Background
Agricultural activities represent the main source of livelihood for a vast majority of the poor in developing countries, where it is mainly operated on a subsistence basis and contributes to the local and global economy through trade. Livestock production is a big part of this and animal products serve as a key protein source in the human diet [
1]. In spite of agriculture’s contribution to the economies of developing countries, it is linked to different forms of adverse events [
2] which are a source for psychosocial problems to farmers. Mental problems arise when people are confronted by adverse events that are left unaddressed, affecting their normal day-to-day functioning.
Livestock farmers in Africa face multiple adverse events, all of which have increased in incidence recently [
1], including disease outbreaks, drought, and conflict. The increased incidence of adverse event has been attributed to climate change [
3]. Due to this, farmers often lose livestock and are left in a traumatic situation [
4]. According to the International Labour Organization (ILO), occupational pressures in any workplace represent the leading source of psychological problems in adults, with high stress levels at work negatively affecting productivity [
5]. The mental health of individuals is therefore a key predictor of their productivity. In a farming context, the loss of livestock, thus, affect the production levels of livestock farmers in the midst of increasing demand from a growing population, creating a mismatch between the demand for livestock products and what is actually being produced [
6].
Even though mental health problems are one of the recognized non-communicable diseases with high burden in both developed and developing countries, it has received less focused attention over the past decades, especially in a rural context [
7]. The World Health Organization (WHO) estimates that each year, more than 450 million people across the general population suffer from mental illness globally and about 75% of people with mental disorders in developing countries, where farming is the only source of income for many, receive no treatment [
8]. Additionally, mental disorder-related deaths occur mainly through suicides, accounting for about 1 million deaths a year globally [
9]. In Ghana, an estimated 3 million persons were living with mental disorders in 2007, with a treatment gap of more than 95% [
10]. A nationally representative survey conducted in Ghana between 2009 and 2010 also found that about 20% of the general population have psychological distress [
11]. The government of Ghana passed the Mental Health Act 2012 (Act 846) in the same year, with the goal of improving the mental healthcare delivery in the country [
12].
Against this background, the United Nations’ Sustainable Development Goals (SDGs) One (1) through Three (3) were formulated, to improve health outcomes, including mental health, food security, and to reduce poverty globally. In spite of the strategies implemented to attain the set indicators of these goals, the United Nations Department of Economic and Social Affairs reports slow progress of some of the indicators in Africa and proposed a proper execution of agricultural practices as the key solution to self-sustainability on the continent [
13].
Livestock production in Ghana has stagnated since 2009, and even fell from 32 to 22% in 2013 [
14], even though over 40% of households in Ghana are involved in livestock rearing [
15]. According to the estimates by the Ministry of Food and Agriculture (MoFA), cattle production in Ghana increased by only 7.6% between 2000 and 2010 [
16]. Over the same period, Ghana’s population grew by more than 30% [
15]. The consequences of this mismatch in growth include high meat imports, high meat prices, and loss of foreign exchange. The production gap is reflected in the total beef imports into Ghana, that have been exponentially increasing by 1876.4%, from a little over 600 metric tons in the year 2000 to about 12,500 metric tons in 2010 [
16]. The global demand for livestock products is estimated by the Food and Agriculture Organization to further double by 2050 [
6]. Therefore, there is the urgent need to identify the causes for loss of livestock and mental health problems in farmers to increase production and wellbeing in order to inform appropriate interventions to address these. Food insecurity in Ghana will increase substantially, if livestock production levels in Ghana are not improved. Identifying the root causes of livestock losses and the drivers of farmers’ mental health are key to meeting the SDGs 1, 2 and 3.
Discussion
Agriculture and livestock production particularly contribute significantly to the growth and development of many developing countries including Ghana, and serve as a livelihood source to a vast majority of the poor in society. Despite these benefits, it is also one of the most stressful occupations. Due to negative effects of climate change, adverse events including droughts and conflict have increased in occurrence, leading to livestock losses to farmers and thereby affecting their productivity. Due to this decline in production of livestock, the local demand for livestock and livestock products is not adequately met, leading to high meat imports, high food prices and loss of foreign exchange. The loss of livestock may also lead to negative livelihood and mental health consequences for livestock farmers. Therefore, identifying the drivers of low mental health of livestock farmers and sources of livestock losses is key to inform interventions and being able to meet the Sustainable Development Goals (SDGs) 1, 2 and 3, which aim to reduce poverty, reduce hunger and ensure good health and wellbeing.
