Assessment of Private Paravets Practices towards Veterinary Extension Services in Nepal

The study aims to assess the performance of paravets towards veterinary extension services in Nepal. The participatory methods like questionnaire survey, key informant interview, focus group discussion, direct field observation, force field analysis and score ranking was adopted during the study. The quality of the Private Paravets was sound in terms of relevance, appropriateness, targeting, and sustainability issues. Project activities associated with Private Paravets promotion were observed appropriate and in line with the needs of farmers. The concerned private paravets were found to be working effectively for institutional, social and economic transformation of the beneficiaries. Large majority of the Paravets have been providing veterinary service on technical advice, curative services (98 %), AI (87 %) and vaccination (75%) against hemorrhagic septicaemia and black quarter diseases in the cattle and buffaloes. There has been increased access to veterinary extension services in the rural farming communities because of increased accessibility to Paravets. In the study areas 89 %paravets have annual turnover of Rs less than 2 lacsto3-5lacs in their fee based private veterinary services. Overwhelming majority of the Paravets had future plan to expand their business. Of the total 96 % Paravets expressed job satisfaction for their current veterinary private practices despite some problems. The private paravets seems to be instrumental and sustainable to provide services towards veterinary and livestock production technology in the study areas. However, there is room for improvements to make it economically viable, technically sound, legally regulated and developing professional ethics as Paravets practices in Nepal. Abstract


Introduction Background
Agriculture is the major sector of Nepalese economy. It provides employment opportunities to around 65 percent of the total population and contributes about 27 percent in the Gross Domestic Products. Therefore, the development of agriculture and livestock sector is key for the development of national economy (MOAD, 2020).Livestock are domesticated animals raised to produce milk, meat, eggs, wool, labor, etc. In Nepal Livestock and its products like milk, meat, and hides, contribute 11.5 % of national GDP (CBS, 2011), and 25.68% of the agricultural GDP (MoAD, 2014). It is also an integral part of Nepalese farming, providing draught power, fertilizer and household fuel. Oxen and male buffaloes are used for hauling and transport of agricultural products and inputs. In the hills and mountains, mules, yaks, sheep and goats make an important contribution as pack animals. It is main source of animal protein and household cash income. Livestock sub-sector has becoming as a commercial enterprise for selfemployment and sustainable livelihoods across the country.
Paravets are those community-based extension workers who assist a veterinary physician in the performance of their duties, or carry out animal health care autonomously as part of a veterinary extension services. In Nepal, paravets are providing veterinary services, livestock development works and front line agricultural extension workers in rural areas. They are popular among the farmers because of easily accessible, cost-effective and communitybased technician. Suvedi and McNamara (2012) stated that the Nepal agriculture policy (2004) recognized Nepal's extension system as pluralistic in nature. In the public sector, extension is provided under the Department of Agriculture and Department of Livestock Services. However, extension is provided by the Council for Technical Education (CTEVT), Agriculture and Forest University, and Tribhuvan University (TU). In addition, the private sector plays an active role in offering improved seeds, pesticides, and artificial insemination for livestock among other services (Suvedi and McNamara, 2012). Likewise, there are a number of NGOs, especially in the remote areas that provide extension services to farmers in Nepal (Jaishi, Nepali and Shahi, 2018).However, the veterinary extension coverage is not sufficient to make a difference in the life of rural farmers.  has pointed out that the agricultural extension service provided by the Government of Nepal has received by only 13 % households in the study area (Thapa, 2019, P 159).
Claire Heffernan and Pilling, D (2002) pointed out that the livestock development has recognized the need to prioritize efforts to help alleviate poverty. Although there is now a concerted effort to direct development research activities at poverty alleviation, there are still a number of potential stumbling blocks. First, little information exists as to how the poor view livestock-related livelihoods in general or livestock disease more specifically. Secondly, the factors that are important to the uptake of animal health technologies are often not known. Researchers compared the findings of a previous project (delivering veterinary services to the poor) to other work on prioritization. The analysis showed that there are large differences in livestock disease reporting between the experts and the poor as illustrated in the table for India below (Fig. 1). Equally, there are further differences among income groups and genders: hemorrhagic septicaemia (HS) is ranked as a more significant problem by the better off, while diarrhea was more important for the poor; women prioritize livestock diseases that affect household income, e.g. mastitis, whereas men tend to rank diseases with high mortality rates. Hence, the analysis has revealed the wide differences in perceptions and opinions of the different stakeholders (Claire Heffernan and Pilling, D., 2002 Heffernan and Pilling, D. 2002 The concept of efficiency, effectiveness, relevance, and sustainability has been briefly described below.
Efficiency: The purpose of the efficiency is to measure the programs or projects in terms of results at the community level through planned programs or projects. An assessment of the results of the project or program in relation to the resources used and time taken is called efficiency.

