on African pilot study swine fever A surveillance in Corsica Applying participatory in the approaches evaluation of surveillancesystems: Preventive Veterinary Medicine

(1)

ContentslistsavailableatScienceDirect

Preventive

Veterinary

Medicine

jou rn al h om ep a g e :w w w . e l s e v i e r . c o m / l o c a t e / p r e v e t m e d

Applying

participatory

approaches

in

the

evaluation

of

surveillance

systems:

A

pilot

study

on

African

swine

fever

surveillance

in

Corsica

Clémentine

Calba

a,∗

_,

_Nicolas

_{Antoine-Moussiaux}

c

_,

_Franc¸

_ois

_Charrier

d

_,

_Pascal

_Hendrikx

e

_,

Claude

Saegerman

b

_,

_Marisa

_Peyre

a

_,

_Flavie

_L.

_Goutard

a

a_Centre_de_Coopération_{Internationale}_en_Recherche_Agronomique_Pour_le_{Développement}_(CIRAD),_Département_ES,_UPR_AGIRs,_TA_C22/E,_Campus

InternationaldeBaillarguet,34398MontpellierCedex5,France

b_Research_Unit_of_Epidemiology_and_Risk_Analysis_applied_to_Veterinary_Sciences_(UREAR-ULg),_Fundamental_and_Applied_Research_for_Animal_and_Health

(FARAH),FacultyofVeterinaryMedicine,UniversityofLiege,QuartierVallée2,AvenuedeCureghem,B-4000Liege,Belgium

c_Tropical_Veterinary_Institute,_Faculty_of_Veterinary_Medicine,_University_of_Liege,_Quartier_Vallée_2,_Avenue_de_Cureghem,_B-4000_Liege,_Belgium

d_Institut_National_de_la_Recherche_Agronomique_(INRA),_Laboratoire_de_Recherches_sur_le_{Développement}_de_Lélevage_(LRDE),_Quartier_Grosseti,_BP_8,

20250Corte,France

e_French_Agency_for_Food,_{Environmental}_and_Occupational_Health_Safety_(ANSES),₃₁_Avenue_Tony_Garnier,₆₉₃₉₄_Lyon_Cedex_07,_France

a

r

t

i

c

l

e

i

n

f

o

Articlehistory:

Received15January2015

Receivedinrevisedform

22September2015 Accepted1October2015 Keywords: Participatoryepidemiology Surveillance Evaluation Acceptability Non-monetarybeneﬁts Corsica

a

b

s

t

r

a

c

t

Theimplementationofregularandrelevantevaluationsofsurveillancesystemsiscriticalinimproving theireffectivenessandtheirrelevancewhilstlimitingtheircost.Thecomplexnatureofthesesystemsand thevariablecontextsinwhichtheyareimplementedcallforthedevelopmentofflexibleevaluationtools. Withinthisscope,participatorytoolshavebeendevelopedandimplementedfortheAfricanswinefever (ASF)surveillancesysteminCorsica(France).Theobjectivesofthispilotstudywere,firstly,toassessthe applicabilityofparticipatoryapproacheswithinadevelopedenvironmentinvolvingvarious stakehold-ersand,secondly,todefineandtestmethodsdevelopedtoassessevaluationattributes.Twoevaluation attributesweretargeted:theacceptabilityofthesurveillancesystemanditsthenon-monetary ben-efits.Individualsemi-structuredinterviewsandfocusgroupswereimplementedwithrepresentatives fromeverylevelofthesystem.Diagrammingandscoringtoolswereusedtoassessthedifferentelements thatcomposethedefinitionofacceptability.Acontingentvaluationmethod,associatedwithproportional piling,wasusedtoassessthenon-monetarybenefits,i.e.,thevalueofsanitaryinformation.Sixteen stake-holderswereinvolvedintheprocess,through3focusgroupsand8individualsemi-structuredinterviews. Stakeholderswereselectedaccordingtotheirroleinthesystemandtotheiravailability.Results high-lightedamoderateacceptabilityofthesystemforfarmersandhuntersandahighacceptabilityforother representatives(e.g.,privateveterinarians,locallaboratories).Outofthe5farmersinvolvedinassessing thenon-monetarybenefits,3wereinterestedinsanitaryinformationonASF.Thedatacollectedvia par-ticipatoryapproachesenablerelevantrecommendationstobemade,basedontheCorsicancontext,to improvethecurrentsurveillancesystem.

1. Introduction

Theregularandrelevantevaluationofsurveillancesystemsis

essentialtoestimatetheusefulness andthecorrect application

ofthedata generated,and toensurethatlimited resourcesare

∗ Correspondingauthor.

E-mailaddresses:[email protected](C.Calba),[email protected]

(N.Antoine-Moussiaux),[email protected](F.Charrier),

[email protected](P.Hendrikx),[email protected]

(C.Saegerman),[email protected](M.Peyre),ﬂ[email protected]

(F.L.Goutard).

usedeffectivelytoprovidetheevidencerequiredforprotecting

ani-malandhumanhealth(Hendrikxetal.,2011;Dreweetal.,2015).

