2. Materials and methods
2.1 Study areas
Both primary and secondary data were collected in this study. The
primary data was derived from a detailed survey conducted in the two
provinces of Kampong Cham (KC) and Pursat (PS). These provinces were
selected for this study as both participated in the ‘Domestic and
International market development for high-value cattle and beef in
South-East Cambodia’ project (Figure 1). Pursat is located in the
western part of the country and bordered with 4 provinces, Tonle Sap
(Sap River) and Thailand. Kampong Cham is located on the central
lowlands of the Mekong River and bordered to six provinces, Mekong River
and Vietnam. The project was a collaborative research effort facilitated
by the University of New England and DAHP, with funding by the
Australian Centre for International Agricultural Research (ACIAR project
AH/2012/046).
>Insert figure 1<
The secondary data was collected during a nationwide review of the
annual reports on VAHW programs, provided from the GDAHP, Ministry of
Agriculture, Forestry and Fisheries, and included personal
communications with the chiefs and vice chiefs of the Provincial Office
of Animal Health and Production (POAHP) involved in the refreshing
training and monitoring of the VAHW programs. The VAHW records were
examined to provided temporal information on trends in the total number
of VAHWs, their gender and their classification as ‘active’ or
otherwise, in each province between 2011 to 2020. Interviews were also
conducted with the Chief of POAHP in the 5 provinces where there was a
high ‘drop out’ rate of VAHWs to provide information on their
perceptions of the reasons for the cessation of VAWH activities.
2.2 Data collection methods
The VAHWs targeted for the primary data survey were identified and
selected through informal discussions and consultations between the
researcher, representatives of the POAHP, DAHP and the ACIAR-funded
project team. The participating VAHWs were selected based on their
active animal health services during the past six months and
recommendations from the POAHP. Primary data was collected from random
sample of VAHWs (n = 198) from PS (n = 113) and KC (n = 85). A
semi-structured questionnaire consisting of open and closed questions
was developed to collect quantitative and qualitative information from
the VAHWs. The questionnaires were initially developed in English and
then translated into Khmer by the senior author, ensuring all questions
were easy to understand and answer. The questionnaire collected
information on the background of VAHWs, household assets, household
incomes, knowledge and experiences of vaccination and diseases, animal
health services provided to both his own and farmers’ livestock, plus
their perceptions on the importance of vaccination. In addition to the
specific questions, information on past vaccination programs’ obstacles
and opportunities were requested, and suggestions for improving
vaccination programs were obtained. Before the survey, the survey team
received a full day of training to ensure that they had a clear
understanding of the study’s aims and objectives and were confident in
their roles.
The questionnaire and delivery technique was tested on three VAHWs in PS
to evaluate suitability and clarity. After initial field testing, the
questions were reviewed and modified by the team. Due to time and budget
limitations, a guided group discussion method involving 20 - 25 VAHWs
lasted 2 to 3 hours. At least two or three enumerators were deployed at
each guided group discussion to ensure they understood and answered the
questions. Every VAHW received a questionnaire in Khmer, and the author
or enumerators conducted a guided group discussion in Khmer (Figure 2).
The enumerators or author read out the question (question by question)
and explained the nature of the response/s requested. All VAHWs were
then given a reasonable time to contemplate before answering each
question. Enumerators ensured that they did not move too quickly between
questions, the VAHWs were requested to respond to open questions by
writing down truthful answers based on their experiences, and it was
emphasised that the completed questionnaires were anonymous with no
names were recorded. The VAHWs were advised not to share answers with
their peers. Besides, during the group interviews, government officials
were excluded from the interview to ensure confidentiality and encourage
honest responses. At the end of the session, all completed
questionnaires were collected and checked to ensure that no information
was missing. The guided group discussions were conducted at each meeting
in February and March 2014 (Figure 2).
>Insert figure 2<
The nationwide review of the annual reports on VAHWs from the GDAHP,
Ministry of Agriculture, Forestry and Fisheries (MAFF), and personal
communications with the chief and vice chiefs of the POAHP involved in
the refreshing training and monitoring of the VAHW programs, provided
the secondary data. The VAHW national records, including the total
number of VAHW and gender in each province between 2011 to 2020 and
‘active’ classification of VAHWs between 2017 to 2020 in the annual
reports, were summarised and analysed. The reasons for the cessation of
the VAHW activities and the low rate of female VAHW were also obtained.
The criteria used to determine whether a VAHW was active was agreed upon
in interviews with the Chiefs of the 5 POAHP, conducted by telephone on
December 16, 2020. Active VAWHs were those who: (1) had good knowledge
of animal health and production and trust by farmers; (2) collaborated
with and assisted the district/provincial veterinary authorities when
needed; (3) providing good animal health and production services to
farmers; and (4) permanently lived in the village.
2.3 Data management and analysis
The primary data were coded and transcribed into a database, and
statistical analysis was performed using SPSS version 21.0 (SPSS Inc.,
IL, USA). Standard descriptive analyses of the data were performed with
proportions of categorical variables. Investigation of variables
considered to be probably associated with FMD vaccination practice was
performed. Statistical analyses were undertaken by application of a
chi-square test to possible associations between age group (1=22 - 40
years old; 2=>40 years old), education (1=high school;
2=secondary school; 3=primary school), annual household income (1=
<USD 1,000; 2=USD 1,000 - USD 2,000; 3=>USD
2,000), number of years working as VAHW (1=<6 years; 2=6 - 10
years; 3=>10 years), and number of villages covered (1=only
one village; 2=2 - 5 villages; 3=>5 villages) with the FMD
vaccination practice, specifically reported by VAHWs (1=yes; 2=no).
The relevant VAHW data (secondary data) from the annual national reports
were translated from Khmer into English, entered into Microsoft Excel
(365), and then exported into SPSS for data analysis. Statistical
analysis was performed using SPSS version 21.0. Descriptive statistics
were used to describe the characteristics of the VAHWs.