Effectiveness:
The purpose of the effectiveness is to measure to make a difference in the life and livelihoods of the local targeted people through planned programs or projects. The extent to which the objectives have been achieved as a result of the project or program itself, and the extent to which other factors have influenced the results. A consideration of the wider context in which projects and programs operate should be an integral part of the evaluation.
Impact is assessing changes that have occurred in the lives of the intended rightholders, and the forces and influence that have contributed to bringing about these changes. These may be project related and wider forces and influences. Impact on other people should also be considered. The changes occurring may be positive or negative, intended or unintended. The impact may differ for women and men, people of different ages, different ethnic groups and other social groupings, so the analysis should consider different groups separately. Consideration should also be given to whether costs can be assessed in relation to importance.

Relevance:
The purpose of the relevance is to measure in terms of need and priority of the local people, government policy, long term plan and priority programs. Relevance is defined as the extent to which the project or programme objectives are valid and appropriate to the priorities and needs of the rightholders. Was the original problem analysis comprehensive enough and is it still relevant? Is the project purpose relevant and will it solve the problem? Are the stakeholders relevant to the problems, objectives and long term sustainability (Thapa, 2018)?

Sustainability:
The purpose of the sustainability is to long lasting of programs for the benefit of people. The extent to which considered in relation to the project or program can be continued in an appropriate way after outside funding support has discontinued . TLDP (2004) has mentioned that the promotion of private veterinary and breeding services started with TLDP (Third Livestock Development Project) intervention back in late 90's. During this period, 30 Paravets were trained and 27 supported to start veterinary and Artificial Insemination services (TLDP, 2004). Based on the success of TLDP, Community Livestock Development Project (CLDP) has also been promoting paravets with the main objective of expanding veterinary and AI services. The CLDP trained a total of 222 Private Vets/Paravets and supported 152 of them until the end of 2010 (CLDP, 2010).
Many of the Paravets promoted by TLDP have expanded their services. Similarly, the performance of most Paravets promoted by CLDP is rated satisfactory, while some are lagging behind in their businesses due to poor skills and low business leadership. It has also been reported that many project supported Paravets have expanded their services by recruiting peers and Village Animal Health Workers due to high demanded by the community and livestock farmers.

Specific objectives
The following specific objectives have been set to map out the performance of Paravets: 1. To assess the performance of private paravets in terms of quality of technical services; and 2. To analyses the sustainability of the business, efficiency, effectiveness, lessons learnt and challenges of the paravets for the private veterinary extension services in Nepal.

Methodology
Approaches to the study Exploratory research design was adopted to collect the primary data from the study areas. The qualitative and quantitative methods were adopted during field study. Data management and analysis was carried out by using simple arithmetical calculations. The gender equity and social inclusion, participatory and approaches were adopted during the field study.

Context
Study site was selected through the mutual understanding between Community Livestock Development Project team and researcher where there is livestock development program. A total of 11 districts were included for the study. These are Morang, Siraha (Province one), Lalitpur, Chitwan (Bagmati province), Kaski, (Gandaki Province), Nawalparasi,Rupandehi, Bardiya (Province five), and Surkhet, (Karnali Province ), Dadeldhura and Kanchanpur district (Sudurpaschim Province). These districts represented the Hills and Terai agroecological zones in order to capture the information.
The area was well stratified to capture the diversified information in terms of ecological setting, caste/ethnicity, accessibility, market etc. The purposive sampling was adopted to select the study areas due to limited time and resources.

Questionnaire Survey
The questionnaire survey research method was used to collect the information from the respondents. A total of 53 Private Paravets (including one Private veterinarian) working in the selected districts were surveyed by administering structured questionnaire developed by researcher to conduct the study among the Private Paravets. The draft questionnaire was pre-tested in Lalitpur district and finalized before the actual field study to make more practical and minimize the errors.

Meeting with concerned stakeholders
Meeting with field staff, and District Livestock Service Offices, and rightholders was organized to map out their perceptions towards quality services provided by private Paravets in veterinary service, artificial insemination (AI) and fodder development issues, key achievement, good practices and areas for improvement etc. Review of previous evaluation reports, annual reports, documents and financial management systems and any other documents related to the study was undertaken.

Focus Group Discussion
A total of 17Focus Group Discussion (FGD) was carried out (1-2 FGD per district)to map out the community perception towards Paravets practices in each district. A total of 8-12 farmers and concerned livestock entrepreneurs were gathered in one place to discuss about their issues related to veterinary services and livestock production etc. The perceptions mapping and challenges and other problems related to private veterinary extension services etc.

Score and Pair wise Ranking
The participatory learning and action tools like score and pair wise ranking to identify the preference of farmers, DLSOs and private paravets towards veterinary practices was used during the field study. These tools were found effective to explore the qualitative information from the respondents.

