The issue of the use of paravets for the delivery of specified veterinary services, inclusive, putatively, of any future PPR eradication strategy, remains one mired in controversy, mis-conceptions and polarised viewpoints. It is well past time that we, as a profession, come together and lay this contentious and long standing issue to rest.
The OIE [TAHC 2013] defines a paravet - termed "Veterinary Para-professional" as "a person who, for the purposes of the Terrestrial Code, is authorised by the veterinary statutory body to carry out certain designated tasks (dependent upon the category of veterinary para-professional) in a territory, and delegated to them under the responsibility and direction of a veterinarian. The tasks for each category of veterinary para-professional should be defined by the veterinary statutory body depending on qualifications and training, and according to need".
This definition, endorsed at the annual OIE meeting by the Official OIE Country Delegates [normally Director of Veterinary Services], contains the following key points:-
1. It is the responsibility of a given country's VSB [normally the Veterinary Board or Veterinary Council] to authorise which designated tasks each category of Veterinary Para-professional [VPP] can undertake.
2. Any such VSB authorised task undertaken by a VPP should be delegated by a veterinarian and be under the direction and responsibility of that veterinarian.
3. It is for each country's VSB to define, according to need, the categories of VPP inline with the qualifications and training they have received.
Veterinary Services in Africa, from their early beginnings in the 1880's, have always used and deployed different categories of paravets - from the very basic cadre [eg veterinary scouts] to the very highly skilled [eg senior laboratory technicians]. All provide essential, needed and valued services.
The elephant in the room came with the introduction, in the 1980's, of Community Based Animal Health Workers [CAHWs] and the variants on the theme of a person selected from the community and who, with some basic training, was deployed to deliver primary animal health care to the livestock of fellow community members. In many ways CAHWs differ little from the recognised and accepted cadre of Veterinary Scout - but with two important and fatal differences - CAHWs were introduced bottom up by NGO's whilst Veterinary Scouts were introduce top down by Veterinary Authorities and the CAHWs lacked a veterinary statutory body [VSB] endorsement or an enabling legal framework. Ask yourself why the Medics have no problem with Primary Health Care workers and you will find one answer in that this was a system both endorsed by WHO and fielded top down by the concerned Medical Authorities. This is why the antipathy to CAHWs increases in direct proportion to your point
on a line from the field to HQ!
We need an open and frank discussion on this subject as I suspect, that just as it was for rinderpest eradication in underserved areas, PPR eradication will also greatly benefit from the services of community based personnel. We need our respective VSB's to provide clear and enabling guidelines for the training standards and permitted tasks for each cadre of veterinary para-professional. We also need a clear statement from the VSB requiring that all veterinary para-professionals must operate under the direction and responsibility of a veterinarian, with a proviso to delegate as appropriate, this responsibility to senior veterinary paraprofessionals. Any such regulation should also stipulate that regular and continuous veterinary education, as now required of veterinary professionals, is extended to all veterinary paraprofessionals and is cascaded along the veterinary service delivery chain from veterinarian to senior veterinary para-professional to
veterinary para-professional.
Dr Chris Daborn.
As always paravets seems to have raised a lot of interest. I feel now that we have covered this topic fairly thoroughly and suggest that we accept that this cadre of veterinary staff, whatever we call them, are undoubtedly important for our future plans with PPR and will play a big role in much that is eventually done in the field. Unless someone has a burning point to add I suggest that we draw a line under this subject. Moderator.
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