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Institutional dimensions of veterinary
services reforms: responses to structural
adjustment in Northern Ghana
abcd b c
Kwadwo Amankwah , Laurens Klerkx , Owuraku Sakyi-Dawson ,
e d b
Naaminong Karbo , Simon J. Oosting , Cees Leeuwis & Akke J. van der
d
Zijpp
a
Animal Health and Production College, PO Box TL 300, Tamale, Ghana
b
Knowledge, Technology and Innovation Group, Wageningen University, PO
Box 8130, 6700 EW Wageningen, The Netherlands
c
Department of Agricultural Extension, College of Agriculture and
Consumer Science, University of Ghana, PO Box LG 68, Legon, Ghana
d
Animal Production Systems Group, Wageningen University, PO Box 338,
6700 AH Wageningen, The Netherlands
e
Animal Research Institute, Council for Scientific and Industrial Research,
PO Box AH 20, Accra, Ghana
Published online: 29 Apr 2014.
To cite this article: Kwadwo Amankwah, Laurens Klerkx, Owuraku Sakyi-Dawson, Naaminong Karbo, Simon
J. Oosting, Cees Leeuwis & Akke J. van der Zijpp (2014): Institutional dimensions of veterinary services
reforms: responses to structural adjustment in Northern Ghana, International Journal of Agricultural
Sustainability, DOI: 10.1080/14735903.2014.909635
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International Journal of Agricultural Sustainability, 2014
http://dx.doi.org/10.1080/14735903.2014.909635
Institutional dimensions of veterinary services reforms: responses to
structural adjustment in Northern Ghana
∗
Kwadwo Amankwaha,b,c,d, , Laurens Klerkxb, Owuraku Sakyi-Dawsonc,
Naaminong Karboe, Simon J. Oostingd, Cees Leeuwisb and Akke J. van der Zijppd
a
Animal Health and Production College, PO Box TL 300, Tamale, Ghana; bKnowledge, Technology and
Innovation Group, Wageningen University, PO Box 8130, 6700 EW Wageningen, The Netherlands;
c
Department of Agricultural Extension, College of Agriculture and Consumer Science, University of
Downloaded by [Wageningen UR Library] at 05:43 30 April 2014
Ghana, PO Box LG 68, Legon, Ghana; dAnimal Production Systems Group, Wageningen University, PO
Box 338, 6700 AH Wageningen, The Netherlands; eAnimal Research Institute, Council for Scientific and
Industrial Research, PO Box AH 20, Accra, Ghana
This study examines the effect of the post-1980s’ structural adjustment reforms on the delivery
and smallholders’ use of veterinary services in two districts in Northern Ghana. Our analytical
framework distinguishes between allocative, cognitive, and normative institutions to analyse
the effects on four areas of service delivery: (1) prevention; (2) clinical services; (3)
provision of drugs, vaccines, and other products; and (4) human health protection. The
reforms were accompanied by substantial reductions in the allocation of both financial and
human resources to public veterinary services; this in turn induced fragmentation in service
supply, preferential service to progressive (or wealthy) farmers, and non-adherence to
international protocols for livestock health reporting. A few communities self-organized to
access veterinary services. Thus, the reforms triggered changes mostly in formal allocative
institutions, but these triggered further changes in informal allocative, cognitive, and
normative institutions that structured the impact of the reforms. The paper concludes that
institutional change is not a one-off outcome of an intervention. Rather, such interventions
trigger new dynamics that policy-makers and analysts need to take into account. This
requires regular monitoring of anticipated and unanticipated effects of privatization and
decentralization to enable policy adjustment.
Keywords: institutions; public goods; veterinary services; smallholder livestock keeping;
structural adjustment; Ghana
1. Introduction
Like other rural services such as extension, in recent years veterinary services in developing
countries have undergone major reforms including decentralization and privatization (Sen and
Chander 2003). These reforms of public agricultural services were the direct result of structural
adjustment policies (SAPs) promoted by the International Monetary Fund (IMF) and World Bank
over the past two decades (World Bank 2009). The SAPs were based on the argument that many
developing countries had failed to create incentive systems for the efficient delivery of goods and
services in the agricultural sector, and that market mechanisms would do a better job (Smith
2001). Hence, the SAPs sought to reduce the role of the public sector in the provision of
goods and services and enhance that of the private sector (Woodford 2004). As a result, services
were decentralized and/or privatized. Decentralization concerns the transfer of administrative
∗
Corresponding author. Email: kojo116@yahoo.com
# 2014 Taylor & Francis
2 K. Amankwah et al.
responsibility, fiscal resources, and political authority from central government agencies to sub-
national government entities, to non-governmental organizations, or to the private sector (Robin-
son 2007). Privatization is the transfer of power, resources, and functions from government to the
private sector, non-governmental organizations, and civil society (Rondinelli 1981). These
reforms have affected a broad spectrum of rural development strategies and activities, including
agricultural research, input supply, rural financial services, agricultural extension, veterinary
services, and water resources management (Smith 2001).
In the case of veterinary services, the reforms aimed to increase the role of private markets in
services delivery, lower public expenditures, improve the quality and coverage of the services
provided to livestock owners, and enhance effective control of animal diseases that endanger
human health (Smith 2001). In developing countries, the reforms resulted in the privatization
of selected tasks, decentralization of veterinary organizations, and a move towards confining
the state veterinary services to delivery of public goods services (Cheneau et al. 2004). Although
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previous studies report on both pros and cons of decentralization and privatization (e.g. Sen and
Chander 2003, Ahuja 2004, Leonard 2004, Woodford 2004), there are few in-depth studies of the
interactions among the diverse stakeholders and the transformations of formal and informal insti-
tutions that result from decentralization and privatization. Nonetheless, as some studies indicate
(Robinson 2007, Awortwi 2010), the outcomes of decentralization reforms are often mediated by
a number of institutional factors beyond the control of local officials, such as the prevailing pol-
itical context, power dynamics at local and national levels, and lack of financial resources. All too
often, the reforms were pursued without due attention to complementary changes in the broader
governance structures and socio-economic conditions. For Ghana also, there is little recent infor-
mation on how the diverse actors reacted to the reforms of the public veterinary services.
The present study aims to fill this gap by examining the effects of privatization and decentra-
lization on veterinary services delivery in Northern Ghana by assessing (1) the changes in delivery
of animal health services and (2) stakeholders’ responses to the reforms. To provide an analytical
lens for the study, the following section outlines dimensions of veterinary services reform to
understand the different elements that constitute veterinary services provision, and the kind of
institutions that influence the provision of, and are affected by, reforms. Section 3 describes
the case and the research methods. In Section 4, the findings are presented. The paper ends
with a discussion and conclusions.
2. Dimensions of reform of veterinary services
2.1. Types and nature of veterinary services
In this study, the term ‘service provision’ refers to the execution of a process intended to enhance
the productivity of resource use in on-farm operations. Examples include technological and
business advisory work, and regulations aimed at plant and animal disease control. Goods pro-
vision, on the other hand, refers to the provision of material goods, for example, fertilizer distri-
bution (Smith 2001). Smith (2001) distinguishes four main categories of veterinary services:
(i) preventive services (avoiding the outbreak of diseases);
(ii) clinical or curative services (treatment of diseased animals and control of production-
limiting disorders);
(iii) production and distribution of drugs, vaccines, and other products (such as artificial inse-
mination); and
(iv) human health protection (inspection of marketed animal products including live animals
in markets, during transportation, and on farms).
