Presented by Jeffrey Mariner at the 13th International Society for Veterinary Epidemiology and Economics (ISVEE) Conference Maastricht, The Netherlands, 20–24 August 2012.

1. Update on the
Participatory Epidemiology Network for
Animal and Public Health (PENAPH)
Jeffrey C. Mariner - PENAPH Coordinator
13th International Society for Veterinary Epidemiology and
Economics (ISVEE) Conference
Maastricht, The Netherlands, 20–24 August 2012
c/o ILRI, P. O. Box 30709, Nairobi, 00100 Kenya; phone: +254-20 422 3000; fax:+ 254-20 422 3001; email:ilri-kenya@cgiar.org

2. Jeffrey Mariner - International Livestock Research Institute (ILRI)
Cyrille Pissang - Vétérinaires sans Frontières – Belgium (VSF-B)
Robert Allport - UN Food and Agriculture Organization (FAO)
Baba Soumare - Interafrican Bureau for Animal Resources (AU-IBAR)
Susanne Munstermann - World Organisation for Animal Health (OIE)
Parmley Jane - Veterinarians without Borders – Canada (VSF-C)
Dirk Pfeiffer - Royal Veterinary College, United Kingdom (RVC)
Peter Bloland - US Centers for Disease Control (US-CDC)
Monday Busuulwa - African Field Epidemiology Network (AFENET)
c/o ILRI, P. O. Box 30709, Nairobi, 00100 Kenya; phone: +254-20 422 3000; fax:+ 254-20 422 3001; email:ilri-kenya@cgiar.org

3. Overview of the presentation
• Definition and Brief History of PE
• Participatory Epidemiology (PE)
• Applications of PE
• Participatory Disease Surveillance (PDS)
• Attributes of PE/PDS Programs
• Participatory Epidemiology Network for Animal and
Public Health (PENAPH)
• First PE Technical Workshop, Chiang Mai, Dec 11-13,
2012

4. Participatory Epidemiology
The use of participatory rural appraisal
techniques to collect epidemiological
knowledge and intelligence

5. Participatory Rural Appraisal
(PRA)
• Qualitative intelligence
gathering process
• Key informants
• Iterative
• Problem-solving
• Decision-making
• Best-bet scenarios

6. Participation
• The empowerment of people to find
solutions to their own development
challenges
• Both an attitude and philosophy
– Learning
– Discovery
– Flexibility
• A response to past
failures

7. Origins of PE
• NGO and development experts
enter into animal health
programmes
– Climate of innovation
– Needs assessments and program
design using PRA
– New insights
• Conventional science sceptical
– Anecdotal vs. qualitative inquiry
– Difficult to publish
– Results of PE applications changed
perceptions
• Widely practiced technique
– Not a panacea
– Fit-to-purpose

8. Existing Veterinary Knowledge
• Traditional terms and
case definitions
• Clinical presentation
• Pathology
• Vectors
• Reservoirs
• Epidemiologic
features

9. Tools
• Secondary sources
• Direct observation
• Semi-structured interviews
– Checklists vs. questionnaires
– Open-ended questions
• Discovery
• Non-leading
– Probing
• Visualization - mapping
• Scoring - piling
• Key diagnostics

11. Applications of PE
• Needs Assessments
– Priorities
– Entry points
• Participatory Epi Research
– Basic epi studies
– Disease modelling
– Risk assessment
• Impact Assessment
– Epidemiological
– Livelihoods
– Well-being
• Strategy and Policy Reform
– More direct link between
decision-makers and the
livestock owners

12. Applications of PE
• Community-based Disease
Reporting
• Participatory Disease
Surveillance
– Case finding
– Disease freedom
– Community assessments
• RP, FMD, PPR
• RVF,CSF, HPAI
– Fit-to-purpose

13. Entry Points and Incentives
Young girl presenting her pet chicken to culling team during a mass
cull, Indramayu District January 2006. Photo by Peter Roeder.

