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PubMed2004

The inception and development of basic animal health systems: examples of German development co-operation.

About thirty years ago the financial, logistic and manpower resources of veterinary and animal production services in the developing world were stretched to the limit. Epizootic disease control was their main and often only field activity, which left livestock owners to manage their daily production and health problems alone. To meet their requirements, Veterinary Services in these countries came under increasing public and political pressure to modify and adjust their approaches. This gave rise to a series of workshops in Africa (e.g. Bujumbura in Burundi and Blantyre in Malawi) and South-East Asia (e.g. Singapore, and Khon Kaen in Thailand), most of which were organised and facilitated by the German Agency for Technical Co-operation (GTZ) in close collaboration with French and British development co-operation agencies and universities. These workshops stimulated discussion with the key stakeholders and, thus, were most beneficial in supporting the process of developing alternative approaches. This paper reports in particular on the outcomes of the regional workshops held in Bujumbura, Burundi, in 1984, Blantyre, Malawi, in 1985, Bangui, Central African Republic, in 1988, Khon Kaen, Thailand, in 1989, Schmitten, Germany, in 1991, and Mzuzu, Malawi, in 1996 and 2000. For more than two decades, concepts of community-based livestock services in general, and primary animal health activities (PAHAs) in particular, have been developed and established in various developing countries. Over the years the PAHA concept has proved to be effective and has shown that livestock-keeping communities clearly benefit from such programmes. In presenting key features from some prominent and successful project examples (GTZ-supported projects in Thailand, Malawi and Somalia) it can be demonstrated that such approaches are not static but rather dynamic, requiring open minded innovative partners on both sides. Over the last few years, the delivery of PAHA has become the domain of non-governmental organisations. The propagation and application of this approach in various developing countries with limited veterinary infrastructure is supporting a privatisation process within the existing governmental veterinary structures, thus, allowing veterinary departments more freedom to focus on their core functions.

Animal Husbandry↗

PubMed2005

Animal welfare and developing countries: opportunities for trade in high-welfare products from developing countries.

Discussion on the potential for developing countries to develop trade in niche markets such as higher welfare standards has been highlighted with moves by the World Organisation for Animal Health (OIE) to set internationally agreed standards for animal welfare. This paper examines the existing and potential trade in value-added higher welfare products using case studies in the beef and poultry sectors from three countries in Africa, Asia and Latin America. It shows that at present there is only a small trade in these products but that this can have a major effect at a national level. In the beef export trade from Namibia, the existence of the only assurance scheme in Africa setting standards in hygiene, veterinary care and animal welfare has created a trusted, safe and healthy product and ensured that Namibia has grown into Africa's largest exporter of beef to the European Union. In Thailand, the broiler industry, which has enjoyed annual growth in the past 15 years, is developing value-added products to develop markets to counter competition from other countries. The development and implementation of standards for organic products in both Thailand and Argentina over the past decade have also resulted in growth in the export markets of these products. The paper concludes that there is growth potential for the sectors in all three markets which can be assisted by the development of OIE baseline standards.

Animal Welfare↗

PubMed1988

Transfer of regulatory toxicology from developed to developing countries.

Over the past two decades, industrialized nations have addressed and attempted to solve the problems of chemical risk through the development of laws, government and private organizations, and specialized manpower. Developing nations are now recognizing that the presence of toxicants in the environment, foods, consumer products, and the workplace can seriously affect human health, the ecology, international relations, and economic activities such as trade and tourism. The design and implementation of regulatory programs in developing countries is hampered by lack of government and public concern, pressure of more urgent needs, vested interests of industry, and lack of adequately trained professionals. These factors have allowed developed nations to sell abroad drugs, pesticides, and other chemicals considered too hazardous for use in their own countries. Conversely, products from developing nations must comply with rigorous standards for acceptance by developed nations. Some of these problems would be lessened by agreement on international chemical control guidelines. Multilateral availability of complete information about chemicals is essential. The coordination of this effort should be in the hands of international organizations and reinforced by bilateral agreements between countries. Appropriate public education and economic incentives at the national level would help in enforcing regulatory toxicology.

Developing Countries↗

PubMed1982

The relative contribution of prematurity and fetal growth retardation to low birth weight in developing and developed societies.

The relative proportions of prematurity (less than or equal to 2,500 gm less than 37 weeks' gestation) and intrauterine growth retardation-low birth weight (IUGR-LBW) (less than or equal to 2,500 gm, greater than or equal 37 weeks' gestation) among total LBW infants were studied in 11 regions in the developed world and 25 developing areas where known gestational ages and birth weights were reported. In developing countries a straight correlation was observed between total LBW incidence and IUGR-LBW incidence rates (r = 0.95; b = 0.98; p less than 0.001); in contrast, prematurity was not significantly associated with total LBW incidence. Data from the developed population showed results exactly opposite to those described for developing areas. Therefore, when the incidence of LBW is higher than 10%, it is almost exclusively due to the increase in IUGR-LBW infants, while prematurity remains almost unchanged (5% to 7%). When LBW incidence is less than 10% (mean=6%), preterm infants represent the major component of LBW. Environmental factors susceptible to changing socioeconomic conditions may be responsible for the observed differences.