International Journal of Agricultural Sustainability 3
Prior to decentralization and privatization, in most sub-Saharan African countries veterinary
services were predominantly delivered by the public sector. Changes brought about by the
reforms include assigning the private sector the responsibility for delivery of services considered
to be private goods, such as clinical services (e.g. diagnosis and treatment) and production and
distribution of drugs and vaccines. On the other hand, the public sector retains responsibility
for human health protection services (i.e. meat inspection, quarantine, and quality control).
Several preventive services have spill-over effects. Hence, they are either delivered by the
public sector or funded collectively by the affected livestock owners (Smith 2001). However,
certain goods and services have mixed public and private characteristics. For example, vacci-
nation to control zoonotic diseases such as anthrax and rabies has a strong private service com-
ponent but has beneficial effects on human health. Consequently, public veterinary services often
take responsibility for control of these zoonoses. Thus, the reforms distinguish between public
and private goods to prescribe channels of veterinary services delivery (Umali et al. 1994).
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2.2. Results of reforms of veterinary services
A review of the literature reveals that the reforms of veterinary services delivery have yielded mixed
results. On the positive side, some studies indicate that the availability and use of veterinary drugs are
significantly higher in developing countries that have privatized services and drug supplies than in
countries maintaining government monopolies (Sen and Chander 2003). After reforms, tsetse-fly
control in Zimbabwe and Botswana and vaccination in Morocco have significantly improved, and
the corresponding cost has been considerably reduced (Holden 1999). A number of studies indicate
that poor people are willing to pay for clinical and preventive veterinary services (Ahuja 2004,
Leonard 2004). Reforms appear to have benefitted less-skilled veterinary service providers such as
para-veterinarians, technical assistants (TAs), and community animal health workers (CAHWs).
According to Woodford (2004), in subsistence and extensive livestock production systems, less-qua-
lified personnel adapted better to reforms in delivery of services than veterinarians. Such para-veter-
inarians acquire skills through practice, are often members of the same ethnic group as their clients,
reside in communities where livestock is found, have lower income aspirations, and can handle 80–
90% of the veterinary interventions in extensive livestock production systems.
On the negative side, Turkson and Brownie (1999) reported only limited evidence that priva-
tization has improved veterinary services delivery in developing countries. The SAPs were often
regarded as imposed by donors; policy-makers often saw them as a cause rather than a solution to
financial problems (Woodford 2004). Animal health policy-makers were technically oriented and
had limited change management skills. The deregulation and deployment of para-veterinarians
induced by the reforms were perceived as a threat by veterinarians. Furthermore, service delivery
by less-qualified staff was constrained by unresolved issues such as how to supervise and resupply
them and how to maintain effective two-way communication with supervisory veterinarians
(Ahuja 2004). Privatization also resulted in a high concentration of private veterinary practices
in urban centres, leaving rural areas uncovered (Woodford 2004). Moreover, in many developing
countries, in the absence of a formal system, unregulated informal animal health delivery systems
have evolved. Thus, in many sub-Saharan countries including Ghana, the SAP-induced reforms
have brought about a reduction in quantity and/or quality of veterinary services to poor commu-
nities (Turkson and Brownie 1999, Woodford 2004).
2.3. Understanding reforms through the lens of different institutional dimensions
In this study, we look at privatization and decentralization as a form of institutional change that
has allocative, cognitive, and normative dimensions (Scott 1995, Elzen et al. 2012). Institutions
4 K. Amankwah et al.
are informal and formal rules or norms actually used by a set of individuals to organize repetitive
activities that produce collective outcomes (Ostrom 1992). Allocative institutions deal with the
way scarce resources are distributed and/or exchanged (Weimer 2006) and relate, for example,
to payment through market arrangements, but also allocative mechanisms used by the state,
e.g. subsidies. Cognitive institutions refer to the common interpretive framework of meaning
(Scott 1995). In the context of this study, cognitive institutions relate to the way knowledge
and skills or expertise are (re)organized. For example, the transfer of technology model is a cog-
nitive view of research and development that many agricultural scientists have adopted and used
to plan and manage the innovation process (Douthwaite et al. 2001). Normative institutions com-
prise the values, norms, and roles which an actor experiences as social expectations, prescriptions,
or moral obligations. These include regulations, enforcement mechanisms, and adherence to stan-
dards (Scott 1995). The different institutions are connected to one another in defining practices,
standards, and policies (Pacheco et al. 2010).
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Using the categories of veterinary services outlined in Section 2.1, we describe stakeholder
responses to the decentralization and privatization dynamics for each category. Then, we
examine how the diverse responses are connected to the allocative, cognitive, and normative insti-
tutional dimensions.
3. Research setting and research methods
3.1. Choice of research setting
Multiple methods of qualitative and quantitative (Neuman 2000) design were employed to
examine the provision of veterinary services to smallholder crop – livestock farmers in the
Upper West Region (UWR) of Ghana. The region (and two districts within it) was selected as
the study area because it has the highest number of food-insecure households in Ghana (Quaye
2008) who are likely to suffer from a change in fully funded veterinary services from public to
partly private provision. The region is located in the north-western corner of Ghana stretching
from Longitude 98 35′ N to 118 N and Latitude 18 25′ to 28 50′ E.
Exploratory interviews with staff from the Ministry of Food and Agriculture (MoFA) in Lawra
and Nadowli in UWR resulted in the purposive selection in each district of two communities
noted for livestock production. Tables 1 and 2 provide the farming system characteristics of
the study communities.
All four communities belong to the same tribe, Dagaaba. The majority of households at Orbili
are Traditionalist (over 90%), at N. Tankyara the majority are Christian (over 90%), at Tangasie
the majority are Traditionalist (60%), and at Tabiasi the majority (60%) are Moslem. Of the
Table 1. Population, households, and percentage of households keeping livestock in the four study
communities.
Percentage of households keeping livestock (%)
a
Community Population (#) Household (#) Cattle Sheep Goats Pigs Chicken Guineafowls
Orbili 302 52 15.4 55.8 94.2 57.7 96.2 9.6
N. Tankyara 321 66 34.8 39.4 84.8 39.4 80.3 27.3
Tangasie 1186 131 6.1 24.4 71.0 97.0 81.7 24.4
Tabiasi 2773 171 70.8 47.4 77.2 11.7 77.8 28.7
a
Ghana Statistical Service (2010) population approximation.
Source: Fieldwork (2012).
International Journal of Agricultural Sustainability 5
Table 2. Average farm size (acres) of households in the four study communities.
Households (#) Mean Standard deviation
Orbili
Grain crops 51 5.9 2.79
Leguminous crops 51 3.2 1.18
N. Tankyara
Grain crops 66 4.8 2.40
Leguminous crops 55 1.1 0.77
Tangasie
Grain crops 97 5.7 4.16
Leguminous crops 93 4.9 3.72
Tabiasi
Grain crops 144 10.7 5.12
Leguminous crops 63 2.5 1.19
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Note: Grain crops: millet, sorghum, maize, and rice; leguminous crops: groundnuts and cowpeas.
Source: Field survey (2012).
household heads, 82% are illiterate. The main types of livestock kept are goats and sheep, cattle,
pigs, chickens, and guineafowls (see Table 1). Few households at Orbili and Tangasie own cattle,
largely due to theft. Over 60% of the households owned cattle about 20 years ago (ICRA and
NAES 1993). Tabiasi has deployed measures that have helped to minimize theft.