Data Analysis
A simple analysis such as editing, coding, classification, tabulation and percentage was done. The gender equality and social inclusion, and effectiveness of service provider were taken into account to measure the performance of Private Paravets. There has been complementarily between the qualitative and quantitative information to verify the performance of the Private Paravets practices. Quantitative Research is used to quantify the problem by way of generating numerical data or data that can be transformed into usable statistics. It is used to quantify attitudes, opinions, behaviors, and other defined variables -and generalize results from a larger sample population. Quantitative Research uses measurable data to formulate facts and uncover patterns in research. Qualitative Research is primarily exploratory research. It is used to gain an understanding of underlying reasons, opinions, and motivations. It provides insights into the problem or helps to develop ideas for potential quantitative research. Qualitative Research was also used to uncover trends in thought and opinions, and dive deeper into the problem (Thapa, 2018).

Findings
This chapter analyses the overall performance of private vet/paravets by using descriptive statistics and qualitative tools of Participatory Learning and Action (PLA) and perceptions mapping of the stakeholders.

Age
The majority of the paravets (79 %) were between 21-40 years of age while 21 per cent were between the ages of 41-60.Overwhelming majority of l Private Paravets fall under the category of economically active population (Table 1). The mean age of the paravets was 34 years.

Sex Composition
Of the total sampled population 88 per cent were men and 12 per cent (Table 2) were women. The population of women Paravets was low as compared to men paravets due to less women literacy and patriarchal social structure. The women Paravets were relatively more confined in urban and periurban areas.

Marital Status
Across the eleven districts large majority of paravets (81%) were married (Table 4).The field observation shows that those couple who married between paravets have found effective service providers due to sharing of knowledge, skills, experiences, role and responsibilities etc in daily professional work.

Socio-economic well being of Paravets
Veterinary mid-skilled technicians generally come from middle to lower middle class families. It was found that the large majority of paravets (72 %) belonged to socio-economically middle class family while 28 per cent were from low socio-economic well-being category ( Table 6). The private practice business has been more instrumental in socioeconomically low and middle class category to generate income by selling goods (veterinary drugs) and services. The field observation revealed that the well-being of the many private paravets has been significantly improved as compared to previous one because of current veterinary practices as a profession.

Previous Profession
Before CLDP training majority of the paravets were operating agrovet shops (53 %). Rests were involved in farming (28 %), and government employment (15 %). It can be assumed that there is high possibility that they will continue their business in the future because of directly related previous background to the current profession (Table 7).

Level of Quality Services
Majority of Paravets assessed their own service provided to the farm community as good (60%), very good (32%) and excellent (8%) in terms of the quality of the service perceived by themselves (Table  11). There has been increased access to veterinary extension services in the rural farming communities because of increased accessibility of Paravets in rural communities. So Paravets could be regarded as "Doctor Saheb" as farmers mostly call them with due respect. They are more approachable, accessible, proximity to smallholder farmers and affordable. Furthermore, they were instrumental to alleviate poverty in the rural areas of Nepal. However, there is room for improvement in terms of professional development, legal provision and regular action review and reflections, participatory monitoring and evaluation etc. There has been some role illusion between paravets and veterinarians in terms of roles, responsibilities and relationships in dealing with clients due to lack of Paravets Act (legal provision) as reported by paravets.  Muna vet is providing home service on distemper and rabies vaccination in pet animals. He charges Rs 500 for rabies and distemper vaccination. The annual turnover of business is Rs 600,000. He gets 15-25 % profit from the business. He is being interested to run the private vet practices because of selfemployment and Wider scope to generate income.

Rating of Quality Service
When he was asked on how you could improve your business in the future? He replied that, he would like to take agriculture loan of Rs 600,000 to expand the business in the future and training on treatment of pet animals. He further added that on the whole paravets has contributed for poverty reduction by providing veterinary services to the smallholder livestock farmers as "Bare Foot Veterinarians". The paravets have encouraged the Gulf countries returnees to start livestock enterprises for income generation within country. They are succeeded to get income from the livestock enterprises.
There is high scope of dairy in Lalitpur so Paravets should be trained in hygienic milk production and milk products as perceived by Mr. Neupane. He added that the Paravets should also focus on large animals care and management despite pet animals.

Affiliation with Paravet Association
The most of the paravets (89 %) have been affiliated with Paravet Association to assert their rights and professional development (

Paravets involvement in FMD, Bird flu, and Swine Flu prevention and control
During the study 53 % and 47 % paravets (Table  13) have found engaged in an implementation of preventive measures/vaccination and advice for prevention of FMD, Bird flu, and swine flu diseases respectively. However, they have yet to be received tailor made training in this area.