Our study provides evidence, that the root causes of livestock losses are from livestock disease outbreaks, cattle theft, pasture shortages and conflicts. The extent to which climate change affected the prevalence of these adverse events, though previously documented [
3,
24,
25], could not be ascertained in this study. Livestock diseases were the leading cause of losses suffered by farmers because of mainly inadequate access to veterinary services and a lack of clarity on the responsibility of farmers, resulting in them treating animal diseases themselves using drugs freely available on the market, arbitrarily without veterinary prescription. These findings agree with a previous study conducted among livestock farmers in the Northern Region of Ghana [
26]. Periodic education provided by veterinary extension workers to livestock farmers could address the problem of pasture shortages. The establishment of a fodder bank for storage of feeds against drought periods and provision of other veterinary services in Wawase in the Kwahu Afram Plains South District by the Ministry of Food and Agriculture in collaboration with the Africa Development Bank [
27] is commendable. Cattle rustling in pastoral communities could be addressed if law enforcement is strengthened in farming communities in Ghana. Some of the farmers in the present study also sell diseased animals on the market to recover some losses. These practices appear to be a coping strategy adopted by the livestock farmers to help them deal with the challenge of inadequate access to veterinary services and thus high losses and is consistent with other studies [
28,
29].
The loss of livestock was found to negatively affect the livelihood and reported physical and mental health of the livestock farmers. The farmers in this study lost an average of USD 1500 per year due to livestock disease outbreaks. This affected their ability to provide for the basic needs of their households. As expected, and as found in previous studies in the United Kingdom [
30] and Australia [
31], following the outbreak of Foot and Mouth Disease (FMD), livestock losses negatively affect the mental health of farmers. The proportion of the livestock farmers with psychological distress (60%) is relatively high, compared to the previously reported prevalence of psychological distress of 20% among the general Ghanaian population [
11]. This finding is not uncommon, as other comparative studies in Europe, America and Australia showed agricultural workers to be highly stressed compared to other occupations [
32‐
34]. The main diseases leading to the losses in Ghana include FMD and Contagious Bovine Pleuropneumonia (CBPP). The occurrence of disease outbreaks of CBPP and FMD were widespread in both study districts. This is despite the availability of vaccination against FMD. It is surprising though that the losses suffered by the farmers to pasture shortages appear to be positively related to mental health with each loss. This may be possible if the farmers attribute losses to normal seasonality of the weather and may be expectant of better conditions during different times of the year.
The contrasting accounts given by the livestock farmers and veterinary officers alike on the reasons for the high prevalence of livestock diseases is worth exploring. While the livestock farmers complained of a delayed or absent response by the veterinary officers to requests for veterinary services, the veterinary officers on the other hand, while acknowledging staff challenges, report that the livestock farmers do not patronize preventive services, especially their vaccination services when organized. The lack of and/or poor uptake of veterinary services appears to be mostly financial in nature. As findings showed, the veterinary personnel often have to pre-finance the drugs and the consumables used in administering them. Thus, they often have to balance their quest to recuperate their investments with the livestock farmers’ need for veterinary services. These facts point to a lack of clearly defined roles and responsibilities for livestock farmers, veterinary officers and the government in the livestock production system. Farmers had taken up duties of veterinarians by administering drugs including intravenous medications, while veterinary officers have become private entrepreneurs in a public service sector. What is clear though is the insufficient level of veterinary services support to livestock farmers.
In addition, as qualitative findings revealed, most livestock farmers do not utilize vaccination services organized, but prefer treating the diseases instead. However, some farmers also report a lack of vaccines at veterinary offices when required. In the instances where vaccinations are organized, the veterinary officers operate with an expectation that farmers would pay them back. This arrangement is problematic, as it may result in neglect of farmers by veterinary officers who do not have adequate finances of their own, when the Ministry of Food and Agriculture fail to own this crucial aspect of veterinary service delivery. The inadequate number of veterinary personnel and other logistical constraints undermine the efforts of the ministry to improve livestock production.
Consequently, the livestock losses to animal diseases have been enormous with economic and health consequences. The livestock farmers in Ghana would benefit immensely from awareness campaigns on preventive services like vaccination of livestock, to reduce economic loss, grief from cattle losses and improve cattle productivity. A similar intervention study among smallholder cattle farmers in Cambodia showed incremental gains in cattle weights, improved farmer knowledge levels and had a positive impact on household income over time for smallholder farmers [
35]. While the economic influence of livestock losses in this study was evident, many of the livestock farmers have also developed a special bond with their livestock. Livestock rearing, therefore, is more than just a source of livelihood to the farmers. These findings are consistent with qualitative inquiries conducted in Maasai communities in Eastern Africa, in Australia and the Alps of Switzerland which found deep emotional bonds between livestock farmers and their cattle [
36‐
38]. This emotional attachment could emanate from the close contact the livestock farmers have with the cattle during milking, feeding, and cleaning of pens among others, which are practices similar to the earlier studies and this present one. The livestock farmers manifest their bond to cattle by talking to the cattle, giving names to cattle and caring for their furs. The emotional attachment to livestock tended to amplify the negative effect of loss on the mental health of farmers, as our findings revealed. The stronger bond of farmers with larger herds is surprising, but may explain why more farmers with large herds tend to seek veterinary care for their sick animals compared to those with smaller herds; apart from the obvious fact that farmers with larger herds are more likely to have resources to pay for veterinary services.