AccordingtotheHealthSystemsStrengtheningGlossarydeveloped

bytheWorldHealthOrganisation(WHO),evaluationrefersto‘the

systematicandobjectiveassessmentoftherelevance,adequacy,

progress,efﬁciency,effectivenessandimpactofacourseofactions,

inrelationtoobjectivesandtakingintoaccounttheresourcesand

facilities that have beendeployed’ (WHO,undated). Applied to

surveillance,thisincludestheassessmentofaseriesofevaluation

attributessuchassensitivity,acceptabilityandtimeliness,using

qualitative,semi-quantitativeorquantitativemethodsandtools

(Dreweetal.,2012).Thecomplexityofsurveillancesystems,and

http://dx.doi.org/10.1016/j.prevetmed.2015.10.001

(2)

thevariablecontextinwhichtheyareimplemented,entailtheneed

forﬂexibleevaluationtoolsdesignedtotakeintoaccountthe

opin-ionofeachstakeholder.Thiscanbeachievedbyusingﬂexibleand

adaptablemethodsbasedonparticipatoryapproacheswithinthe

evaluationprocess.

Participatoryapproachesrefertoarangeofmethodsandtools

thatenablestakeholders,toa variableextent,toplay anactive

roleinthedeﬁnitionandintheanalysisoftheproblemstheymay

encounter,andintheirsolution(Pretty,1995;Prettyetal.,1995;

Johnsonetal.,2004;Marineretal.,2011;Peyreetal.,2014).Indeed,

theuse of visualizationtools through participatoryapproaches

leadstoopendiscussionbetween stakeholdersand encourages

awide participation(Bradleyetal.,2002).Bytaking

stakehold-ers’perceptions,needsandexpectationsintoconsideration,these

approachescouldhelpustoachieveabetterunderstandingofthe

system(Hoischen-Taubneret al.,2014).Thesemethodsmake it

possibletocapturelocking pointsin thesystem, suchas

com-municationand coordination between stakeholders, which can

gounnoticed when using classical evaluation tools. Theuse of

thesetoolsshouldgiverisetorealisticandcontext-adapted

rec-ommendations.More importantly,thesetoolslead toenhanced

acceptabilityoftheevaluation,toanimprovedfeelingof

belong-ingtothesystem,andtoevenownershipoftheevaluationoutputs

(Pahl-Wostl,2002).

Factorsusedtoassessthequalityof systemimplementation

(e.g.,acceptability, communication),or the non-monetarycosts

andbeneﬁts ofsurveillance,are rarelyconsidereddespitetheir

importancefordecisionmakersandtheirimpactonsystem

perfor-mance(Calbaetal.,2015;Peyreetal.,2014).Acceptabilityrefers

tothewillingnessofpersonsandorganizationstoparticipatein

thesurveillancesystem,andtothedegreetowhicheachofthese

usersisinvolvedinthesurveillance(Hoinvilleetal.,2013);ithas

beenlistedbytheCentersforDiseaseControlandPrevention(CDC)

asoneofthemainqualitiesofsurveillance(Germanetal.,2001).

Thedecisiontoreportasuspectedeventisacriticalfunctionofan

emerginginfectiousdiseasesurveillancesystem(Tsaietal.,2009).

Inordertolimittheunder-reportingofsuspectedcasesandto

iden-tifythebestwaystoimprovethecurrentsurveillancesystem,itis

crucialtoassessthestakeholders’willingnesstoparticipateinthis

system(Bronneretal.,2014).Non-monetarybeneﬁtsrefertothe

positivedirectandindirectconsequencesproducedbythe

surveil-lancesystemandhelptoassesswhetherusersaresatisﬁedthat

theirrequirementshave beenmet(deﬁnitiondeveloped bythe

RISKSUR1_Consortium)._The_objective_of_this_work_was_to_develop

methodsandtoolsbasedonsociology,economicsandparticipatory

approachestoassesstheacceptabilityofanimalhealthsurveillance

systemsandtheirnon-monetarybeneﬁtsthroughanestimationof

theperceivedeconomicvalueofsanitaryinformation.

ApilotstudywasimplementedinCorsicainordertotestthe

applicabilityofthesemethodsandtoolsinadevelopedcontext.

ThecaseofAfricanswinefever(ASF)surveillanceinCorsicawas

chosenfortwomainreasons.Firstly,currentfarmingpracticesare

mainlybasedonatraditionalforest-pastoralsystem(outdoor

free-rangebreeding)(Casabiancaetal.,1989),andonlyasmallnumber

ofruralprivateveterinariansworkontheisland(personal

com-munication,OscarMaestrini,INRA).Secondly, Corsicanbreeding

systemsarethreatenedbytheendemicpresenceofASFinSardinia;

thisquestionsthecurrentsurveillancesystemfacedwithincreased

riskofintroduction,spreadandmaintenanceofASFthrough

Cor-sica(Desvauxetal.,2014;EuropeanCommission,2011;Muretal., 2014a).Indeed,ASFhasbeenrecognizedtobeamongthemost

dev-astatingofpigdiseaseswithseveresocio-economicconsequences

1 _Risk-based_animal_health_surveillance_systems,_EU_project₍_{www.fp7-risksur.}

eu).

Fig.1. GraphicalrepresentationoftheAfricanswinefever(ASF)surveillancesystem

inCorsica(France).

(Moennig,2000;Costardetal.,2013;Torreetal.,2013;Muretal., 2014b).

Originally,thesurveillancesystemtargetedbothASFand

Clas-sical swinefever(CSF)but, duetotheincreasing threat,public

authorities decidedtoredirectsurveillancetotarget principally

ASF.Theobjectiveofthissystemistoensuretheearlydetection

ofbothdiseasesbyusingapassivesurveillanceapproachbased

onclinicalﬁndingswithintheentirepopulationofdomesticpigs

andwildboars.Thesystemthusreliesonthewillingnessof

stake-holderstoreportsuspicions,particularlygiventhefactthatitis

impossibletoregularlyassessthehealthofeachanimal(Sawford,

2011).