14. Participatory Disease
Surveillance
• Targeted surveillance
done by professionals
• Risk-based
• Highly sensitive
– Traditional information
networks
– Extended time frame
• Specificity
– Validation
– Cross-checking Photo: C. Pissang Tchangaï, VSF-B
– Diagnostic testing

15. Example from
participatory mapping
from Indonesia

16. Integrating PDS into surveillance
• Surveillance assessment
and plan
• Surveillance fit-to-
purpose
• Define objectives
– National priorities
• Optimal balance of
attributes
– Sensitivity, timeliness, etc.
• Optimal mix of activities

17. Attributes of PE/PDS Programs
– Flexible approach that allows for discovery
– Practitioners are problem-solvers and not
enumerators
– Strength of the approach lies in its flexible and
qualitative nature
– Orients and complements, but does not
replace structured and quantitative methods
– Information from diverse sources and methods
– Analyzed in an iterative process referred to as
triangulation
– Integrates daignostic testing and quantitative
methods when appropriate to objectives

18. Lessons
• Use PE/PDS for its strengths
– Flexibility and discovery vs. standardization
• Institutionalization
– Organizations and rules of the game
– What is the objective?
• An accepted problem solving tool or a
• Structured routine to fill databases?
• Invest in expert teams
– Focus on quality not quantity of personnel

19. Appropriate Combinations of
Complimentary Techniques
• Participatory approaches
• Diagnostic testing
• Analytical methods
Persistence as a Function of Initial Herd Immunity
800
Length of Outbreak (Days)
700
600
500
400
300
200
1 00
0
0 20000 40000 60000 80000 1 00000 1 20000 1 40000 1 60000 1 80000 200000
Initial Number Recovered (Immune)

20. PENAPH
Participatory Epidemiology Network for
Animal and Public Health
• Building Surveillance Capacity
• Good Practice Guidelines
• Certification of Training
• Research, Policy and Advocacy
• Pro-Poor and One Health Focus
• Knowledge Exchange
c/o ILRI, P. O. Box 30709, Nairobi, 00100 Kenya; phone: +254-20 422 3000; fax:+ 254-20 422 3001; email:ilri-kenya@cgiar.org

21. PENAPH
Participatory Epidemiology Network for
Animal and Public Health
• Nine Core Partners
- Action-oriented
- Decisions by consensus
• Practitioners, Trainers and Organizations
- Key stakeholders
- Over 300 members to date
• Linkages with Regional and National Organizations
c/o ILRI, P. O. Box 30709, Nairobi, 00100 Kenya; phone: +254-20 422 3000; fax:+ 254-20 422 3001; email:ilri-kenya@cgiar.org

22. PENAPH Activities
•Capacity building
• Institutional approach
•Development of standards – policy briefs
•Action research
•Project development
•PENAPH website and virtual community of practice
www.penaph.net
•Policy dialogue and advocacy
c/o ILRI, P. O. Box 30709, Nairobi, 00100 Kenya; phone: +254-20 422 3000; fax:+ 254-20 422 3001; email:ilri-kenya@cgiar.org

23. PENAPH Certification
• Practitioners
- Practical Intro training
- Field practice
- Refresher
• Trainers
- Experienced practitioners
- Training on training
- Mentored training experience
• Master Trainers
• Policy Brief
c/o ILRI, P. O. Box 30709, Nairobi, 00100 Kenya; phone: +254-20 422 3000; fax:+ 254-20 422 3001; email:ilri-kenya@cgiar.org

24. PENAPH Capacity Building
• International training of trainers
- Geographically diverse
- English, French, etc.
• Training support
 2 projects
• Regional Networks
 4 projects
• Mentoring process
 3 projects
• Certification
c/o ILRI, P. O. Box 30709, Nairobi, 00100 Kenya; phone: +254-20 422 3000; fax:+ 254-20 422 3001; email:ilri-kenya@cgiar.org

25. First Technical Workshop
Chiang Mai Dec 11-13
• Presentation of papers and discussion
forums
– 55 abstracts submitted
• Forums
– Incorporating participation in epi and
surveillance
– Methods for evaluation
– Information at www.penaph.net
c/o ILRI, P. O. Box 30709, Nairobi, 00100 Kenya; phone: +254-20 422 3000; fax:+ 254-20 422 3001; email:ilri-kenya@cgiar.org

26. Conclusion
• Participatory epidemiology is an accepted tool for
addressing animal health issues that compliments more
structured or quantitative approaches
• Combining PE with more conventional approaches can add
value and strength
• Guidelines rather than
rules
• Appropriate training is
essential for quality
results
• Don’t cut corners.

27. Thank you!