The ecological zone is mainly Guinea Savannah characterized by low vegetative growth of
grasses, shrubs, and sparsely distributed trees. Rainfall is unimodal and occurs from May to
October, with a dry season the rest of the year. The dominant farming system is crop – livestock
mixed farming. The crops grown are cereals (millet, sorghum, and maize) and legumes (ground-
nuts and cowpeas) (see Table 2). Table 2 shows that N. Tankyara and Tabiasi have the smallest
and largest farm sizes, respectively. The farm sizes reflect the availability of arable land. Apart
from Tabiasi, the communities cultivate both compound and bush farms. Compound farming is
the cultivation of the plot around the homestead. Bush farms are further away from residences
(0.5 kilometre or more). Compound farming compels the farmers to tether animals to prevent
grazing on cropped fields during the farming season from May to October. Tethering restricts
animal movement and feeding, with consequent increases in diseases and mortalities. Tabiasi
has adequate arable land; thus, farmers there have only bush farms and hence do not tether
animals. In the dry season, animals are free range, roam freely, and are exposed to theft and pre-
dators such as dogs. Communal grazing land is the principal resource for livestock feeding.
The characteristics of the other key stakeholders, MoFA staff, are shown in Table 3. TAs and
technical officers (TOs) are less-skilled technicians who work directly with smallholder farmers.
The other staff members play supervisory or advisory roles.
3.2. Data collection and analysis
To obtain an overview of the study area, a quantitative survey was conducted in January 2012
to characterize the farming systems. Focus group discussions were held in the first half of 2012
in each of the four communities about their experience of veterinary services delivery before
and after decentralization and privatization. In the second half of 2012, in-depth interviews
in the local language (through an interpreter) were conducted with five elderly farmers per com-
munity on their personal experiences of the reforms. In both the focus group discussions and
the in-depth interviews, farmers compared the period before and after the reforms. The topics
discussed included who the veterinary TOs were, types of veterinary services accessed by
6 K. Amankwah et al.
Table 3. Characteristics of key MoFA staff with an active role in the veterinary services reforms.
Staff category Qualification or training Main role
TA Six weeks training Assists TO in providing services to clients/
farmers
TO Three-year certificate Veterinary services to clients/farmers
DVO Veterinary medicine Supervises veterinary TO at district level
degree
District Director BSc or higher degree Head of district
Deputy Director and Director of BSc or higher degree Policy advisors at VSD and MoFA
VSD headquarters
farmers, requests made to the TOs and responses received, charges, vaccination regimes, and
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mortality rates. In-depth interviews were also conducted with traders, Fulani herdsmen, and
licensed and unlicensed veterinary drugstore operators identified through snowball sampling
on their viewpoints on changes in the veterinary services they employ and/or deliver. MoFA
staff from national headquarters, regional, and district level were interviewed about their experi-
ences of the changes before and after the reforms. Documents about MoFA’s decentralization
and privatization (Humado 2003, Amezah 2007) were reviewed. Direct observations were
also used to collect data. For example, we spent about 10 hours observing customers purchas-
ing veterinary drugs from four licensed stores and two hours at one unlicensed store watching
customers. We interviewed 10 livestock traders and tracked eight of them from Babile Market
(the biggest livestock market in Lawra District) to the two main southern Ghana markets
(Kumasi and Accra). For an overview of the research methods and numbers of actors inter-
viewed, see Table 4.
Qualitative data (from field notes and transcripts) were analysed using Atlas.ti version 5. The
data were coded using the questions: ‘What is the actor doing or saying in this data segment?’
‘What salient factors affect the actor’s actions and what are the consequences?’ Guided by
these analytical questions, concepts were identified and short notes or memos written for each
concept. Patterns in terms of recurrent and concurrent concepts were identified, and narrative
summaries were composed from the memos (Neuman 2000). The quantitative survey data
were summarized using descriptive statistics.
Table 4. Overview of research methods and sample categories in the study.
Research method Study sample unit Total respondents
Survey HH heads in four villages 355
Focus group discussion Groups of 12 members in three villages 36
In-depth interviews Farmers in four villages 20
TOs 12
Deputy Directors (VSD Headquarters) 4
Deputy Directors (MoFA Headquarters) 2
Senior Staff MoFA (UWR) 7
Traders 10
Fulani herdsmen 3
CAHW 2
Licensed veterinary store operators 4
Unlicensed veterinary store operators 2
Total 457
International Journal of Agricultural Sustainability 7
4. Findings
The findings are organized into three sections: first, we give an overview of the evolution of the
reforms, followed by crosscutting changes introduced by the reforms. Then, we present salient
changes in the four types of veterinary service (preventive, clinical, drug provision, and human
health protection).
4.1. Overview of the evolution of the reform
There have been over five decades of reforms, and Table 5 traces the evolution of the agricul-
tural reforms within the context of national policies and programmes. As Table 5 shows, the
Provisional National Defence Council (PNDC) Government took over a country saddled with
economic crisis and consequently had few options. They turned to the World Bank and the
IMF and subscribed to their policy conditions in 1983 (Toye 1992). However, before SAP
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adoption, the PNDC already made it explicit that its basic policy position in 1982 was ‘to
promote participatory democracy through a decentralized government system’ (Ahwoi 2010,
p. 1). The architects of local government decentralization in Ghana posited that this involved
‘the transfer of functions and powers, skills and competence and means and resources from
Central Government to local government authorities’ (Ahwoi 2010, p. 7). They employed
Table 5. Reforms in Ghana: chronology of events from 1960 to 2012.
Year Event
1960 –1966 Centralized governance system adopted during the first republic. The state pursued
extensive investment in infrastructure and large-scale industries which proved
unprofitable
1970 –1980 Ghana transformed itself from a middle-income country into a low-income country on the
brink of bankruptcy
1981 –1982 New government (PNDC) declared commitment to decentralization in stated policy
position: to promote participatory democracy by introducing a ‘truly decentralized
government system’
1983 Adoption of structural adjustment programmes (SAP) consequent to collapse of the
economy and few options available to the PNDC
1987 –1995 Privatization of veterinary services
1987 –1997 Unified Extension System implemented nationwide
1988 Local Government Law, PNDCL 207promulgated: District assemblies established as basic
local government units
1989 –1993 PAMSCAD to mitigate hardships suffered by poor people as a result of SAP
1993 Local Government Act 462 and Civil Service Law PNDCL 327 promulgated to back
establishment of decentralized departments of district assembly including MoFA,
Ministry of Health, and Ministry of Education and Ghana Education Service
1996 –2000 Ghana Vision 2020 to guide Ghana into becoming a middle-income country by 2020
1997 Decentralization of agricultural services and Unified Extension System
2003 New government (NPP) promulgated Local Government Service Act 656: Department of
Agriculture and others retained as departments of the district assemblies; Ministry of
Health, and Ministry of Education and Ghana Education Service excluded and placed
under Central Government
2003 –2005 Ghana Poverty Reduction Strategy (GPRS I) to accelerate growth and reduce poverty
2007 –2009 Growth and Poverty Reduction Strategy (GPRS II) to consolidate gains in GPRSI and to
reduce further poverty
2012 Fiscal decentralization of district assembly scheduled to begin but not effected by
September 2012
Source: Toye (1992), Ahwoi (2010), Field interviews (2012).
