Addressing governance challenges in the provision of animal health services: A review of the literature and empirical application transaction cost theory.

Providing adequate animal health services to smallholder farmers in developing countries has remained a challenge, in spite of various reform efforts during the past decades. The focuses of the past reforms were on market failures to decide what the public sector, the private sector, and the "third sector" (the community-based sector) should do with regard to providing animal health services. However, such frameworks have paid limited attention to the governance challenges inherent in the provision of animal health services. This paper presents a framework for analyzing institutional arrangements for providing animal health services that focus not only on market failures, but also on governance challenges, such as elite capture, and absenteeism of staff. As an analytical basis, Williamson's discriminating alignment hypothesis is applied to assess the cost-effectiveness of different institutional arrangements for animal health services in view of both market failures and governance challenges. This framework is used to generate testable hypotheses on the appropriateness of different institutional arrangements for providing animal health services, depending on context-specific circumstances. Data from Uganda and Kenya on clinical veterinary services is used to provide an empirical test of these hypotheses and to demonstrate application of Williamson's transaction cost theory to veterinary service delivery. The paper concludes that strong public sector involvement, especially in building and strengthening a synergistic relation-based referral arrangement between paraprofessionals and veterinarians is imperative in improving animal health service delivery in developing countries.

Determinants of referrals from paraprofessionals to veterinarians in Uganda and Kenya.

Referrals between paraprofessionals and veterinarians are seen as a solution for improving disease surveillance, detection, and reporting as well as ensuring prudent use of antimicrobial agents in animals. This paper used data collected from paraprofessionals in Kenya and Uganda to identify factors influencing referrals to veterinarians by paraprofessionals using a probit regression model. The results show that the determinants of paraprofessional referrals to veterinarians include the following: paraprofessional's mobile phone ownership, gender, and training, as well as attendance of short term trainings, annual assessments, and membership in paraprofessional associations. The paper argues that legislation or supervision of paraprofessionals as well as expansion of mobile phone ownership by paraprofessionals, supporting the formation of paraprofessional associations, and investing in short term training are important factors for strengthening referrals from paraprofessionals to veterinarians.