics model of the South African commercial broiler system and used it to engage stakeholders in policy discussions within the boundaries of health, nutrition, and environmental sustainability. A problem statement and key system elements were drawn from a previously published qualitative study and were validated by 15 stakeholders via an online questionnaire. From this, a seed model was developed, expanded into a larger model, and shared in a modular format with stakeholders in virtual meetings, on an individual or institutional basis, for feedback and validation, and for discussion of areas for policy consideration. Refinements were incorporated into the modules, policy considerations were summarised, and crosscutting issues were identified. The model demonstrated the system's complexity, interlinkages, feedbacks, reinforcing and balancing loops, and behaviour archetypes. The modular presentation format created a suitable platform for stakeholder engagement. Current policies focus on local commercial production, formal markets, and affordability without cognisance of the broader system represented by the model. Inequality pervades throughout the system. Commercial producers, linked to large supermarkets and fast-food chains, dominate the system, presenting barriers to entry. Affordability is unintentionally traded off against non-communicable disease risks through brining of most frozen products, and ultra-processing of fast-food items. Foodborne disease control is critical, given the proportion of vulnerable individuals, and greater coherence of food safety policy is urgently needed. The environmental footprint of broilers, whilst less than that of ruminants, deserves closer scrutiny based on its dependence on intensive cereal production for feed. This study's food systems approach provides a system-wide perspective and a foundation for policymakers to develop more integrated and transformative policies.

Dietary and agricultural adaptations to drought among smallholder farmers in South Africa: A qualitative study.

Building resilience to environmental change is an integral part of long-term climate adaptation planning and local policy. There is an increased understanding of the impact of climate change on global crop production however, little focus has been given to local adaptation pathways and rural smallholder community responses, especially regarding food security. It is becoming increasingly evident that local level decision-making plays a vital role in reducing vulnerability to environmental change. This research aimed to qualitatively investigate coping and adaptive strategies adopted by smallholder farming households to respond to the impacts of drought in rural KwaZulu-Natal, South Africa. Focus group discussions (n = 7) consisting of 5-9 participants and individual interviews (n = 9) using pre-tested topic guides, involving a total of 57 adults were conducted in rural areas of drought-affected districts: Msinga, Richmond and Umbumbulu of KwaZulu-Natal, in July 2018. The data were analysed using thematic analysis in NVivo 12. Thematic analysis identified three principal themes: 1. Perceived effects of droughts on the local food system and diets; 2. Current coping strategies; and 3. Enablers for successful adaptation. All sites reported a change in food consumption habits, with the majority perceiving drought to be the main driver behind a shift from vegetable-based to starch-based diets and decreased animal source food consumption. Only short-term coping strategies were implemented across the study sites. However, knowledge of long-term adaptation strategies existed but was unattainable to most respondents. Recommendations of perceived context-specific long-term adaptation strategies that could be used at a local scale were communicated by the respondents. However, they would need external help to actualize them. A need exists to support smallholder communities' short-term response methods to drought to achieve more holistic resilience and successful adaptation. Short-term adaptation strategies, if implemented alone, often have significant trade-offs with longer-term adaptation and building resilience. This study highlights the need for targeted, contextualised policy solutions to improve smallholder productivity during drought through a strategic combination of both short- and longer-term adaptation measures, i.e. short-term adaptation should be guided by a long-term adaptation strategy. Proper planning, including the use of climate scenarios combined with information on nutritional status, is needed to develop context-specific and transformative adaptation strategies. These strategies should aim to strengthen resilience at a local level and should be included as policy recommendations.

Cost-benefit and feasibility analysis for establishing a foot-and-mouth disease free zone in Rukwa region in Tanzania.

Tanzania has the second largest livestock population in Africa and livestock keeping is an integral part of most people's livelihoods. Foot-and-mouth disease (FMD) is a transboundary disease, affecting cloven-hoofed animals, that is currently endemic in Tanzania. The Tanzania Development Vision 2025 aspires to make the livestock sector more competitive. Part of this plan foresees establishing a FMD-free zone in the Rukwa region to be able to increase the export of animals and animal products. The aim of this study was to assess the economic efficiency and feasibility of establishing such an FMD-free zone and to advise policy makers on the profitability of the investment. A stochastic benefit-cost model, set-up in Palisade @Risk for Excel for a time frame of ten years, was developed to assess whether the benefits of establishing a FMD-free zone would outweigh the costs. Data were collated from reviewing literature, government statistics, and key informant interviews with farmers, traders and veterinarians in Tanzania, and complemented by informed assumptions and expert opinion. Moreover, feasibility aspects including underlying infrastructure, market structures and resource availability were discussed based on key informant interviews, literature review and historical analyses. The net present value for the establishment of a FMD-free zone was negative and the benefit-cost ratio was below one (mean 0.09, min 0.05 - max 0.15 in the scenario considering vaccination of all susceptible domestic animals, and mean 0.11, min 0.06 - max 0.20 when considering vaccinating cattle only), excluding potential benefits from trade. The sensitivity analysis showed that variables related to the cost of vaccination had the largest negative impact on the net present value. The proposed FMD-free zone in Rukwa region is unlikely to be cost-effective with the current FMD status and export trade prospects in Tanzania. Interviews with stakeholders revealed that vaccine availability, funding, farmers' willingness to participate, and lack of staff continuity in key roles were the main barriers to establish a reliable FMD control programme in the country. Recommendations towards FMD control and potential short and middle term strategies are discussed.