2. Materialandmethods

2.1. Descriptionofthesurveillancesystemandtargetpopulation

Our ﬁrst approach consisted of identifying stakeholders

involvedinthesurveillancesystem.Thesewerethendividedinto

threelevels(Fig.1).Level1includedfarmersandhunters,whoare

onthefrontlineofpassivesurveillance.Intheeventofasuspected

caseofASFinfarmanimals,oramongthewildanimalpopulation,

theyaresupposedtocontactthenextlevelinthesurveillance

net-work(level2)whichcanbecomposedofprivateveterinarians,of

“GroupementsdeDéfenseSanitaire”animalhealthgroups(GDS,

associationoffarmers addressinghealth issues,ofﬁcially

recog-nizedbyFrenchlaw(Bronneretal.,2014)),oflocallaboratories,or

ofwildlifeorganizations(hunters’federations,forexample).Any

suspicionsmustbedeclaredtotheVeterinaryServices,atlocal,

regional,andnationallevels.Thesestakeholdersrepresentthethird

levelinthesurveillancesystem(level3).Theyareindirect

con-tactwiththeauthoritiesinchargeofanimalhealthsurveillance

coordination,theDirectorateGeneralforFood(DGAL),which is

supervisedbytheFrenchMinistryofAgriculture,Agribusinessand

(3)

Participantswerethusselectedaccordingtotheirroleinthe

surveillance system (i.e., according to the level to which they

belonged),andalsoaccordingtotheiravailabilityandwillingness

toparticipate.UsingacontactlistprovidedbytheNational

Insti-tuteforAgriculturalResearch(INRA),stakeholderswereidentiﬁed

andindividuallycontactedbyphone.

Participantswereinterviewedusingfocusgroupsorindividual

semi-structuredinterviews.Focusgroupsaredesignedtoexpose

a groupof peopletocommonstimuli (Pahl-Wostl,2002).They

areparticularlyimportantinassessingcomplexissuesthroughthe

analysisofsocialprocessesanddiscussions(Pahl-Wostl,2002).The

datacollectionprocessreliedoninterviewingrepresentativesat

everylevelofthesurveillancesystem.Indeed,itiscommonin

qual-itativeapproachestorelyon‘purposivesampling’tomaximizethe

diversityofthedatacollected(i.e.,perceptionsandpointofviews)

(GlaserandStrauss,1967;CorbinandStrauss,1990).Thequalityof

thesampleisthereforeconsideredtobemoreimportantthanthe

samplesizeinsuchapproaches(CôteandTurgeon,2002).Another

objectivewastoreachtheoreticalsaturationwhichhasbecomethe

goldstandardforhealthscienceresearch(Guestetal.,2006)and

whichreferstothepointatwhichnonewinformationisobserved

inthedata(Guestetal.,2006).

Theintentionwastoimplementfocusgroupswith(i)ten

farm-ers(2groupsof5participants),and(ii)5hunters(onegroup)for

level1;(iii)5privateveterinarians(onegroup),and(iv)3GDS

tech-nicians(onegroup)forlevel2.Forotherstakeholders,theintention

wastoimplementindividualsemi-structuredinterviews:with

rep-resentativesfromeachlocallaboratory(twoinCorsica),andone

representativeofawildlifeorganizationforlevel2;two

representa-tivesofVeterinaryServicesatthelocallevel,andoneattheregional

levelforlevel3.

InterviewswereconductedbetweenApril andJune 2014by

ateamof2–3evaluators:onewasinchargeofleadingthe

dis-cussion,andtheotherswereresponsibleforobservingparticipant

behaviorandtakingnotes.Alloftheinterviewswererecordedwith

theparticipantsconsentandweresubsequentlytranscribedinto

textformatusingMicrosoftWordsoftware(MicrosoftOfﬁce2010,

Redmond,WA98052-7329,USA).

3. Assessmentofacceptability

Acceptabilityisrelevanttodifferentaspectsofthesurveillance

system.Itﬁrstreferstotheactors’acceptanceofthesystem’s

objec-tivesandofthewayitisoperates.Theacceptanceofthewaythe

systemoperatesrefersto(i)theroleofeachactorandthe

rep-resentationoftheirownutility,(ii)theconsequencesoftheﬂow

ofinformationforeachactor(i.e.,changesintheiractivityandin

theirrelationsfollowingasuspicion),(iii)theperceptionbyeach

actoroftheimportanceandrecognitionoftheirownrolerelative

tothatofotheractors,and(iv)therelationsbetween

stakehold-ers.Trustisanotheressentialelementofacceptability;trustinthe

systemandalsotrustinotherstakeholdersinvolvedinthesystem.

Theseelementswereassessedusingacombinationof

participa-torydiagramingandscoringtools,bothofwhichweredeveloped

for,andadaptedto,thisspeciﬁccontext.Threemaintoolswere

implemented:(i)relationaldiagrams,(ii)ﬂow diagrams

(associ-atedwithproportionalpiling),and(iii)impactdiagrams(associated

withproportionalpiling).Thesetoolswereimplementedwithall

participants,either through focus groups orthrough individual

semi-structuredinterviews.