8 K. Amankwah et al.
decentralization as a process with political, administrative, and fiscal elements. The political
aspect involved the establishment of district assemblies or local government structures; the
administrative component related to the establishment of decentralized departments such as
MoFA and the Ministry of Health as part of district assemblies; and the fiscal aspect entailed
an arrangement to transfer resources to district assemblies to enable them to perform to expec-
tations (Ahwoi 2010, Awortwi 2010).
Thus, the government’s main objective for decentralization of MoFA was to accommodate the
ministry as one of the departments under the district assembly (i.e. local government service).
MoFA’s reforms entailed merging 11 parallel departments under one administrative head, i.e.
the district or regional director (Humado 2003). Table 5 also shows that the MoFA reforms are
one of a number of interventions induced by the SAP and other programmes. It is striking that
the SAP interventions apparently worsened the plight of poor people in society, as indicated
by interventions such as the Programme of Actions to Mitigate the Social Costs of Adjustments
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and Development (PAMSCAD, a US$90 million donor-supported intervention) that sought to
lessen hardships experienced by the poor and vulnerable groups consequent to the SAP
(Ahwoi 2010). The foregoing forms the backdrop to the decentralization and privatization of
veterinary services in Ghana. This study focuses on how the various actors responded to the
MoFA reforms.
4.2. Crosscutting changes introduced by the reforms
The reforms set in motion a number of fundamental changes in the allocation of public expendi-
tures, supply of technical personnel, participation of private practitioners in service delivery,
control of resources for veterinary activities, and demand for veterinary services. The changes
simultaneously aimed to scale down public-sector involvement and increase private-sector par-
ticipation. These changes are described below.
4.2.1. Dwindling public funding for veterinary services
The reforms of the public veterinary service were driven by the financial crisis in the early
1980s (Turkson and Brownie 1999). For instance, the proportion of the national
budget allocated to the Veterinary Services Department/Directorate (VSD) (nationwide)
declined steadily from 0.4% in 1990 to 0.1% in 1994, followed by a rise in 1995 (Turkson
and Brownie 1999, p. 35). In the past five years, a similar decline has been recorded for
VSD (i.e. headquarters; figures for nationwide not available): from 0.08% in 2007 to 0.02%
in 2011 (MoFA 2007 – 2011). In the post-reform period, the government did not invest in con-
struction, equipment, and vehicles but continued to pay salaries. For example, between 1990
and 1995, public expenditure for investment and staff salaries in veterinary services fell by
20.5% and 3.6%, respectively (Turkson and Brownie 1999). Between 1995 and 1997, the
investment expenditure fell to zero. The data available from 2008 to 2011 also show that invest-
ment was zero (VSD 2009 – 2011).
In addition to the reduction in funding, the number of public veterinary technical staff (veter-
inarians and technicians) has decreased in relation to the livestock population since the reforms
(Table 6). The staff reduction was achieved by ending the automatic employment of graduates
from agricultural colleges and universities, and by retrenching veterinary TAs. The reduction
in staff was prompted by implementation of SAP and economic recovery programme in Ghana
from 1983 onwards (Turkson and Brownie 1999). The staff reduction has a knock-on effect on
the availability of TOs for veterinary services delivery in rural communities
International Journal of Agricultural Sustainability 9
Table 6. National trends in public veterinary service performance.
Period Employed veterinary technical staff TLUa to veterinary technical staff ratio
Pre-reform (1990– 1995) 1009 1245.3
Early reform (1996–2000) 786 1819.6b
Post-reform (2001–2010) 755 2242.7b
a
TLU (Tropical Livestock Unit): cattle ¼ 0.70; sheep/goats ¼ 0.10 (Otte and Chilonda 2002).
b
TLU values from 1997 were based on projections.
Source: Staff list, VSD (2012), ISSER (2000, 2011).
4.2.2. Private practice offered by veterinarians and CAHWs
In the mid-1990s, the government encouraged and supported veterinary professionals to enter
private practice. In 1997, there were two private veterinarians in Ghana (Staff list, VSD,
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2012); in 2011, there were 18 (Diop et al. 2012). According to a VSD deputy director, private
veterinarians were only able to establish in major cities such as Accra and Kumasi where they
focused on pets (e.g. cats, dogs).
The government also promoted a CAHWs’ scheme. CAHWs were selected by communities,
trained in basic animal healthcare, and provided with starter kits by VSD. Between 1995 and
2000, 1007 CAHWs were trained nationwide (VSD records, Accra, 2012). They charged
nominal fees for their work in their respective communities and were supervised by the TO
and the district veterinary officer (DVO). The CAHW licences were renewed annually by
VSD. The consensus among the veterinary personnel whom we interviewed was that the
scheme worked for a few years and then broke down. Only one of our four study communities
(Tabiasi) had an active CAHW. He told us that only few farmers consulted him because the
majority had learnt to treat their animals themselves. Farmers in a second community (N. Tan-
kyara) said that they had previously made use of their CAHW but that this person had stopped
providing services.
Another important factor that contributed to the collapse of the CAHW scheme was that, over
time, the scheme lost the support of both veterinarians and para-veterinarians. A deputy director at
VSD headquarters and a DVO (TO by rank) in the study area explained that the CAHWs were
restricted to providing basic animal healthcare treatment but that many went beyond that and pro-
vided injections and even engaged in surgery. According to the deputy director,
We [VSD] trained CAHWs to treat wounds, de-tick, and arrange meetings. They were not supposed to
inject or do surgery. When they did inject, other farmers saw it and copied them. Thus, we brought
self-medication by farmers upon ourselves.
The VSD officers implied that they had begun to perceive CAHWs as competitors, and
cooperation with them waned. However, in two communities in this study with records of
CAHWs activities, the CAHWs did not perceive themselves as competing with the veterinary
TOs. For example, at Tabiasi, the CAHW said that he always referred cases beyond his compe-
tence, e.g. vaccinations, post-mortems, to the TO, but that he had not been backstopped by the
(new) TO since 2007. He concluded that TOs are not supervised and monitored so they do not
deliver the services expected of them. Similarly, at Tankyara, the CAHW said the main reason
he stopped practicing was that the TO with whom he used to work was transferred and the
new TO discontinued the working relationship. Apparently, VSD staff may have undermined
the scheme by withdrawing support even in instances where the CAHWs operated within their
prescribed limits.
10 K. Amankwah et al.
4.2.3. Control of resources for veterinary activities at district and regional levels
One of the main changes that decentralization imposed on public veterinary services was a new
organizational structure. Before the reform, a direct chain of command linked the VSD director
and field staff through the regional veterinary officer (RVO), as shown in Figure 1(a). After the
reforms, communication was channelled through the District Director, Regional Director, and
the Chief Director and copied to the RVO and the Director of VSD along the way
(see Figure 1(b)).
MoFA’s new organizational structure meant that the District Director became the cost
centre manager with discretionary control over the quarterly budget allocation for district veter-
inary activities. Among the veterinary and other MoFA staff whom we interviewed, the con-
sensus was that giving control over public veterinary services to the MoFA District Director is
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Figure 1a. (a) Before decentralisation: line of communication in VSD.
Notes: TA, technical assistant; TO, technical officer; VSD, Veterinary Services Department; MoFA, Ministry
of Food and Agriculture
International Journal of Agricultural Sustainability 11
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Figure 1b. (b) After decentralisation: line of communication in MoFA.
