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Our findings also show that the responses of the diverse actors to the reforms can be structured according to three dimensions of institutions (allocative, cognitive, and normative) that are inter-linked or explain further changes. For example, reductions in public funding and staff numbers led veterinary TOs to mark up the price of service provision (i.e. changes in allocative institutions induced further change). The breakdown of public-sector controls (change in normative institution) led to easy access to veterinary drugs on the open market. Such changes within the veterinary services domain, in turn, interacted with other institutional elements and forces outside the reforms. For example, farmers’ increased dependence on livestock to meet livelihood needs led many farmers to appropriate knowledge and skills for self-treatment (i.e. change in cognitive institutions). This widespread self-medication cannot be captured in public-sector reports; this contributes to non-observance of the international protocol for reporting livestock diseases (a normative issue). The institutional analysis of the responses to the reforms indicates the need to consider emergent cognitive and normative institutional changes that are triggered by changes in allocative institutions. As discussed, the reforms introduced changes primarily in formal allocative institutions. The analysis of the responses to these changes shows that they are not a one-off outcome of the reforms. Instead, they interact with a whole set of other institutional changes at national, district, and community levels. This suggests that policy-makers who implement change in one institutional dimension can expect the emergence of a new institutional setup that involves other institutional dimensions. Our findings reflect those of a number of studies – not only in veterinary services provision but also in other disciplines – showing that institutional elements interact in unforeseen ways, with unintended consequences for the outcomes of reforms (Gros 1994, Harrington et al. 2001, Munyua and Wabacha 2003). For example, integrated natural resources management research shows that there are inter-linkages among policies and institutions, farm-level practices, plant and animal growth, biophysical processes, and impacts and outcomes, with consequences for food security, poverty alleviation, and environmental protection (Harrington et al. 2001). Our study shows that changes in allocative institutions are inter-linked with changes in cognitive and normative (including regulative) institutions. These changes prompted both public- and private-sector actors to engage in practices that may have negative externalities and may under-mine the efficacy of disease management (following Liebenehm et al. 2011).
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