The state of mental health of livestock farmers in Ghana is worrying. While we found in this study that about two-thirds of livestock farmers had psychological problems, previous studies in Ghana showed a prevalence of psychological distress in less than one-third of the general population [
11]. This finding is similar to previous research by the International Labour Organization which identified agriculture as one of the most stressful occupations [
32]. The high levels of stress livestock farmers are confronted with from multiple adverse events they suffer could be contributory to the higher than normal prevalence of psychological problems among farmers compared to the general population. Additionally, the tendency of livestock farmers to live in areas isolated from human settlements in order to gain access to pasture as well as avoid confrontations with other land users, limit their access to health services that are not readily available in rural areas in developing countries. The Mental Health Authority in Ghana would be instrumental in devising strategies to make mental health services more accessible to farmers. The state of a farmers’ physical health also affected their mental health. The livestock farmers’ that reported some physical ill health were more likely to have psychological problems compared to those without physical ailments. Improved access to health services can therefore greatly influence the general health of livestock farmers.
Nevertheless, the ability of the livestock farmers to adapt easily to the lack of veterinary services by learning to treat diseases themselves and selling of diseased meat can be described as a resilience strategy. This is one of many other adaptive strategies of livestock farmers to adverse events found in other studies conducted in East Africa [
39,
40]. This presents an opportunity that can be harnessed by the appropriate government agencies as farmers show a willingness to do everything possible to keep their herd healthy. The timely provision of support services to farmers can therefore contribute to increased productivity and attaining food security and general growth and development. The recently launched program, “rearing for food and jobs”, by the Ministry of Food and Agriculture in Ghana, will come to nothing if the shortfalls in veterinary service delivery are left unaddressed.
More so, the arbitrary use of freely available veterinary drugs to treat diseases and the sale of diseased livestock for meat on the markets by livestock farmers, presents potential food safety concerns. The insufficient number of veterinary personnel would mean that not all meat presented at the markets would have been cleared to be wholesome for the consumption of the public. This is also a concern for the emergence of antimicrobial resistance (AMR) in retailed food. The identification of AMR bacteria including:
Campylobacter, Enterococcus, Salmonella, Escherichia coli, Listeria, and
Vibrio spp., in meat have been attributed to the indiscriminate use of veterinary drugs by farmers to treat animal diseases [
41‐
43]. Hence, the formulation of the AMR policy by the government of Ghana through the Ministries of Food and Agriculture, Health, and Environment, Science and Technology is commendable. The policy is very well formulated, but requires concerted efforts to implement the strategies outlined.
We have demonstrated how the health of humans, animals and the environment depend on each other. There is a need for sensitization campaigns for the key stakeholders in the livestock production system. These interventions can increase vaccination rates and availability of vaccines supplied by the government, and forestall the negative practices. It is also essential that an evaluation of the performance of veterinary services in Ghana is conducted. Considering the potential of transferring resistant bacterial strains from food to humans, there is need for an intensified surveillance by veterinary personnel at livestock markets and slaughter areas to reduce the sale of veterinary drugs and diseased meat. We propose a future study, which would assess for resistant pathogens and drug residues in retail livestock products and explore any links with resistant pathogens which are isolated from human patients presenting with foodborne illnesses in Ghana though the utilization of the One Health approach to explore ways of maximizing the benefits accruable from the implementation of these policies.
Our study revealed concerning findings, by showing the complexity of the challenges faced by livestock farmers in Ghana. Inadequate veterinary services support together with non-adoption of preventive measures such as vaccinations, increases the frequency of adverse events resulting in livestock loss, and poor mental health. The prevalence of psychological problems among farmers is higher than observed in the general population in Ghana. What is more alarming, the coping strategies employed by farmers include arbitrary drug use for treating animal diseases and the sale of unsafe meat at local markets. These findings raise concerns about the low quality of life of livestock farmers and threats to public health through high-risk meat entering the food chain.
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