Notes: TO, technical officer; AEA, agricultural extension agent; VET, veterinary; MIS, Management Infor-
mation System; PPRS, plant protection and regulatory services; EXT, extension; ENG, engineering; WIAD,
women in agricultural development; PPMED, Policy, Planning, Monitoring and Evaluation Directorate;
APD, Animal Production Directorate.
the most significant constraint inhibiting animal health services delivery in the post-reform
period, as illustrated by the viewpoint of a non-veterinarian. A Regional Director who had
been District Extension Officer and District Director before and after decentralization explained
that
there are issues [in veterinary services] that require use of money. Because its money is subsumed
under DADU and RADU [district and regional agriculture development unit, respectively], the direc-
tor can take the money allocated to veterinary work and use it, and by so doing deny veterinary
services their share at the time they might request money.
12 K. Amankwah et al.
This connects to findings by Humado (2003) who reported that many District Directors used
funds meant for veterinary service activities for other purposes, thus reflecting incomplete decen-
tralization in that the District Directors were accountable neither to their former headquarter
bosses in Accra nor to the District Assembly because a local government service had not been
established.
4.2.4. Shifting demand for veterinary services
The broader social context affected veterinary services delivery over the course of the reforms.
For example, demand for public veterinary services shifted from cattle farmers to owners of
both small ruminants and cattle because of incessant cattle theft. Twenty years ago, over 80%
and 60% of households owned small ruminants and cattle, respectively, in UWR (ICRA and
NAES 1993). Excluding Tabiasi, 79.5% and 15.7% of households kept goats and cattle, respect-
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ively, in three communities in 2012 (extrapolated from the data in Table 1). This is reflected in the
change in demand for veterinary services by households keeping small ruminants and cattle in the
communities (Table 7).
In two (Tabiasi and N. Tankyara) of our four study communities, we observed an increase in
the demand for, and use of, public veterinary services. Two inter-related factors contributed to
this: first, in these two communities, groups of farmers self-organized to create access to veterin-
ary services. For example, in Tabiasi, respondents told us that, during the past five years, the
incumbent veterinary TO was almost always absent from the community. In response, the
farmers organized themselves into groups to use the services of the previous veterinary TO
who had been transferred to another district, about 80 kilometres away. The farmers explained
that they willingly pay a higher price for this TO’s services because he is very effective.
The Tabiasi TO (from 1997 to 2007) explained his approach as follows:
My main goal is to satisfy the farmer. If he is satisfied, tomorrow he will look for you. You see the only
thing is to make sure you do effective work for them to see. If they have confidence in you, they are
prepared to pay.
Another TO (retired in 2004) was also convinced that farmers would pay for satisfactory veter-
inary services. Farmers in Kumalsa (Lawra District) remembered that his services helped to
reduce livestock mortality in their community.
In the two other communities, Orbili and Tangasie, most farmers said they only used clinical
services when they observed illness in their flocks, and this information from focus group discus-
sions was confirmed by the respective TOs. This is consistent with an earlier study (Amankwah
et al. 2012) that found that most farmers keep livestock for purposes of security in bad times, for
sale during food shortage, but not as a business for profit. Hence, they limit costs and accept
Table 7. Number of smallholder households with livestock in each of the four study communities and
percentage using public veterinary services.
Number of households with ruminant % of households with livestock using
Community livestock services
Tangasie 100 9.0
Tabiasi 148 61.5
Orbili 51 9.8
N. Tankyara 56 74.4
Source: Field interviews (2012).
International Journal of Agricultural Sustainability 13
disease and mortality (Amankwah et al. 2012). However, 9 out of 12 TOs interviewed believed
that most smallholders are what Rogers (2003) called ‘laggards’ who are reluctant to change their
animal health practices. Apparently, the TOs do not understand the principle of risk avoidance that
characterizes the smallholder farming system (Animal Research Institute 1999).
In summary, we can conclude that the allocation of financial and human resources for the
delivery of public veterinary services was considerably reduced. In addition, theft reduced the
demand for veterinary services for cattle. The reduced resource allocation affected the quality
of service delivery. The government’s reaction boiled down to ‘let’s wait and see what
happens’ or ‘let’s see how people cope’. The next section examines ‘what happens’ in the delivery
of the four categories of veterinary services.
4.3. Changes in each of the four veterinary service categories
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Table 8 summarizes the salient changes that occurred at national and community levels in the four
categories of veterinary service consequent to the reforms and actors’ responses within the frame-
work of the identified institutional dimensions. A description and example of each service follows.
4.3.1. Preventive vaccinations: shift in procurement from public to private sector and
cessation of mass vaccinations by organized teams of technicians
Preventive vaccinations were the main focus of veterinary interventions in the pre-reform period.
The reforms changed two important aspects of preventive vaccination. The first change relates to
procurement of vaccines (for diseases such as Peste Des Petits Ruminants [PPR], anthrax, and
Newcastle disease in poultry). Respondents from VSD headquarters reported that, prior to the
reforms, VSD imported vaccines without having to go through lengthy procurement procedures.
However, for the greater part of the post-reform period it has become impossible to access gov-
ernment funds in time to procure vaccines. Consequently, VSD has made alternative arrange-
ments with private traders to import them. However, because of frequent changes in VSD
directors (retirement almost every two to four years) and because of the unofficial nature of the
arrangements, vaccine procurement at national level has fallen short. For instance, according to
officials at the Central Laboratory at Pong Tamale (the unit responsible for distribution and
sale of vaccines in Northern Ghana) and the TOs in the study area, from June 2011 to August
2012, in the whole of Ghana no routine PPR vaccinations took place.
The second important change in preventive vaccination relates to the organizational arrange-
ments for the delivery of vaccination services. During the pre-reform period, annual mass vacci-
nations of livestock were administered by teams of veterinary technicians. In the post-reform
period, vaccinations have been provided on an ad-hoc basis or in selected communities by indi-
vidual TOs. Vaccination teams are now only mobilized when serious disease outbreaks occur in
the districts and emergency disease control is required.
TOs at community level have responded in diverse ways to the changes in procurement and
organization of vaccination services. Six out of nine veterinary TOs in the study area only deliver
vaccination services to progressive (rich) farmers or to a few communities that are ready to pay for
animal healthcare interventions. Three out of nine TOs do not provide vaccinations at all. Inter-
views with farmers suggested that two of these three were absent from their post most of the time,
using office hours to engage in personal affairs. The third TO explained that he does not undertake
late vaccinations because the animals may be sick already and vaccination might contribute to
livestock mortality. The changes are reflected in livestock mortalities in the communities. For
example, Orbili, N. Tankyara, and Tangasie ranked high livestock mortality rates as a priority con-
straint, next to water shortage in the dry season. Mortality rates in 2010 were 63% among kids
14 K. Amankwah et al.
Table 8. Changes in categories of veterinary services and typology of institutional responses.