A Qualitative Analysis of the Commercial Broiler System, and the Links to Consumers' Nutrition and Health, and to Environmental Sustainability: A South African Case Study.

Food systems face growing challenges to meet targets of Zero Hunger (SDG 2), and South Africa is no exception given its triple burden of malnutrition, foodborne disease outbreaks, and threats of climate change to food production. Broiler meat is South Africa's most affordable meat option, supporting household food and nutrition security. Although considered healthier and less environmentally harmful than ruminant meat, it is not without food safety risks and environmental impacts. This research aimed to present the foremost commercial broiler system narratives in South Africa, around targets of SDG 2, and to discuss key considerations for policymakers. Twenty-nine key informants and stakeholders, purposively selected to cover a wide range of opinions, participated in semi-structured interviews. Transcripts underwent a qualitative framework analysis. Results showed a highly efficient system, dominated by a small number of interlinked large-scale actors, vulnerable to competition from cheaper imports, yet pressurized to maintain high food safety and environmental impact standards, with a price-sensitive consumer base. Existing policies lack integration and enforcement capacity, and are undermined by siloed government departments, and mistrust and power struggles between public and private sectors. We propose removal of silo walls, and trust building through participatory policy development, with collaborative and transformative public-private partnerships that are designed to build capacity to deliver sustainable solutions.

Using Qualitative System Dynamics Analysis to Promote Inclusive Livestock Value Chains: A Case Study of the South African Broiler Value Chain.

Livestock value chains globally are increasingly dualistic, with integrated market-leaders co-existing with comparatively disadvantaged small producers who, nevertheless, support rural livelihoods and food access, and can also contribute to more resilient supply chains. The South African broiler value chain provides a highly illustrative case study. The purpose of this study is to identify potential leverage points for policy intervention to support small and emerging producers in the South African broiler value chain, and to discuss the strengths and limitations of system dynamics approaches to promote inclusive food value chains. This study develops a causal loop diagram (CLD) based on semi-structured stakeholder interviews and policy documents. The main challenges, key variables and causal relationships between them are systematically identified. Variables are coded, generalised and graphically represented, and entry points for intervention and their links to existing policies are mapped. The challenges faced by smallholders in the context of our study can be characterised, using a CLD, as a set of interlinked and reinforcing dynamics which perpetuate existing disadvantages and reinforce duality in the value chain. Key policy entry points have been identified that could be targeted by a coordinated policy package, including: Direct support for infrastructure investment and input access through grants, subsidies or other policies; credit and liquidity provision for day-to-day expenses; creation of aggregation mechanisms for both inputs and outputs; regulations or initiatives that directly target the relationship of farmers with the commercial segment to improve access to day-old-chicks and, finally, training in business and technical skills. Although most of these interventions have been addressed at some point, implementation has been fragmented, failing to fully consider their complementary nature, thus undermining effectiveness. Existing approaches to consensus building and stakeholder participation in system dynamics research can present challenges when it comes to engaging with complex policy processes and issues of conflict of interest that are relevant in the context of smallholder promotion and equitable food systems, but there are promising avenues for addressing. Despite some methodological challenges, we find that there is considerable scope for system dynamics approaches to inform policy for smallholder promotion, even in contexts characterised by complex policy processes.

A systems analysis and conceptual system dynamics model of the livestock-derived food system in South Africa: A tool for policy guidance.

