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The second important change in preventive vaccination relates to the organizational arrangements for the delivery of vaccination services. During the pre-reform period, annual mass vaccinations of livestock were administered by teams of veterinary technicians. In the post-reform period, vaccinations have been provided on an ad-hoc basis or in selected communities by indi-vidual TOs. Vaccination teams are now only mobilized when serious disease outbreaks occur in the districts and emergency disease control is required. TOs at community level have responded in diverse ways to the changes in procurement and organization of vaccination services. Six out of nine veterinary TOs in the study area only deliver vaccination services to progressive (rich) farmers or to a few communities that are ready to pay for animal healthcare interventions. Three out of nine TOs do not provide vaccinations at all. Interviews with farmers suggested that two of these three were absent from their post most of the time, using office hours to engage in personal affairs. The third TO explained that he does not undertake late vaccinations because the animals may be sick already and vaccination might contribute to livestock mortality. The changes are reflected in livestock mortalities in the communities. For example, Orbili, N. Tankyara, and Tangasie ranked high livestock mortality rates as a priority constraint, next to water shortage in the dry season. Mortality rates in 2010 were 63% among kids. Two changes in clinical services recurred in the interviews with most of the veterinary personnel: the cost of farm-gate clinical services and the treatment of ill animals by farmers themselves. Before the reforms, the allowances for fuel and maintenance allowed the TOs to use their motorbikes to attend to reported ill animals and conduct disease surveillance. Veterinary drugs were issued to the TOs from the district office store, and at the end of the month returns were submitted to the office. However, after the reforms, the allowances were often delayed and a quarter (three months) or more might pass before allowances were paid. Many TOs report that they have to buy drugs directly from the market rather than through the DVO, who often marks up the price. In addition to the mandated service charge for attending to ill animals, many TOs charge farmers for fuel because they do not receive the transport allowance in time.
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