Category of
veterinary
service Allocative institutions Cognitive institutions Normative institutions
Preventive In the post-reform period, Recurrent shortages in vaccine Public Procurement Act 663
vaccinations VSD arranged with supply at national level of 2003 made it
private traders to import Team of TOs for mass cumbersome for VSD to
vaccines vaccination disbanded; secure funds in time to
Reduction in public funding Individual TOs deliver import vaccines
services in limited number
of villages
Clinical A service charge introduced, CAHWs trained in basic Annual renewal of CAHWs’
services requiring clients to pay for animal health care by VSD licence by VSD initially
services Many Fulani herdsmen and made the scheme effective,
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Private practice of farmers have learnt by trial- but later the arrangement
veterinarians and and-error to practice self- broke down
community livestock medication Quality standards not upheld:
workers (CAHWs) TOs complain about lack of in- public personnel engage in
introduced service training in the post- private practice (Diop et al.
reform period 2012), treat animals, and
under-report
Drug supply Privatization of drug Only 30% of drugstore Nebulous regulation of
distribution and sale operators have veterinary veterinary drug supply and
shifted responsibility from training (Gyabaah-Yeboah stores by Food and Drugs
the public to the private 2005) Board
sector Drugstore operators educate Only 44% of veterinary drugs
Increase in number of Fulani customers that drug on Ghanaian market
herdsmen and farmers administration is based on registered with Food and
who purchase veterinary body weight Drugs Board (Gyabaah-
drugs from stores (for self- Yeboah 2005)
medication)
Public health District Director designated Many technical staff have left Decentralization and Unified
sole spending officer at VSD; inadequate staff for Extension System
district level disease surveillance, meat introduced
Reduction in public funding inspection at many urban Livestock census and cattle
slaughter slabs, and branding ceased
monitoring movement of Non-adherence to
animals international OIE protocols
The general public is often and standards
sensitized in the media to The Veterinary Surgeons Bill
avoid meat from unhygienic of 2010 that seeks to grant
abattoirs (Mensah 2013) authority for meat
inspection to VSD prepared
but not passed
(under one year); 59% among lambs (under one year); 47% among goats (over one year); and
12% among sheep (over one year) (Amankwah et al. 2012).
4.3.2. Clinical services at district level and cost of farm-gate clinical services
Two changes in clinical services recurred in the interviews with most of the veterinary personnel:
the cost of farm-gate clinical services and the treatment of ill animals by farmers themselves.
Before the reforms, the allowances for fuel and maintenance allowed the TOs to use their
International Journal of Agricultural Sustainability 15
motorbikes to attend to reported ill animals and conduct disease surveillance. Veterinary drugs
were issued to the TOs from the district office store, and at the end of the month returns were sub-
mitted to the office. However, after the reforms, the allowances were often delayed and a quarter
(three months) or more might pass before allowances were paid.
Many TOs report that they have to buy drugs directly from the market rather than through the
DVO, who often marks up the price. In addition to the mandated service charge for attending to ill
animals, many TOs charge farmers for fuel because they do not receive the transport allowance in
time. A VSD Deputy Director observed that, because of hardships, many TOs under-reported the
services they provided in order to avoid payment of service charges. For example, since 2009,
farm visits and house calls attract a service charge of 2 Gh¢ and 3Gh¢ per treatment of a
sheep/goat and cattle, respectively (Fees and Charges Act 793, 2009). A TO said that in 2011
his ‘monthly service charge sometimes was 3Gh¢ or 5Gh¢’. He reasoned that it was not worth-
while to use his own funds to buy drugs and then pay service charges to the government. This is
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typical of TOs who paid service charges.
In response to the reduced number of veterinary staff, the increased cost of accessing public
service, coupled to the increased importance of livestock as ‘savings’ for meeting needs and emer-
gencies in households, many smallholders have taken up self-medication. ‘Self-medication is a
practice whereby clients purchase drugs and vaccines and administer these to their animals
without consulting veterinary staff’ (Turkson 2008, p. 19). Cattle-owning farmers especially indi-
cated that self-medication has risen after the reforms, as indicated at a focus group meeting at
Tabiasi. As one of them indicated:
At first, people didn’t realise the importance of animals, but today everything you do involves money.
Examples are health insurance, school fees, fertiliser, and naming ceremony, to mention just a few.
More to the point, there isn’t any vet. So if you do not treat your own, [whiles] the means are numer-
ous, a time will come when you will be at risk [no cattle to fall back on for cash]. So this is the major
reason why farmers are forced to learn about some of these issues.
The most common form of self-medication is treatment of wounds and skin diseases, using either
herbs or orthodox products such as iodine solutions and insecticides. The second is prophylaxis and
curative treatments using herbal preparations, notably a common salt solution with dawadawa (a
fermented condiment prepared with beans of a tree legume, Parkiabiglobasa) that animals can
drink. Third, farmers inject ill animals using antibiotics such as oxytectracycline and procaine peni-
cillin. The fourth type is top-up treatment when the TO has failed to cure an ill animal. Most small-
holders cannot afford a follow-up visit by the TO so they monitor their animals and provide the
needed follow-up treatment themselves. The top-up treatment often involves both herbal prep-
arations and orthodox products. The first and second types of self-medication were common in
all four communities studied. The third and fourth types were observed mostly in Tabiasi.
4.3.3. Drug supply: privatization of veterinary drug sale and lax quality controls
The main change in drug supply relates to the privatization of veterinary drug distribution and sale
that began in the mid-1990s. Prior to this privatization, VSD procured and distributed all veter-
inary drugs in Ghana mainly through its field staff. After privatization, VSD withdrew from mar-
keting veterinary drugs and chemicals (excluding vaccines), and private individuals or companies
took over these functions.
An outcome of privatization is that licensed shops now sell veterinary drugs in the country’s
major cities and towns. Increasingly, however, unlicensed itinerant traders sell veterinary drugs in
towns and rural communities with little or no quality control. For instance, in Tabiasi, Fulani
16 K. Amankwah et al.
herdsmen are the main source of veterinary drugs. In an interview, the chief Fulani herdsman in
that village indicated that he buys drugs from stores in the regional capital, Wa. Two other Fulani
herdsmen said that the cattle owners often do not make provision for veterinary treatment but hold
them responsible in the event of mortality. Hence, they are compelled to treat the animals using
both conventional and herbal preparations in cases of ill-health so as to prevent mortality and keep
their herding job. Interviews with four of the six licensed veterinary store operators in Wa revealed
that traders who cross the border from Burkina Faso are other important sources of veterinary
drugs for the Fulani and farmers. One of the operators concluded that Fulani herdsmen have
taken over the job of veterinary officers. In Nandom, which is close to N. Tankyara, veterinary
drugs are sold in unlicensed table-top shops on weekly market days. Two Deputy Directors of
VSD said that, by law, the Food and Drugs Board has responsibility for the sale of drugs on
the open market and there is not much VSD can do about it.
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4.3.4. Public health service: non-adherence to international protocols
The most important change with respect to public health services relates to difficulty about col-
lecting data on livestock diseases, stock movements, and animal numbers. The reforms have
affected VSD’s reporting on disease surveillance to the World Organisation for Animal Health
(OIE), the FAO, the International Bureau of Animal Resources, and the International Livestock
Research Institute (Humado 2003). A gap analysis of public veterinary services in Ghana con-
ducted by OIE consultants (Diop et al. 2012) blamed the new MoFA structure introduced by
the reforms (see Figure 1(a) and 1(b)).
According to Humado (2003), the new structure placed emphasis on extension services deliv-
ery and led to a reduction in the capacity of veterinary staff to deliver services because of lack of
staff. Furthermore, budget allocation shortfalls resulted when district directors committed a dis-
proportionate percentage of funds to their area of specialization and administrative expenses
(especially vehicle repair and fuel), to the disadvantage of technical services such as veterinary
services delivery.
Additionally, a number of public services have ceased, including the annual national livestock
census and the branding of cattle before issuing movement permits to traders to enable them to
transport animals across district boundaries. Meat inspection has also been affected by the
changes. For example, visits to the central abattoirs in Accra and Kumasi during this study
showed that they have qualified veterinary officers to conduct meat inspection. However, visits
to two slaughter slabs attached to small ruminant markets in Kumasi and another in Accra
showed that they did not have veterinary officers for meat inspection. A VSD official stationed
at one of the central markets in Accra lamented over the growing number of slaughter slabs in
the city where the department cannot conduct meat inspection because of the lack of manpower.
