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Optimizing rabies control in Bali: An EcoHealth approach

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Presented by Winda Widyastuti to the Progress Meeting on Ecosystem Approaches to the Better Management of Zoonotic Emerging Infectious Diseases in the South East Asian Region, Bangkok, 10-13 December 2011.

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Optimizing rabies control in Bali: An EcoHealth approach

  1. 1. Optimizing Rabies Control Program in Bali: An Ecohealth Approach M.D. Winda Widyastuti Present at EcoZD Annual Meeting Bangkok , 10-12 December 201 1
  2. 2. Indonesian Team Members <ul><li>Anak Agung Gde Putra </li></ul><ul><li>Iwan Willyanto </li></ul><ul><li>Edi Basuno </li></ul><ul><li>Soelih Estoepangestie </li></ul><ul><li>Ari e Rukmantara </li></ul><ul><li>M.D. Winda Widyastuti </li></ul><ul><li>Sunandar </li></ul><ul><li>Andri Jatikusumah </li></ul><ul><li>Riana Aryani Arief </li></ul><ul><li>Chaerul Basri </li></ul>
  3. 3. <ul><li>Buffalo 1884 (Esser) </li></ul><ul><li>Dog 1889 (Penning) </li></ul><ul><li>Human 1894 (E. V. de Haan) </li></ul><ul><li>until 2011  2 4 of 33 provinces infected </li></ul>Environment Dog ↔ Human <ul><li>Ecology virus </li></ul><ul><li>Topogra phy </li></ul><ul><li>Habitat sharing </li></ul><ul><li>Food source availablity </li></ul><ul><li>Historically free (Statblaad 1926) </li></ul><ul><li>November 2008 </li></ul><ul><li>Bali is unique </li></ul>Rabies <ul><li>Dog </li></ul><ul><li>Imunit y </li></ul><ul><li>Behaviour </li></ul><ul><li>Fecundity </li></ul><ul><li>Demography </li></ul><ul><li>Human </li></ul><ul><li>So c io- C ultur e </li></ul>
  4. 4. Objective To help government in optimizing rabies control program in Bali Field Studies Community Engagement Data: Rabies Control Program Dog Demography Dog Behavior Dog Fecundity Data: Socio-Culture background in relation with Dog-Human relationship Increasing public awareness & community participation
  5. 5. Objective Technical Decision Maker Formal & Informal Leader Technical Field Officials Community/Concern Citizen School Teacher Animal Human Health Socio-Culture Education
  6. 6. Methods Interview Field Observation Focus Group Discussion Focus Group Discussion Presentation Interactive Discussion Medias (film, song, poster, leaflet) Training (class teaching, scenario-simulation) Monitoring – evaluation Studies Community Engagement
  7. 7. Dog Demography Study (1) <ul><li> Dog : Human Dog Sex Ratio </li></ul><ul><li>( M : F ) </li></ul><ul><li>Denpasar 1 : 24 1 : 1 </li></ul><ul><li>( Urban ) </li></ul><ul><li>Gianyar 1 : 35 3 : 1 </li></ul><ul><li>( Sub-urban ) </li></ul><ul><li>Karangasem 1 : 14 3 : 1 </li></ul><ul><li>( Rural ) </li></ul>
  8. 8. Dog Demography Study (2)
  9. 9. Dog Demography Study
  10. 10. Dog Fecundity Study (1) Feb Augst 41% females giving a birth <ul><li>Average puppies / birth = 4 heads </li></ul><ul><li>164 puppies = 87 Ma, 77 Fem </li></ul><ul><li>Puppy mortality = 18,3% (30 hds)  14 Ma, </li></ul><ul><li>16 Fem </li></ul>+ 134 dogs 1,34 X N0 (100 dogs) N1 ( 234 dogs)
  11. 11. Dog Fecundity Study (2)
  12. 12. Dog Fecundity Study (3)
  13. 13. Dog Fecundity Study (4)
  14. 14. Dog Behaviour Study (1) Average of Rest Activity Duration (minutes) on Adult Male and Female in Daily
  15. 15. Dog Behaviour Study (2) Average of Dog-Human Contact per Hour based on Age and Sex  
  16. 16. Dog Behavior Study (3)
  17. 17. Dog Behavior Study (5) Abang Village-Rural
  18. 18. Dog Behavior Study (5) Dangin Puri - Urban