3.1. Relationaldiagrams

Relationaldiagramsweredevelopedandusedtoidentify

pro-fessional networks and interactions among stakeholders. The

participants’statusororganizationwasplaced inthemiddleof

aﬂipchart.Facilitatorsthenaskedthemtolistthestakeholders

andorganizationswithwhichtheyinteractedandtodescribethese

interactions(i.e.,frequencyandreciprocity).

3.1.1. Flowdiagramsandproportionalpiling

Flowdiagramsweredevelopedandusedtoassessthe

partici-pants’knowledgeoftheinformationﬂowinthecaseofsuspected

ASFandtoidentifyhowtheinformationcirculated.Thediagrams

weredevelopedbeginningwitharepresentationoflevel1

stake-holders(i.e.,farmersorhunters)forwhomparticipantswereasked

toshow thecustomaryﬂow of information within thesystem,

i.e.,towhichstakeholder,ororganization,thesuspicionwouldbe

reported.Oncetheparticipantsconsideredthediagramtobe

com-plete,proportionalpilingwasperformedtoquantifythelevelof

trusttheyhadinthesystem(providingapercentage)andinthe

otherstakeholdersinvolved.Thistechniqueallowedparticipants

togiverelativescorestoanumberofdifferentitemsorcategories

accordingtoonecriterion (Hendrickx etal.,2011).Themethod

wasbasedonvisualization,butresultswererecordednumerically

(Catleyetal.,2012).Facilitatorsaskedtheparticipantstodivide

100countersintotwoparts,onerepresentingtheirconﬁdencein

thesystemandtheirlackofconﬁdence.Thecountersallocatedto

conﬁdencewerethenusedtospecifythelevelofconﬁdenceinthe

actorsandorganizationsrepresentedinthediagram.

3.1.2. Impactdiagramsandproportionalpiling

Impactdiagrams,adaptedtoassessbothpositiveandnegative

impacts of a speciﬁc event,are useful todocument the

conse-quences as experienced directlyand indirectly bystakeholders

(KariukiandNjuki,2013).Inthispilotstudy,thespeciﬁceventwas

asuspicionofASFinCorsica.Facilitatorsaskedtheparticipantsto

listandexplainthepositiveandnegativeimpactsofasuspicionin

theirownwork,organizationandrelations.Proportionalpilingwas

thenimplementedonthediagrambyﬁrstdividingthe100counters

betweenpositiveandnegativeimpactsaccordingtotheirweights,

andthenbysplittingthecountersacrosstheidentiﬁedimpactsto

assesstheirprobabilityofoccurrence.

4. OASISﬂashevaluation

OASIS is a standardized semi-quantitative assessment tool

whichwasdevelopedfortheassessmentofzoonoticandanimal

diseasesurveillancesystems(Hendrikxetal.,2011).Thistoolis

basedonadetailedquestionnaireusedtocollectinformationto

describetheoperationofthesystemunderevaluation.The

infor-mationcollectedissynthesizedaccordingalistofcriteria(78in

total),forwhichparticipantsprovidescores(from0to3)following

ascoringguide.

TherearetwowaysofimplementinganOASISevaluation.One

wayistocompletethequestionnairedirectlywithstakeholders

throughinterviews;anotherway(‘OASISﬂash’)istocompletethe

questionnairebasedontheavailabledocumentation.Duetotime

constraints,itwasdecidedtoimplementanOASISﬂashevaluation.

5. Assessmentofnon-monetarybeneﬁts

The economic value of sanitary information was assessed

throughacontingentvaluationmethod(CVM)usingproportional

pilingandwasimplementedthroughindividualsemi-structured

interviewswithfarmers.Thismethodhasbeenusedbyeconomists

tovaluechanges innatural resourcesandenvironments,and it

is somewhatsimilartomethods usedin marketing toevaluate

newconceptsforgoodsandproducts(Louviereetal.,2003).Ithas

(4)

surveil-lanceinSouthEastAsia(Delabougliseetal.,2015).Thismethod

consistsofdirectinterviewsduringwhichfacilitatorsask

individu-alswhattheywouldbewillingtopayforachange(Louviereetal.,

2003);inthepresentstudy,theywereaskedwhattheywouldbe

willingtopayforsanitaryinformationrelatedtoASF.

AspresentedinFig.2,theﬁrststepoftheprocesswasforfarmers

toidentifyandtodrawupalistofthemainexpenditureitemsfor

theirfarms.Facilitatorsaskedthemtogiveanaveragecostofthese

expendituresforoneyear.Proportionalpilingwasthenusedfor

theseexpendituresinordertorepresenttheircostswith100

coun-ters.ThesecondstepwastohighlightwhichinformationonASF

wasofinteresttotheinterviewee:whichtypeofsanitary

infor-mationandatwhich geographicallevel(e.g.,village,commune,

region).Thisinformationwasthenaddedtothelistof

expendi-tures;thefacilitatoraskedparticipantstodividethecountersused

fortheﬁrststepsoastorepresenttheirinterestinthisinformation

andthentoexplaintheirchoice.

6. Dataanalysis

6.1. Assessmentofacceptability

Eachelementofacceptability wasassessed byanalyzingthe

picturesof thediagramsand alsobyusing thetranscribed

dis-cussions asstated inTable 1.The discussionswere transcribed

usingMicrosoft Wordsoftware. The acceptability of the

objec-tiveofthesurveillancesystemwasassessedusingthequalitative

datacollectedduringtheelaborationoftheimpactdiagrams(i.e.,

discussions).The acceptability of theway thesystem operated

wasassessed using all three diagrams (relation diagrams, ﬂow

diagrams,andimpactdiagrams)andusingthequalitativedata

col-lectedwhilsttheywerebeingdrawn(Table1).Thetrustinthe

systemasawholeandinotherstakeholderswasanalyzedonthe

basisoftheproportionalpilingimplementedonﬂowdiagrams,and

byanalyzingthequalitativedatacollectedduringthe

implemen-tation.

