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In the mid-1990s, the government encouraged and supported veterinary professionals to enter private practice. In 1997, there were two private veterinarians in Ghana (Staff list, VSD, 2012); in 2011, there were 18 (Diop et al. 2012). According to a VSD deputy director, private veterinarians were only able to establish in major cities such as Accra and Kumasi where they focused on pets (e.g. cats, dogs). The government also promoted a CAHWs’ scheme. CAHWs were selected by communities, trained in basic animal healthcare, and provided with starter kits by VSD. Between 1995 and 2000, 1007 CAHWs were trained nationwide (VSD records, Accra, 2012). They charged nominal fees for their work in their respective communities and were supervised by the TO and the district veterinary officer (DVO). The CAHW licences were renewed annually by VSD. The consensus among the veterinary personnel whom we interviewed was that the scheme worked for a few years and then broke down. Only one of our four study communities (Tabiasi) had an active CAHW. He told us that only few farmers consulted him because the majority had learnt to treat their animals themselves. Farmers in a second community (N. Tan-kyara) said that they had previously made use of their CAHW but that this person had stopped providing services. Another important factor that contributed to the collapse of the CAHW scheme was that, over time, the scheme lost the support of both veterinarians and para-veterinarians. A deputy director at VSD headquarters and a DVO (TO by rank) in the study area explained that the CAHWs were restricted to providing basic animal healthcare treatment but that many went beyond that and provided injections and even engaged in surgery. According to the deputy director, the VSD officers implied that they had begun to perceive CAHWs as competitors, and cooperation with them waned. However, in two communities in this study with records of CAHWs activities, the CAHWs did not perceive themselves as competing with the veterinary TOs. For example, at Tabiasi, the CAHW said that he always referred cases beyond his competence, e.g. vaccinations, post-mortems, to the TO, but that he had not been backstopped by the (new) TO since 2007. He concluded that TOs are not supervised and monitored so they do not deliver the services expected of them. Similarly, at Tankyara, the CAHW said the main reason he stopped practicing was that the TO with whom he used to work was transferred and the new TO discontinued the working relationship. Apparently, VSD staff may have undermined the scheme by withdrawing support even in instances where the CAHWs operated within their prescribed limits. Notes: TA, technical assistant; TO, technical officer; VSD, Veterinary Services Department; MoFA, Ministry of Food and Agr the most significant constraint inhibiting animal health services delivery in the post-reform period, as illustrated by the viewpoint of a non-veterinarian. A Regional Director who had been District Extension Officer and District Director before and after decentralization explained that there are issues [in veterinary services] that require use of money.
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