In summary, the reforms gave the public and private sectors shared responsibility for deliver-
ing veterinary services. One of the four service categories, drugs distribution and sale, was shifted
entirely to the private sector. For the other three categories (prevention, clinical, and human health
protection), the public sector retained responsibility for production and distribution, but funding
was shifted to the private sector. However, the public sector had to improvise in order to continue
to provide these services. The gaps have been persistently renegotiated and filled by activities of
various actors in response to dynamics in the institutional elements (Gyabaah-Yeboah 2005).
5. Discussion
A number of theoretical and policy implications can be derived from our study. In line with the
analytical lens set out in Section 2.3, we raise two main issues: (1) allocative institutions and
International Journal of Agricultural Sustainability 17
coverage of veterinary services and (2) the interconnectedness of the three institutional dimen-
sions (allocative, cognitive, and normative) in veterinary services reforms.
5.1. Allocative institutions and coverage of veterinary services
Our findings indicate that changes in the allocation of resources were the major contributor to
the reduction in coverage and delivery of veterinary services. Allocative institutional issues
come to the fore in two significant changes: a substantial reduction in the allocation of finan-
cial and human resources to public veterinary services, and placing VSD under a non-veter-
inarian director at district level. The response of the public sector included unequal service
delivery in communities, focus on progressive (rich) farmers, farmers’ increased transaction
cost in accessing services, and cheating by public veterinarians and para-veterinarians
through private practice and under-reporting. Consequently, the quality of service declined,
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and non-adherence to international protocols for reporting livestock diseases prevailed. In
the private sector, many farmers and Fulani herdsmen purchased and administered veterinary
drugs that had not been subject to quality control. Only a few communities self-organized to
access veterinary services; this indicates farmers’ limited willingness to pay for effective veter-
inary services.
We call attention to the fact that the process of shifting responsibility from the public to the
private sector was not regulated. Consequently, the reforms resulted in unintended negative
responses from both public- and private-sector actors. Our findings reinforce earlier critical
studies of veterinary services reforms in Ghana (Turkson and Brownie 1999, Turkson 2008)
and Cameroon (Gros 1994) as well as in several other developing countries (Woodford 2004).
These studies also show that governments substantially reduced public expenditure on veterinary
services and passively engaged in the reform process. The public sector proved unable to respond
to the emergence of an informal animal health delivery system characterized by the prevalence of
self-medication and the absence of quality control.
5.2. The interconnectedness of the institutional elements in veterinary services reforms
Our findings also show that the responses of the diverse actors to the reforms can be structured
according to three dimensions of institutions (allocative, cognitive, and normative) that are
inter-linked or explain further changes. For example, reductions in public funding and staff
numbers led veterinary TOs to mark up the price of service provision (i.e. changes in allocative
institutions induced further change). The breakdown of public-sector controls (change in norma-
tive institution) led to easy access to veterinary drugs on the open market. Such changes within the
veterinary services domain, in turn, interacted with other institutional elements and forces outside
the reforms. For example, farmers’ increased dependence on livestock to meet livelihood needs
led many farmers to appropriate knowledge and skills for self-treatment (i.e. change in cognitive
institutions). This widespread self-medication cannot be captured in public-sector reports; this
contributes to non-observance of the international protocol for reporting livestock diseases (a nor-
mative issue). The institutional analysis of the responses to the reforms indicates the need to con-
sider emergent cognitive and normative institutional changes that are triggered by changes in
allocative institutions. As discussed, the reforms introduced changes primarily in formal alloca-
tive institutions. The analysis of the responses to these changes shows that they are not a one-off
outcome of the reforms. Instead, they interact with a whole set of other institutional changes at
national, district, and community levels. This suggests that policy-makers who implement
change in one institutional dimension can expect the emergence of a new institutional setup
that involves other institutional dimensions.
18 K. Amankwah et al.
Our findings reflect those of a number of studies – not only in veterinary services provision
but also in other disciplines – showing that institutional elements interact in unforeseen ways,
with unintended consequences for the outcomes of reforms (Gros 1994, Harrington et al.
2001, Munyua and Wabacha 2003). For example, integrated natural resources management
research shows that there are inter-linkages among policies and institutions, farm-level practices,
plant and animal growth, biophysical processes, and impacts and outcomes, with consequences
for food security, poverty alleviation, and environmental protection (Harrington et al. 2001).
Our study shows that changes in allocative institutions are inter-linked with changes in cognitive
and normative (including regulative) institutions. These changes prompted both public- and
private-sector actors to engage in practices that may have negative externalities and may under-
mine the efficacy of disease management (following Liebenehm et al. 2011).
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6. Conclusions
This study examined the outcomes of decentralization and privatization reforms for the delivery
of veterinary services and smallholders’ use of these services in two districts in Northern
Ghana, where the settlements are scattered and an extensive system of livestock keeping pre-
vails. The study shows that these outcomes have not been altogether positive. The sharp
reductions in financial and staff resources allocated for public-sector veterinary services have
led to irregular mass vaccinations against contagious animal diseases, greater inequity of
service delivery, the collapse of quality controls of drugs, the proliferation of drugs from infor-
mal sources on the market, often inadequately informed self-medication, and the moonlighting
of public veterinarians and para-veterinarians for private purposes. This ‘litany of woes’ does
not necessarily imply a return to the public-sector system installed by the British colonial
power. The public sector still has a relevant role to play, e.g. for surveillance and control of
infectious or zoonotic diseases, guarantee of quality control of drugs and vaccines, and adher-
ence to international protocols for livestock reporting systems. Our study shows that the public
sector requires urgent action to enable it to play these essential roles. On the other hand, the
self-organization of a few communities to effectively use veterinary staff and the apparent will-
ingness of farmers to pay for effective services suggest that strategies to mainstream the deliv-
ery of customer-oriented services by private para-veterinarians to groups in rural areas may
hold prospects. The study also shows that measures to implement agency-driven change,
such as economizing on public-sector costs (i.e. change in allocative institutions) trigger
unforeseen and inter-linked institutional changes in other domains with unintended conse-
quences. Awareness of such dynamics might help policy-makers and analysts to better under-
stand the issues involved in co-ordinating multiple fronts of change and could help in assessing
where government could act as a market or system facilitator (Carney 1998, Klerkx and
Leeuwis 2008) in order to counteract undesirable effects of reforms through, e.g. quality
control or by facilitating a match between the demand and the supply sides of the veterinary
services system.
References
Ahuja, V., 2004. The economic rationale of public and private sector roles in the provision of animal health
services. OIE revue scientifique et technique, 23 (1), 33– 45.
Ahwoi, K., 2010. Local government and decentralisation in Ghana. Accra, Ghana: Unimax Macmillan.
Amankwah, K., et al., 2012. Diagnosing constraints to market participation of small ruminant producers in
Northern Ghana: an innovation systems analysis. NJAS – Wageningen journal of life sciences, 60– 63,
37 –47.
International Journal of Agricultural Sustainability 19
Amezah, K., 2007. Re – MoFA decentralization, unified extension and services delivery within the ministry.
Accra, Ghana: Department of Agricultural Extension Services, Ministry of Food and Agriculture.