Global food production systems are currently under scrutiny, in particular the health, nutrition, and environmental impacts of livestock-derived food (LDF). Despite South Africa's recent socio-economic transformation and increased per-capita LDF consumption, the triple burden of malnutrition persists. Policy responses to such complex problems often fail because of linear thinking with short-term goals. However, a systems approach helps identify root causes, feedback mechanisms, potential unintended consequences, and opportunities for integrated, durable solutions. Participation in the systems-thinking process improves stakeholder understanding and buy-in. Our participatory workshop facilitated the development of a systems map for South African LDF, identifying key system elements, linkages, and nexus points. The latter included climate change, land access and management, livestock management and productivity, farming systems, food safety, policy articulation, agricultural knowledge, and income. Based on these findings, and an overview of related literature, we produced a conceptual system dynamics model of the LDF system. We identified key vari-ables and causal relationships, vicious and virtuous loops, system archetypes, conceptual stock and flows, and links to Sustainable Development Goals. The LDF system is complex and dynamic, with a dominance of commercial enterprises across agriculture and food retail, presenting barriers for small and medium-scale individuals. Other key elements relate to population growth and urbanization, land access, deregulation of international trade, climate change vulnerability, feed production limitations, and food safety. Our work provides a unique reference for policymakers, identifying the need for deep structural change, highlighting the possible unintended consequences, and thereby mitigating the risk of system destabilization.

A One Health Evaluation of the Southern African Centre for Infectious Disease Surveillance.

Rooted in the recognition that emerging infectious diseases occur at the interface of human, animal, and ecosystem health, the Southern African Centre for Infectious Disease Surveillance (SACIDS) initiative aims to promote a trans-sectoral approach to address better infectious disease risk management in five countries of the Southern African Development Community. Nine years after SACIDS' inception, this study aimed to evaluate the program by applying a One Health (OH) evaluation framework developed by the Network for Evaluation of One Health (NEOH). The evaluation included a description of the context and the initiative, illustration of the theory of change, identification of outputs and outcomes, and assessment of the One Healthness. The latter is the sum of characteristics that defines an integrated approach and includes OH thinking, OH planning, OH working, sharing infrastructure, learning infrastructure, and systemic organization. The protocols made available by NEOH were used to develop data collection protocols and identify the study design. The framework relies on a mixed methods approach by combining a descriptive and qualitative assessment with a semi-quantitative evaluation (scoring). Data for the analysis were gathered during a document review, in group and individual interviews and in an online survey. Operational aspects (i.e., OH thinking, planning, and working) were found to be balanced overall with the highest score in the planning dimension, whereas the infrastructure (learning infrastructure, systemic organization, and sharing infrastructure) was high for the first two dimensions, but low for sharing. The OH index calculated was 0.359, and the OH ratio calculated was 1.495. The program was praised for its great innovative energy in a difficult landscape dominated by poor infrastructure and its ability to create awareness for OH and enthuse people for the concept; training of people and networking. Shortcomings were identified regarding the balance of contributions, funds and activities across member countries in the South, lack of data sharing, unequal allocation of resources, top-down management structures, and limited horizontal collaboration. Despite these challenges, SACIDS is perceived to be an effective agent in tackling infectious diseases in an integrated manner.

A Systems Approach to Evaluate One Health Initiatives.

Challenges calling for integrated approaches to health, such as the One Health (OH) approach, typically arise from the intertwined spheres of humans, animals, and ecosystems constituting their environment. Initiatives addressing such wicked problems commonly consist of complex structures and dynamics. As a result of the EU COST Action (TD 1404) "Network for Evaluation of One Health" (NEOH), we propose an evaluation framework anchored in systems theory to address the intrinsic complexity of OH initiatives and regard them as subsystems of the context within which they operate. Typically, they intend to influence a system with a view to improve human, animal, and environmental health. The NEOH evaluation framework consists of four overarching elements, namely: (1) the definition of the initiative and its context, (2) the description of the theory of change with an assessment of expected and unexpected outcomes, (3) the process evaluation of operational and supporting infrastructures (the "OH-ness"), and (4) an assessment of the association(s) between the process evaluation and the outcomes produced. It relies on a mixed methods approach by combining a descriptive and qualitative assessment with a semi-quantitative scoring for the evaluation of the degree and structural balance of "OH-ness" (summarised in an OH-index and OH-ratio, respectively) and conventional metrics for different outcomes in a multi-criteria-decision-analysis. Here, we focus on the methodology for Elements (1) and (3) including ready-to-use Microsoft Excel spreadsheets for the assessment of the "OH-ness". We also provide an overview of Element (2), and refer to the NEOH handbook for further details, also regarding Element (4) (http://neoh.onehealthglobal.net). The presented approach helps researchers, practitioners, and evaluators to conceptualise and conduct evaluations of integrated approaches to health and facilitates comparison and learning across different OH activities thereby facilitating decisions on resource allocation. The application of the framework has been described in eight case studies in the same Frontiers research topic and provides first data on OH-index and OH-ratio, which is an important step towards their validation and the creation of a dataset for future benchmarking, and to demonstrate under which circumstances OH initiatives provide added value compared to disciplinary or conventional health initiatives.

Using local language syndromic terminology in participatory epidemiology: Lessons for One Health practitioners among the Maasai of Ngorongoro, Tanzania.

