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).
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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).
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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.