Birth Weight↗

PubMed2007

Child development: risk factors for adverse outcomes in developing countries.

Poverty and associated health, nutrition, and social factors prevent at least 200 million children in developing countries from attaining their developmental potential. We review the evidence linking compromised development with modifiable biological and psychosocial risks encountered by children from birth to 5 years of age. We identify four key risk factors where the need for intervention is urgent: stunting, inadequate cognitive stimulation, iodine deficiency, and iron deficiency anaemia. The evidence is also sufficient to warrant interventions for malaria, intrauterine growth restriction, maternal depression, exposure to violence, and exposure to heavy metals. We discuss the research needed to clarify the effect of other potential risk factors on child development. The prevalence of the risk factors and their effect on development and human potential are substantial. Furthermore, risks often occur together or cumulatively, with concomitant increased adverse effects on the development of the world's poorest children.

Child Development↗

PubMed2000

Developmental care for promoting development and preventing morbidity in preterm infants.

BACKGROUND: Preterm infants experience a range of morbidity related to the immaturity of their organ systems and to concurrent disease states. An unfavourable environment in the neonatal intensive care unit (NICU) may compound this morbidity. Modification of the environment could minimize the iatrogenic effects. Developmental care is a broad category of interventions designed to minimize the stress of the NICU environment. These interventions may include one or more elements such as control of external stimuli (vestibular, auditory, visual, tactile), clustering of nursery care activities, and positioning or swaddling of the preterm infant. Individual strategies have also been combined to form programs, such as the 'Neonatal Individualized Developmental Care and Assessment Program' (NIDCAP) (Als 1986). OBJECTIVES: In preterm infants, do developmental care interventions reduce neurodevelopmental delay, poor weight gain, length of hospital stay, length of mechanical ventilation, physiological stress and other clinically relevant adverse outcomes? SEARCH STRATEGY: The Neonatal Review Group search strategy was utilized. Searches were made of Medline from 1966 to July, 2000, and of CINAHL, The Cochrane Library, and conference and symposia proceedings in the English language from 1990 to July, 2000. A list of all relevant articles was sent to two experts in the field to identify any omissions or additional unpublished studies. SELECTION CRITERIA: Randomized trials in which elements of developmental care are compared to routine nursery care for infants < 37 weeks gestation and that measured clinically relevant outcomes. Reports were in English or a language for which a translator was available. Computerized searches were conducted and all potentially relevant titles and abstracts were extracted. Retrieved articles were assessed for relevance independently by two reviewers, based on predetermined criteria. Articles that met all criteria for relevance were assessed for methodological quality based on predetermined criteria. Articles judged to have the appropriate quality by both reviewers were included in the analysis. DATA COLLECTION AND ANALYSIS: Data were extracted independently by the two authors. Meta-analyses were conducted for each intervention where the same outcome measures and/or instruments were used within comparable time points. MAIN RESULTS: This review detected 31 eligible randomized controlled trials involving four major groups of developmental care interventions, 19 sub-groups and multiple clinical outcomes. The results of the review indicate that developmental care interventions demonstrate some benefit to preterm infants with respect to: improved short-term growth outcomes, decreased respiratory support, decreased length and cost of hospital stay, and improved neurodevelopmental outcomes to 24 months corrected age. These findings were based on two or three small trials for each outcome, and did not involve meta-analyses of more than two trials for any one outcome. Although a number of other benefits were demonstrated, those results were from single studies with small sample sizes. The lack of blinding of the assessors was a significant methodological flaw in half of the studies. The cost of the interventions and personnel was not considered in any of the studies. REVIEWER'S CONCLUSIONS: Because of the inclusion of multiple interventions in most studies, the determination of the effect of any single intervention is difficult. Although there is evidence of some benefit of developmental care interventions overall, and no major harmful effects reported, there were a large number of outcomes for which no or conflicting effects were demonstrated. The single trials that did show a significant effect of an intervention on a major clinical outcome were based on small sample sizes, and the findings were often not supported in other small trials. Before a clear direction for practice can be supported, evidence demonstrating more consistent effects of developmental care interventions on important short- and long-term clinical outcomes is needed. The economic impact of the implementation and maintenance of developmental care practices should be considered by individual institutions.

Developmental Disabilities↗

PubMed1955