Followingthisﬁrstanalysis,andinordertobeabletocompare

resultsobtainedforeachlevel,qualitativedatawereconvertedinto

semi-quantitativedata.Thus,evaluationcriteriaweredeveloped

foreachelement.Eachcriterionwasassignedascoreasfollows:

low(−1),medium(0),orhigh(+1).Thisscalefrom−1to+1was

selectedinordertofacilitatetherepresentationoftheresults,using

0asacentralvalue.

Theﬁrststepoftheanalysiswasimplementedattheinterview

level(i.e.,focusgrouporindividualsemi-structuredinterview)and

thescoresobtainedwereusedtocalculatethearithmeticmeanfor

eachlevelusingMicrosoftExcelsoftware(MicrosoftOfﬁce2010,

Redmond,WA98052-7329,USA).Accordingtothemeanvalue,

theacceptabilityofeach elementwasdeﬁned, ateach level,as

low(₋₁to_−0.33),medium(_−0.32to+0.33),orhigh(+0.34to+1).

Theseintervalswerechosenwiththeobjectiveofdividingthetotal

distributionspaceintothreeequalparts.

6.2. Assessmentofnon-monetarybeneﬁts

Farmerswereaskedtoprovidealistofthemainexpenditures

withtheirassociatedcostsrepresentingtheirproductioncostsin

thefarmforthelastyear.Proportionalpilingwasimplementedon

expendituresandtheeconomicvalueofeachcounterwas

calcu-lated.Thisvaluewasthenusedtoestimatetheeconomicvalueof

sanitaryinformationandthewillingnessofparticipantstopayfor

it.

6.3. ComparisonwiththeOASISﬂashevaluation

Sevenstakeholderswereinvitedtojointhescoringprocess:four

representativesoftheVeterinaryServices(onefromthelocallevel,

onefromthenationallevelandtwofromtheregionallevel),one

representativeoftheanimalhealthassociation,onerepresentative

ofthelocallaboratoryandoneprivateveterinarian.

Theassessmentofacceptabilitywasbasedon20criteria

accord-ingtotheOASISﬂashmethod,whichcanbegroupedinto8main

categories:theorganizationofthesurveillancesystem(e.g.,

exis-tenceofacharter),itsanimation(e.g.,meetingsfrequencies),and

organization(e.g.,integrationoflaboratoriesinthesystem),the

human and material resources, feedback to stakeholders,

con-sequences of a suspicion, training provided, partnerships and

stakeholdersensitization.

7. Results

7.1. Demographicsoftheinterviews

Atotal of16 actorswereincluded,ofwhich3 werewomen

and 13 were men. Eight stakeholders were involved through

focusgroups,and8throughindividualsemi-structuredinterviews

(Table3).Threefocusgroupswereheld:onewith3farmers,one

with3 representativesoftheGDS (including one woman),and

anotheronewithtworepresentativesoftheVeterinaryServicesat

theregionallevel(includingonewoman).Eightindividual

semi-structured interviewswere implemented: 2 farmers/hunters, 3

hunters,oneprivateveterinarian,onerepresentativeofthelocal

laboratory,andonerepresentativeofthelocalVeterinaryServices

(woman).Focusgroupslasted between2and3hwhile

individ-ualsemi-structuredinterviewslasted2honaverage.Inaddition,a

totalof5individualsemi-structuredinterviewstargetingthe

non-monetarybeneﬁtswereimplementedwithfarmers(men),each

lasting1h.

7.2. Acceptability

7.2.1. Implementationofthetools

Relationaldiagramswereeasilyimplementedwithmost

stake-holders,andweremostlywell-understood.Thistoolwasagood

waytointroducetheprocess.It allowedparticipantstodiscuss

their work and the relations they have with other

stakehold-ers.Theimplementationofthistoolwasmorecomplicatedwith

‘isolated’ participants(some hunters and farmers) due to their

poor/inexistentprofessionalnetwork.

Flowdiagramsallowedthecollectionofinformationrelativeto

participants’knowledgeaboutthesystemandtheidentiﬁcation

oftheformaland informal pathwaysfor transmissionof

suspi-cioninformationwithinthesystem.Theimplementationofﬂow

diagramswasalsomoredifﬁcultwith‘isolated’participants.The

implementationofproportionalpiling wasinitially complexfor

participantstounderstandbutallofthemgainedaclear

under-standingoftheapproach.Moreover,participantsspontaneously

explainedtheirchoicesinthenumberofcountersallocatedtoeach

stakeholderduringthecourseoftheactivities.Nonetheless,this

toolcouldnotbeimplementedduringthefarmers’focusgroup.

Indeed,theywerereluctantto‘evaluate’theidentiﬁedstakeholders

throughtheproportionalpiling.