Pastoralists and agro-pastoralists often occupy remote and hostile environments, which lack infrastructure and capacity in human and veterinary healthcare and disease surveillance systems. Participatory epidemiology (PE) and Participatory Disease Surveillance (PDS) are particularly useful in situations of resource scarcity, where conventional diagnostics and surveillance data of disease prevalence may be intermittent or limited. Livestock keepers, when participating in PE studies about health issues, commonly use their local language terms, which are often syndromic and descriptive in nature. Practitioners of PE recommend confirmation of their findings with triangulation including biomedical diagnostic techniques. However, the latter is not practiced in all studies, usually due to time, financial or logistical constraints. A cross sectional study was undertaken with the Maasai of Ngorongoro District, Tanzania. It aimed to identify the terms used to describe the infectious diseases of livestock and humans with the greatest perceived impact on livelihoods. Furthermore, it aimed to characterise the usefulness and limitations of relying on local terminology when conducting PE studies in which diagnoses were not confirmed. Semi-structured interviews were held with 23 small groups, totalling 117 community members within five villages across the district. In addition, informal discussions and field observations were conducted with village elders, district veterinary and medical officers, meat inspectors and livestock field officers. For human conditions including zoonoses, several biomedical terms are now part of the common language. Conversely, livestock conditions are described using local Maasai terms, usually associated with the signs observed by the livestock keeper. Several of these descriptive, syndromic terms are used inconsistently and showed temporal and spatial variations. This study highlights the complexity and ambiguity which may exist in local terminology when used in PE studies. It emphases the need for further analysis of such findings, including laboratory diagnosis where possible to improve specificity before incorporating them into PDS or disease control interventions.

Exploring local knowledge and perceptions on zoonoses among pastoralists in northern and eastern Tanzania.

BACKGROUND: Zoonoses account for the most commonly reported emerging and re-emerging infectious diseases in Sub-Saharan Africa. However, there is limited knowledge on how pastoral communities perceive zoonoses in relation to their livelihoods, culture and their wider ecology. This study was carried out to explore local knowledge and perceptions on zoonoses among pastoralists in Tanzania. METHODOLOGY AND PRINCIPAL FINDINGS: This study involved pastoralists in Ngorongoro district in northern Tanzania and Kibaha and Bagamoyo districts in eastern Tanzania. Qualitative methods of focus group discussions, participatory epidemiology and interviews were used. A total of 223 people were involved in the study. Among the pastoralists, there was no specific term in their local language that describes zoonosis. Pastoralists from northern Tanzania possessed a higher understanding on the existence of a number of zoonoses than their eastern districts' counterparts. Understanding of zoonoses could be categorized into two broad groups: a local syndromic framework, whereby specific symptoms of a particular illness in humans concurred with symptoms in animals, and the biomedical framework, where a case definition is supported by diagnostic tests. Some pastoralists understand the possibility of some infections that could cross over to humans from animals but harm from these are generally tolerated and are not considered as threats. A number of social and cultural practices aimed at maintaining specific cultural functions including social cohesion and rites of passage involve animal products, which present zoonotic risk. CONCLUSIONS: These findings show how zoonoses are locally understood, and how epidemiology and biomedicine are shaping pastoralists perceptions to zoonoses. Evidence is needed to understand better the true burden and impact of zoonoses in these communities. More studies are needed that seek to clarify the common understanding of zoonoses that could be used to guide effective and locally relevant interventions. Such studies should consider in their approaches the pastoralists' wider social, cultural and economic set up.

A One Health approach to antimicrobial resistance surveillance: is there a business case for it?

Antimicrobial resistance is a global problem of complex epidemiology, suited to a broad, integrated One Health approach. Resistant organisms exist in humans, animals, food and the environment, and the main driver of this resistance is antimicrobial usage. A One Health conceptual framework for surveillance is presented to include all of these aspects. Global and European (regional and national) surveillance systems are described, highlighting shortcomings compared with the framework. Policy decisions rely on economic and scientific evidence, so the business case for a fully integrated system is presented. The costs of integrated surveillance are offset by the costs of unchecked resistance and the benefits arising from interventions and outcomes. Current estimates focus on costs and benefits of human health outcomes. A One Health assessment includes wider societal costs of lost labour, changes in health-seeking behaviour, impacts on animal health and welfare, higher costs of animal-origin food production, and reduced consumer confidence in safety and international trade of such food. Benefits of surveillance may take years to realise and are dependent on effective and accepted interventions. Benefits, including the less tangible, such as improved synergies and efficiencies in service delivery and more timely and accurate risk identification, should also be recognised. By including these less tangible benefits to society, animal welfare, ecosystem health and resilience, together with the savings and efficiencies through shared resources and social capital-building, a stronger business case for a One Health approach to surveillance can be made.