Annual Turnover by Paravets
Overwhelmingly large majority of (89 %) paravets have annual turnover of Rs less than o. 2 million to 0.5 million in their private business. The rates of annual turnover of Private vet/Paravets during the period of five years have been reported (Table 14).The Private vet/Paravets practices have found better performance in the case of urban and Terai areas as compared to rural areas of Hills and Mountains due to increase market access of livestock products. (2) 0 Year 5 05 (10 ) 06 (12 ) 01 (2) 01 (2) 01 (2)

Expansion of Business
Overwhelming majority of paravets have formed future plans to expand their private business in the years to come because of profit-making, having knowledge and skills on veterinary practices through trainings and working experience in the veterinary services as profession to shape their lives and livelihoods (Table 15).

Job Satisfaction
Overwhelming majority of the paravets (96 %) expressed satisfied to highly satisfied from their current veterinary private practices due to good scope of work, bread earning and increased social prestige in the community (Table 16)

Major Challenges Faced by the Paravets
The private paravets have faced the following challenges:

Lack of clear policy and procedures:
The clear policy and procedures are not in place to mobilize the private paravets to strengthen veterinary private practices in remote rural areas. There has not been clear cut demarcation of veterinary services and livestock extension services between the private paravets and District Livestock Service Offices in handling of clinical cases. However, the quality of services was reported to be better in case of veterinarians as compared to paravets.

Poor action review and reflection process:
There are insufficient regular quarterly action review and reflection workshop/meetings with the private paravets in order to discuss their issues, challenges, sharing of knowledge and best practices among them.

Less refresher training:
There is not enough refresher training to paravets especially on AI, veterinary medicines, handling of surgical cases and laboratory test to increase professional development and promotion of private practices.

Poor record keeping system:
There is poor record keeping system in case of AI, vaccination and handling of surgical cases that resulted in difficulty in measuring the impact of work done by front line workers in the livestock subsector.

No provision of life insurance:
No provision of life insurance of private vets/paravets while handling the high risk cases.
6. Less access to credit: lack of provision for low interest rate credit remained the limiting factor to expand their business as reported by some paravets.

No academic career opportunity:
The career opportunity to increase academic qualification within the country is one of the important limiting factors for the motivation of Paravets. The paravets have no provision of further academic study as career development.

Force Field Analysis
The driving and resisting forces have been identified through discussion with private paravets during the field study which are as follows (Fig.3): The driving forces need to be strengthened and resisting forces minimized towards achieving sustainability of private paravets practices. The sustainability depends upon the increased level of knowledge, skills, positive attitudes, behavior, enabling policy environment, regular cash income, social prestige, credibility, and commitment to action. The driving forces are stronger as drivers of private paravets practices as compared to resisting forces to serve the purpose.

Prioritization of treatment by animal species in Rupandehi
Paravets and DLSO staffs were asked to prioritize the treatment of livestock. They ranked first for cattle, second for Buffaloes, third for goat, fourth for Pig and fifth for dog with following reasons (Table 19). When Ms. Dhimal was asked about the performance of paravets in Morang district, she replied "the paravets are serving the smallholder farmers to care the livestock. They kept veterinary medicines in their clinics for veterinary practices. We call them for the treatment of animals. They provide home service upon our request. The Quality of service is also good "says Kalpana Dhimal, 25, Urlabari VDC ward 9, Morang. 2010.

Conclusion and Recommendations Conclusion
Livestock plays an important role in rural economy of Nepal. It provides essential source of protein and cash income in the livelihoods of the rural people. The qualities of the Private Paravets have found to be effective in terms of relevance, appropriateness, targeting, and sustainability issues. Project activities associated with Private Paravets promotion were observed appropriate in line with the needs and priorities of rural people of Nepal. The private paravets were found working satisfactorily for their institutional, socio-economic transformation etc. The majority of Private Paravets have found successful in providing private veterinary services to make a difference in the lives of smallholder farmers.
An overwhelmingly majority of the paravets have found Junior Technical Assistant/Junior Technicians. The large majority of the paravets have come from middle class families. This business have found more instrumental in socio-economically low and middle class category to generate income by serving the poor farmers. Overwhelming majority of paravets is providing service on technical advice, curative services, AI and vaccination against bacterial diseases in the cattle and buffaloes. The large majority of the paravets have found good to excellent rating in terms of quality service providers. There has been increased access to veterinary extension services in the rural farming communities because of increased access to paravets. Overwhelmingly large majority of paravets have found handsome amount of turnover in their fee based private veterinary services. The large majority of the paravets had job satisfaction with some improvements. This research was conducted as sample survey due to limited time and resources. It could not cover across the country particularly in high Mountain areas like Karnali Province. There is a need of policy research and how to use of the Paravets to increase access to veterinary extension services focusing to remote rural areas in the context of Federal Democratic Republic System of Nepal. There is lack of veterinary technical human resource in the rural municipalities to provide extension service at the community level. The veterinary extension service regarded as important technical subject matter to increase household income from the commercial livestock farming.