Impactdiagramswereproblematic,andnoteasilyunderstood

byparticipants.Theyhadtroubleidentifyingpositiveimpacts

fol-lowingasuspicion,mostlyduetothefactthattheywerefocusing

moreonoutbreaksratherthanonsuspectedcases.Regardingthe

proportionalpilingimplementedonthesediagrams,theﬁrststep

(5)

Fig.2. Contingencyvaluationmethodassociatedwithproportionalpilingtoassesstheeconomicvalueoftheinformationofinterest.1ststep—proportionalpilingwas

implementedonexpendituresandtheeconomicvalueofeachcounterwascalculated.2ndstep—theparticipantswereaskedtorepresenttheirwillingnesstopayfor

sanitaryinformationbytackingcountersfromthealreadylistedexpendituresitemstoacirclerepresentinginformation.

Table1

Participatorymethodsandtoolsusedtoassesstheacceptabilityofanimalhealthsurveillancesystems.

Acceptabilityelements Associatedquestions Associatedparticipatorymethodsand

tools

Objective Istheobjective(s)ofthesurveillance

systeminthelinewiththe stakeholders’expectedobjective(s)?

Impactdiagram

Operation – –

Roleofeachactorandrepresentationofitsownutility Arestakeholderssatisﬁedwiththeir duty?

Flowdiagram Consequencesofinformationﬂow Arestakeholderssatisﬁedwiththe

consequencesofinformationﬂow?

Impactdiagramassociatedwith proportionalpiling

Perceptionbyeachactorofitsownrolerelativetootheractors’ Whatistheperceptionofeachactorof itsownrolerelativetootheractors’?

Flowdiagram

Relationsbetweenstakeholders Arestakeholderssatisﬁedwiththe

relationstheyhavewithother stakeholders?

Relationaldiagram

Trust –

Inthesystem Dostakeholderstrustthesystemto

fulﬁlitssurveillanceobjective(s)?

Flowdiagramassociated withproportionalpiling Inotherstakeholdersinvolvedinthesystem Dostakeholderstrusttheother

stakeholderstofulﬁltheirroleinthe system?

Flowdiagramassociated withproportionalpiling

negativeimpacts)waseasilyimplemented;whereas thesecond step(i.e.,dividingthecountersbetweenthedifferentidentiﬁed impacts)wasmore confusingforsomeparticipantsand it took moretimeforthemtounderstandtheprocess.

7.2.2. Scoringcriteria

Basedontheanalysisofthequalitativedatagatheredduring thediscussions,andtheanalysisofthediagramsandproportional piling,scoringcriteriaforeachelementofacceptabilitywere devel-oped(Table2).

Informationprovidedbyrelationaldiagramswasconvertedinto

quantitativedata.Tomeasurethefrequencylevel,eacharrowwas

associatedtoanumericalvalue:0forveryrare,2forrare,4for

regularand6forverycommon(Table2).Thesameprocesswas

implementedforreciprocity:0whentherewasnorelation,2when

itwasone-sidedand4whentherelationwasmutual(Table2).

Nonetheless,‘theperceptionbyeachactoroftheimportance

andrecognitionoftheirownrolerelativetootheractors’couldnot

beassessedusingthecollecteddataduetothefactthatthiselement

didnotappearspontaneouslyinasufﬁcientnumberofinterviews.

Thereforeithasbeenleftoutfromthepresentanalysis.

7.2.3. Participatoryassessment

Elementsofacceptabilitywerescoredaccordingtothecriteria

developed.TheseresultsaresummarizedinFig.3.

Theacceptabilityoftheobjectiveofthesurveillancesystemwas

consideredasmediumforlevel1(0.2)andforlevel2(0.33)(Fig.3).

Itwashighforlevel3(1)(Fig.3).Accordingtoparticipants,

pas-sivesurveillanceseemedinsufﬁcienttoreachtheobjectiveofearly

detection.Theystatedthatoncethediseaseisactuallydetectedin

pigsitisalreadytoolatetoprotectpigpopulationsfrominfection.

Consequently,theintroductionofthediseasemustbeavoidedand

harbor surveillanceandawareness campaignstargeting tourists

shouldbereinforced.

Mostlevel1participants(6/8)understoodtheirroleinthe

sys-temandacceptedit,includingthereportingofanyASFsuspicion.

Thereforetheacceptabilityoftheirroleandutilitywashigh(0.4)

(Fig.3).Theconsequencesoftheinformationﬂowseemedtoyield

alow levelofacceptability(−0.6)(Fig.3), butdifferedbetween

farmersandhunters.Thethreehuntersdidnotidentifyany

conse-quencesfollowingasuspicionduetothefactthattheyhadnever

experiencedanASFepidemic.For allfarmers,theconsequences

(6)

Table2

Criteriadevelopedtoprovidescoresandlevelstotheelementsofanimalhealthsurveillancesystemsacceptability.

Acceptabilityelements Criteria Associatedscores

Objective Participantsdidnotidentifyanyobjective,ortheyidentiﬁed objectivesthatdidnotcorrespondtotheobjectiveofthe surveillancesystem

Weak −1

Theidentiﬁedobjectivewaspartiallycorrespondingtotheone ofthesystem

Medium 0

Theidentiﬁedobjectiveexactlycorrespondedtotheobjective ofthesystem

Good +1

Operation

Roleofeachactorandrepresentationofits ownutility

Participantsidentiﬁedonlynegativepointsrelativetotheir ownroleandutility

Weak −1

Therewasabalancebetweennegativeandpositivepoints Medium 0

Mostlypositivepointscameout Good +1

Consequencesofinformationﬂow Themajorityoftheconsequencesidentiﬁedwerenegative,or theweightofnegativeconsequenceswasmuchhigherthan theoneofthepositiveconsequences