  19. 19. Banjar Dinas (Klian Banjar) Village (Kepala Desa) Sub-District District Province Majelis Madya Desa Pekraman (Chairman) Majelis Desa Pekraman (Bendesa) Banjar Adat (Klian Adat) Lingkungan / Tempekan Majelis Utama Desa Pekraman (Chairman) Social-Culture Study (1) Majelis Alit Desa Pekraman (Chairman) Social control (awig-awig, oral agreement) Sangkep Meetin g
  20. 20. Socio-Culture Study (2) Keeping Dog Management (%)
  21. 21. Socio-Culture Study ( 3 ) Availabilty of Traditional Rule (%)
  22. 22. Community Engagement (1) <ul><li>School Community  Student + Teachers </li></ul><ul><li>2. Banjar Community </li></ul>Sibetan Village ( animal + human rabies case) Melinggih Kelod Village ( animal case + bite rabies case to human )
  23. 23. (1) School Community S C H O O L <ul><li>Elementary + Junior High School </li></ul><ul><li>2 step program - Pre-post test evalu </li></ul><ul><li>Classes presentation, movie, singing, scenario, interactive discussion </li></ul><ul><li>≥ 40% targeted students increase their knowledge </li></ul>??? .... Event competition...? Connecting to livestock & health service office, village leader
  24. 24. (2) Banjar Program Identification of Village Characteristics Sosialization / Information Transfer Proccess Selection for Rabies Cadres Training for Rabies Cadres Monitoring - Evaluation & Program Adjusment <ul><ul><li>Banjar Status </li></ul></ul><ul><li>( Dog Registration, </li></ul><ul><li>Update Rabies Cases, Knowlegde Change, Behavior Change) </li></ul><ul><li>Cadres Activities </li></ul><ul><li>(Sosialization, dog registration, case repport follow-up ) </li></ul>FGD Presentation Movie <ul><li>(FGD +Banjar Head Approach) </li></ul><ul><li>Father, Mother, Youth </li></ul><ul><li>Head of banjar, gov officer, teacher, community </li></ul>*Mother –Father-Youth Community * Topography, rural-suburban * Community behavior *classes presentation, scenario-simulation, next plan * Rabies, pet- ownership responsibility, cadres & communication technique, dog registration program 1 2 3 4 5
  25. 25. Next Plan <ul><li>Continuing on-going program : Dog Fecundity Study (until Jan 2012), Dog Behavior Study (until Dec 2012), Dog Demography Study (until March 2012), Community Engagement (until August 2012) </li></ul><ul><li>Result presentation to government (provincial livestock services) – advocation & legitimation </li></ul><ul><li>Paper & Film Publication </li></ul>
  26. 26. Expected O utputs and O utcomes <ul><li>Report (of each study or activity to ILRI; project report to ILRI and Indonesian Gov) </li></ul><ul><li>Film publication </li></ul><ul><li>Paper publication </li></ul><ul><li>Behavior changes of our boundary partners ( presented on Outcome Mapping) </li></ul>
  27. 27. Perspectives <ul><li>Dog ecology information could be used in general for Indonesia, but should be adjusted in specific area if needed </li></ul><ul><li>Social cultural characteristics must be specified for each local area related with perception and community behavior on keeping dog </li></ul><ul><li>Community engagement on rabies control program with an ecohealth approach could be used as model for other area in Bali specifically, but must be adjusted in other area based on specific culture and behaviour of the community </li></ul><ul><li>Our project shows that zoonotic diseases could not be approached from one or two aspects alone; a holistic approach is needed to be effective and efficient </li></ul>
  28. 28. <ul><li>Terimakasih Thank You </li></ul>Thank You

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