Animal Research Institute, 1999. Livestock systems diagnostic survey: Lawra District, Upper West Region,
Ghana. Accra, Ghana: Animal Research Institute (CSIR).
Awortwi, N., 2010. The past, present, and future of decentralisation in Africa: a comparative case study of
local government development trajectories of Ghana and Uganda. International journal of public admin-
istration, 33 (12–13), 620– 634.
Carney, D., 1998. Changing public and private roles in agricultural service provision. London: Overseas
Development Institute.
Cheneau, Y., El Idrissi, A.H., and Ward, D., 2004. An assessment of the strengths and weaknesses of current
veterinary systems in the developing world. OIE revue scientifique et technique, 23 (1), 351–359.
Diop, B., Daborn, C., and Schneider, H., 2012. PVS gap analysis report: Ghana, 8–16 August, 2011. Paris:
World Organisation for Animal Health (OIE).
Douthwaite, B., Keatinge, J.D.H., and Park, J.R., 2001. Why promising technologies fail: the neglected role
of user innovation during adoption. Research policy, 30, 819–836.
Elzen, B., van Mierlo, B., and Leeuwis, C., 2012. Anchoring of innovations: assessing Dutch efforts to
Downloaded by [Wageningen UR Library] at 05:43 30 April 2014
harvest energy from glasshouses. Environmental innovation and societal transitions, 5, 1–18.
Gros, J.S., 1994. Of cattle, farmers, veterinarians and the World Bank: the political economy of veterinary
services privatization in Cameroon. Public administration and development, 14 (1), 37 –51.
Gyabaah-Yeboah, C., 2005. Veterinary survey of veterinary drugs and services in Ghana and assay veter-
inary albendazole suspension. 12th International Students Congress of Medical Sciences (ISCOMS)
Book of Abstracts, Groningen, The Netherlands.
Harrington, L., et al., 2001. Delivering the goods: scaling out results of natural resource management
research [online]. Conservation ecology, 5 (2), 19. Available from: http://www.consecol.org/vol5/iss2/
art19/ [Accessed 9 October 2013].
Holden, S., 1999. The economy of the delivery of veterinary services. OIE revue scientifique et technique,
18 (2), 425 –439.
Humado, C.K., 2003. Final report on review of the decentralization process of the Ministry of Food and
Agriculture. Accra, Ghana: Republic of Ghana, Ministry of Food and Agriculture.
ICRA and NAES, 1993. Coping with uncertainty: challenges for agricultural development in the Guinea
savanna zone of the Upper West Region of Ghana. Wageningen, The Netherlands: International Centre
for Development Oriented Research in Agriculture (ICRA) and Nyankpala Agricultural Experiment
Station (NAES) Ghana.
ISSER, 2000. The state of the Ghanaian economy in 1999. Accra, Ghana: The Institute of Statistical, Social
and Economic Research (ISSER), University of Ghana, Legon.
ISSER, 2011. The state of the Ghanaian economy in 2010. Accra, Ghana: The Institute of Statistical, Social
and Economic Research (ISSER), University of Ghana, Legon.
Klerkx, L. and Leeuwis, C., 2008. Matching demand and supply in the agricultural knowledge infrastructure:
experiences with innovation intermediaries. Food policy, 33 (3), 260–276.
Leonard, D.K., 2004. Tools from the new institutional economics for the reforming the delivery of veterinary
services. OIE revue scientifique et technique, 23 (1), 47– 57.
Liebenehm, S., Affognon, H., and Waibel, H., 2011. Collective livestock research for sustainable disease
management in Mali and Burkina Faso. International journal of agricultural sustainability, 9 (1),
212 –221.
Mensah, D.E., 2013. The stinking abattoir, serving ’poisonous meat’ to an uncaring public [online].
Accra, Ghana: Myjoyonline.com. Available from: http://www.myjoyonline.com/ [Accessed 15
February 2013].
MoFA, 2007–2011. The medium term expenditure framework (MTEF) for 2007– 2011 and the annual esti-
mates for 2007 –2011. Accra, Ghana: Ministry of Food and Agriculture.
Munyua, S.J.M. and Wabacha, K.J., 2003. Community-based animal health in Kenya: Kenya’s policy
experiences in reengineering its structural, policy and legal frameworks. In: IDL Group, ed.
Community-based animal health workers: threat or opportunity? Crewkerne, Somerset: The IDL
Group, 135 –148.
Neuman, W.L., 2000. Social research methods: qualitative and quantitative approaches. 4th ed. Boston,
MA: Allyn and Bacon.
Ostrom, E., 1992. Crafting institutions for self-governing irrigation systems. San Francisco, CA: Institute for
Contemporary Studies Press.
20 K. Amankwah et al.
Otte, M.J. and Chilonda, P., 2002. Cattle and small ruminant production systems in sub-Saharan Africa: a
systematic approach. Rome: FAO.
Pacheco, D.F., et al., 2010. The coevolution of institutional entrepreneurship: a tale of two theories. Journal
of management, 36 (4), 974 –1010.
Quaye, W., 2008. Food security situation in northern Ghana, coping strategies and related constraints.
African journal of agricultural research, 3 (5), 334–342.
Robinson, M., 2007. Does decentralisation improve equity and efficiency in public service delivery pro-
vision? IDS bulletin, 38 (1), 7–17.
Rogers, E.M., 2003. Diffusion of innovations. New York: Free Press.
Rondinelli, D.A., 1981. Government decentralization in comparative perspective: developing countries.
International review of adminstrative science, 47 (2), 133–145.
Scott, W.R., 1995. Institutions and organizations. Thousand Oaks, CA: Sage.
Sen, A. and Chander, M., 2003. Privatization of veterinary services in developing countries: a review.
Tropical animal health and production, 35 (3), 223–236.
Smith, L.D., 2001. Reform and decentralization of agricultural services: a policy framework. Rome: FAO.
Toye, J., 1992. Structural adjustment in Ghana: an evaluation. Brighton: Ministry of Foreign Affairs,
Downloaded by [Wageningen UR Library] at 05:43 30 April 2014
Government of Japan, summary report.
Turkson, P.K., 2008. Client assessment of animal health care delivery in peri-urban Ghana. OIE revue scien-
tifique et technique, 27 (3), 731– 740.
Turkson, P.K. and Brownie, C.F., 1999. Financing the delivery of animal health services in developing aoun-
tries: a case study of Ghana. Tropical animal health and production, 31 (1), 33–44.
Umali, D.L., Feder, G., and de Haan, C., 1994. Animal health services: finding the balance between public
and private delivery. The world bank research observer, 9 (1), 71 –96.
VSD, 2009–2011. Annual performance report for 2009–2011. Accra, Ghana: Veterinary Services
Directorate, Ministry of Food and Agriculture (MoFA).
VSD, 2012. Staff list records. Accra, Ghana: Veterinary Services Directorate, Ministry of Food and
Agriculture.
Weimer, D.L., 2006. The puzzle of private rulemaking: expertise, flexibility, and blame avoidance in U.S.
regulation. Public adminstration review, 66 (4), 569–582.
Woodford, J.D., 2004. Synergies between veterinarians and para-professionals in the public and private
sectors: organisational and institutional relationships that facilitate the processes of privatising animal
health services in developing countries. OIE revue scientifique et technique, 23(1), 115 –135.
World Bank, 2009. Minding the stock: bringing public policy to bear on livestock sector development.
Washington, DC: The World Bank, Agriculture and Rual Development Department.