Weak −1

Therewasabalancebetweenthepositiveandnegative impacts,ortherewasabalancebetweentheweightofpositive andnegativesimpacts

Medium 0

Mostlypositiveconsequenceswereidentiﬁed,orwhentheir weightwasmuchhigherthantheoneofnegativeimpacts

Good +1

Perceptionbyeachactorofitsownrole relativetootheractors’

Nocriteria – –

Relationsbetweenstakeholders Frequency+reciprocity

[0;3] Weak −1

[4;7] Medium 0

[8;10] Good +1

Trustinthesystem Numberofcountersallocatedforthetrustinthesystem

[0;33] Weak −1

[34;66] Medium 0

[67;100] Good +1

implementedonthefarm(i.e.,animalshavetobepenned), lead-ingtoincreasedfeedcosts.Inaddition,anddespitethefactthat ASFisnotazoonoticdisease,consumerconﬁdenceintheproduct couldbeaffected,causing damagethroughouttheentiresector. However,respondentsanticipated thatif therewasa suspicion ofASFinCorsica,farmerswouldfacetheproblemtogether;this wouldprobably giveriseto collectiveeffortsand contributeto improvingthesector’sorganization.Satisfactionregardingthe rela-tionsbetweenstakeholderswasmedium(-0.2)(Fig.3).Allfarmers

feltisolatedand‘completelyabandoned’byanimalhealthservices

(by private veterinarians, GDS and Veterinary Services).

Farm-erscommentedthat ‘contactswiththeveterinariancorrespond

tominimumrequirements’,2_stating_more_than_once,_and_ﬁnding

regrettable,that‘90%oftheinformationcamefromfarmers’.2_Most

ofthehunters(four outof theﬁve interviewees,includingtwo

farmers/hunters)hadaverypoornetwork,theirsolerelationsbeing

withotherhunters.

Level2 participantswerenotcompletelysatisﬁedwiththeir

role,theacceptabilityofthiselementwasthereforemedium(0)

(Fig.3).Theprivateveterinarianhighlightedthefactsthatinthe

caseofanASFsuspicion‘itisimpossibletocomplywithsafety

stan-dardsimposedbyemergencyplans’.3 _The_local_laboratory_stated

that ‘the perception of each other’s roles in the systemis not

clear’.4_GDS_technicians_described_the_{difﬁculties}_of_being_a

moder-atorbetweenVeterinaryServicesandfarmers.Theconsequences

ofinformation ﬂow wereconsidered tobeof low acceptability

(−1)(Fig.3).Level2participantshighlightedthatanASF

suspi-cionwouldcauseanincreaseanddisorganizationoftheirworkload,

leadingtoadecreaseinthesurveillanceofotherdiseases,evenif

2 _Focus_group_with_farmers,_28th_May_2014.

3 _Individual_{semi-structured}_interview_with_a_private_{veterinarian,}_6th_June_2014.

4 _Individual_{semi-structured}_interview_with_a_local_laboratory,_3th_June_2014.

itcouldspuranincreaseincontactandcollaboration.The

satisfac-tionoftherelationsbetweenstakeholderswaslow(_−0.3)(Fig.3).

Nonetheless,boththeprivateveterinarianandtheGDStechnicians

complainedabouttherelationswiththeVeterinaryServicesatlocal

level.TheystatedthattheVeterinaryServicesdidnotalways

pro-videtherequiredinformation.However,theyhighlightedthatthis

wasmostlyduetohumanconstraints.Althoughtheywereaware

ofthepotentiallyimportantroleofwildlifeinthespread ofthe

disease,theycomplainedaboutthelackofcollaborationbetween

wildlifeandanimalhealthsectors.

Alllevel3participantsagreedonahighacceptabilityoftheir

roleandutilityinthesystem(1)andexpressedmedium

accept-abilityfortheconsequencesofinformationﬂow(0)(Fig.3).They

Table3

Demographicsoftheinterviewsimplementedfortheparticipatoryapproachesand

fortheOASISﬂashevaluationtoolinthescopeoftheassessmentoftheAfrican

swinefever(ASF)surveillancesystemacceptabilityinCorsica.

Evaluation process

Participants Number Interviewtype

OASIS VS—Nationallevel 1 Expertopinion

VS—Regionallevel 1 VS—Locallevel 1 GDS 1 Total 4 Participatory approaches

Farmers 3 Focusgroupsdiscussion

Farmers/hunters 2 Individualinterview

Hunters 3 Individualinterview

Privateveterinarian 1 Individualinterview

GDS 3 Focusgroupsdiscussion

Laboratory 1 Individualinterview VS—Locallevel 1 Individualinterview VS—Regionallevel 2 Focusgroupsdiscussion

(7)

Fig.3. GraphicalrepresentationoftheacceptabilityoftheAfricanswinefever(ASF)surveillancesysteminCorsica.Level1—farmersandhunters;level2—privateveterinarians, animalhealthgroupsandlocallaboratories;level3—veterinaryservices(locallevelandregionallevel).

statedthatasuspicion‘couldresultinfeedbackwhichwouldallow thesystemtobetestedandraiseawarenessamongstakeholders’5_;

andcouldincrease contactandcollaborationbetween

organiza-tions.Nonetheless,theystatedthatasuspicionwouldalsocause

anincreaseanddisorganizationoftheirworkload.Thesatisfaction

oftherelationsbetweenstakeholderswasmedium(0)(Fig.3).Also,

therewasacertainlackofdirectcontactwithlevel1.

