motivation, culture and health in a socio-ecological system in africa

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Director General CSRS

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“Motivation, Culture and Health in a Socio-Ecological System in Africa”Bassirou Bonfoh 23.03.16

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Associate ResearchInstitute of AfricanUniversities

Adiopodoumé Route de Dabou, Km 17, rte Dabou

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Plan de Présentationwww.csrs.ch

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1. CSRS

2. Research set up

3. Socio-ecological system

4. Motivation/ Culture/ Knowledge transformation

5. Incentives and impacts

6. Capacity building beyond academic

7. Conclusions

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CSRS

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1. Interdisciplinary Research

2. Capacity building “Research training”

3. Expertise/ information and services

4. Research and grants administration/ facilitation

Strategic goals

65 years, diplomatic status (MESRS-SEFRI)

90 supporting staff

170 researchers (Msc, PhD, Postdoc, Seniors…)

7 field stations, specialised labs, HDSS)

> 80 projects and partnerships

> 100 publications per year

10 PhD thesis & 10-15 Masters per year

(in collaboration with Swiss, African, Ivorian

Universities)

6 ongoing interventions (health, sanitation,

agriculture, conservation, biodiversity, research

governance…)

4 major programs (PASRES, Afrique One, AVECNET,

YAMSYS…)

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CSRS Network

170 collaborators in 27 countries

6 (Switzerland, France,

Germany, Norway, UK,

Kyrgystan)

3 (Vietnam, Thailand, Japan,

Australia)

16 (Benin, Burkina Faso, Mali,

Mauritania, Tchad, Cameroun, Uganda, Tanzania, Senegal, Ghana, Liberia,

Togo, Gabon, Kenya, Nigeria, Ethiopia)

CSRS – Abidjan, Côte d‘Ivoire

2 (Canada, USA)

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11 Partnership principles

Common research agenda definition, shared capacity and applied results can foster good communication

Partnership principles

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Research set up in

Socio-ecological system

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10 thematic focus (DAP)

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Biodiversity and conservation Ecosystem services

Agriculture and food technology Household economy

Nutrition Wellbeing

Health Socio-ecological determinants

Co-infections

Participatory Risk Analysis

Health systems

Institution (formal and informal) Vulnerability/ Resilience

Culture, behaviour

Education

Multi thematic sites

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2008-….

Cohort: 45’000 people

• Population dynamic

• Neglected Tropical Diseases

• Non Communicable Diseases

• Nutrition

• Health interventions

• Production systems/ household economy…

Surveillance-Response/ INDEPTH

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Socio-ecological system

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• Geographic (rural, urban, slums..)

• Climate (arid, semi-arid, humid…)

• Gender (women, men…)

• Age (children, elders…)

• Status (wealth, poor..)

• Culture (minorities, ethnic, religion, believes, tabous…)

• Power (civilian, militaries…)

Socio-ecological factors/ changes

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– Complexity

– Uncertainty

– Transaction cost

Financial

Social

Environmental

– People’s perspetive

Behaviour

Bilieves

Tabous

Religion

Socio-ecological implications

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Access to social services/ contact with livestock/ mobility

Access to clean water/ permanent source of infection

E.g. Rural

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Water, energy, technology

Education, livelihoods

E.g. Urban

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Vulnerability and resilience framework

Vulnerability & Resilience

Practices

Risks

Exposure

Responses

Mitigation

Transformation

Intervention

Consequences

Context

Times

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Motivation/ Culture/ Knowledge transformation

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Certain needs or wants allow to do certain things (behavior) which satisfy those needs (satisfaction), by intensifying certain ones, or allowing to move on to other ones.

Motivation theory

http://www.analytictech.com/mb021/motivation.htm>

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Motivation theory

Risk perception Probability of risk occurence

Severness of risk

Experience with that given risk

Coping perception Possibilities of action

Effectiveness of action

Cost/effort of action (revenu)

Action

• Reactive

• Preventive

• Selective

food

No Action

• Denial

• Wishful thinking

• Fatalism

Consumption habits

Spiritual

Ethical

Moral

Confessional

Conviction

Tolerance

Risk conscienciousness Trust

Compensation

Cost of quality

Inte

ntion o

f action

Access to liv

elih

oods a

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Exte

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Context specific: individual, household, tribe, community, country….

Cultural double impact: Conception of the disease

Relationship with the environment

Role of culture Enabling factor/ protective (e.g. nutrition, tabous, restriction..)

First health seeking behaviour (e.g. traditional healers, plantes…)

Alternative to culture Evidence/ compensation (e.g. slaughter…)

Motivation to support global health and environment (e.g. care of dead bodies in Ebola cases

Experience Academic knowledge (e.g. boiled milk for a 85 old Fulani)

Gain

Application to health

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“Hygienic measures around a dead body are culturally difficult to accept, and with the highly deadly Ebola epidemic, we need to understand the socio-cultural and ecological determinants of health” (Ndri-Yoman, 2015)

• Language: sensitisation

• Behaviour: washing-disinfection

• Law enforcement: bush meat consumption

• Command & control…..

• Sometime it works but not last long!!!

Ebola crisis: Côte d’Ivoire

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Soft vs Hard intervention

After deworming

… rapid reworming

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Technology effectiveness

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Incentives and impacts in dairy sector

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Trade-offs: food vs diseases

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In the cycle of poverty food save lifes as medicine in disease does!

Food quality/ safety drive market, health and wellbeing?

From where do we start intervention?

Which language to use and on which lever do we push?

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Risk Analysis

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Evidence on:

Vomiting and diarrhoea among consumers

Brucellosis seropositive among febrile clinical patients

High microbial resistance to most of the used antibiotic in vet field

Reporting???

Regulation Command and control!!!!

25%75% >107 ufc/ml 6,4%30%

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Hazards/ diseases vs Revenu/ Livelihood

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Grace, ILRI 2010

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Socio-economic impact

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1’100’000 invested: Dairy, Technology, Training

Parameters 2005 2015 Units

Total milk collected 1’500 7’000 Litre/day

Collecting sites 1 17 sites

Livestock ownersmembership

35 776 Households

Animal supplemented feed 50 1’000 tons

Selling points 1 53 sites

Employement created 50 2’000 Peoples

Gross revenu of 50’000 1’760’000 Euros

Improved milk quality and safety

Women exclusion

Substitution of local milk with powder milk fro children

Increase livestock and pasture degradation

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Capacity building beyond academic

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2009-2016 “Ecosystem and Population Health: Expanding frontiers in Health

Community of practice of “One Health” in Africa”

One Health Initiative/ Wellcome Trust

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Towards ASPIRE

Extent of problem

Transmiss. dynamics

Infection control

Transmission control

Elimination

Rabies

Mycobacterial infections

Brucellosis

Food-borne diseases

Surveillance-Response

East

West

Adapted from Utzinger, 2012, Plos NTDs

2016-2020 “African Science Partnership for Intervention Research Excellence

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Field and studio

1st MOOC on One Health

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Conclusion

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Cultural change at all levels

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Cultural change in researchScientific knowledge + transformation knowledge

Individual Local community Specialised/ academic Organisational/ policy, governance Holistic/ collective

Co-construction of knowledge Community service effectiveness Scale of One Health implementation Incentives/ added value (loss, gain)

Socio-ecological

system

Time/ scale

Service effectiveness/ social cost/

Incentives

Capacity building-Education

Language/ Behaviour

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Partners and funders

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