Thetrustoflevel1participantsinthesystemwaslow(−0.7)

(Fig.3)andrangedfrom15to56%.Onehunterstatedthat

‘peo-plewilllistenifthere isa problem,but Iamnotsurethatany

actionwillbetaken’.6_The_two_other_hunters_involved_knew

noth-ingaboutthewayinwhichthesystemwasorganizedandoperated,

thus theycouldnot draw theﬂow diagram. Theother

partici-pantsshowedsomehesitationindrawingthesurveillancesystem

scheme.Thetimetakentodo theexerciseandholdtherelative

discussionsshowedthattheseactorswerenotveryfamiliarwith

thesystembeyondtheirfarmenvironment.Fourfarmersdidnot

completelytrustotherfarmers because‘someofthemwillhide

it[suspicion],atleastinitially’7_;_and_did_not_trust_Veterinary

Ser-vicesatthelocallevelbecauseofbudgetconstraints,andatthe

nationallevelbecause‘forthemCorsicaisjustadropintheocean

comparedtoFranceasawhole’.Twofarmers/huntersdidnot

com-pletelytrusthunterseitherbecauseoftheirlackofawareness,and

didnottrustwildlifeorganizationsbecauserelationsbetweenthem

wereminimal.

Forlevel2,thetrustallocatedtothesystemasawholewas

medium(0)(Fig.3),about37%.Allparticipantsagreedthatthere

wereproblemswiththelocallaboratoriesduetobudgetaryand

humanconstraints,andtothedifﬁcultiesinsendingsamplesto

mainlandFrance.GDSrepresentativesstatedthattheydidnottrust

allprivateveterinariansbecause‘they arenotinterested inthe

pigsector’.8 _Even_the_private_veterinarian_highlighted_that_most

ofthemhadneverexperiencedASFintheﬁeld,andcouldmissa

suspicioncaseastheymightnotsuspectthisdisease.Theyagreed

that‘thecriticalpointisthefarmers’,because‘theywillcallatthe

lastmoment[incaseofsuspicion],theywilleventendtohideit’.

Forlevel3,thetrustallocatedtotheentiresystemwasmedium

(0)(Fig.3),about40%.Again,locallaboratorieswereidentiﬁedasa

criticalpointinthesystem,duetothesamereasonsstatedbylevel2

5_Individual_{semi-structured}_interview_with_Veterinary_Services_at_the_local_level,

12thJune2014.

6_Individual_{semi-structured}_interview_with_a_hunter,_4th_June_2014.

7_Focus_group_with_farmers,_28th_May_2014.

8_Focus_group_with_GDS_{representatives,}_23th_May_2014.

participants.VeterinaryServicesrepresentativeshadalackoftrust

regardingfarmers,especiallyduetothespeciﬁcitiesofthe

dom-inantfarming system(free-ranging). Indeed,as onerespondent

highlighted,farmersdonotseetheiranimalseverydayandcan

thereforetakesometimetonoticethatsomeanimalsaremissing.

7.2.4. OASISﬂashassessment

Atotaloffourstakeholdersjoinedthescoringprocess:three

representativesfromtheVeterinaryServices(onefromeachlocal,

nationalandregionallevel),andonerepresentativeoftheanimal

health association (Table 3).Results from this evaluation

high-lighteda moderateacceptabilitymostlydue tothemeasuresto

beimplementedinsuspiciousfarms(i.e.,farmswithatleastone

suspectedcaseofASF).

7.3. Non-monetarybeneﬁts

Threeoutoftheﬁvefarmersinterviewedshowedaninterestin

sanitaryinformation(Table4),andmorespeciﬁcallyinASF.They

wereinterestedinthisinformationattheregionallevel.They

high-lightedthattheinformationwouldnotbethatusefulduetothefact

thattheydonotknowhowtodealwithanepidemicofthis

dis-ease.Nonetheless,theywereawareofitsrapidspread,andofthe

highmortalityratesandthecurrentlackofavaccine.Theseactors

showedawillingness-to-paybetween187D and5283D for

infor-mationrelatedtoASFinCorsicaforayear(Table4),representing

from1.76to4.13%oftheirfarmproductioncosts(Table4).

Thetwootherfarmerswerenotinterestedin sanitary

infor-mationrelatedtoASF.Bothofthemsaidthatdiseases‘arepartof

nature’andthatthereisnothingtodobuttowaitfortheendof

apotentialepidemic,especiallyforASF.Thus,noneofthemwere

readytoinvestinsanitaryinformation(Table4).

8. Discussion

Thispilotstudydevelopedandtesteda methodologyforthe

implementation of participatory tools to measure acceptability

andnon-monetarybeneﬁtsusingqualitativeandsemi-quantitative

data.Moreover,ithighlightedtheadvantagesandlimitationsof

usingsuchapproaches.Bydirectlyassessingstakeholder

percep-tionsandexpectations,arelationshipoftrustwasdevelopedwith

theinterviewees.Thestakeholders’interestinASFandinthe

exist-ingsurveillancesystemwasalsoraised.Participatorymethodsand

toolsfurtherfacilitatedthediscussionaboutmonetaryaspectswith

farmers.Thevisualizationtoolshelpedthestakeholderstodiscuss

(8)

Table4

Resultsfromthecontingencyvaluationmethodimplementedwithfarmers,usedtoassesstheeconomicvalueofthesanitaryinformationofinterestinCorsica.NA—Not

applicable.

Farmers Numberofanimals Listofexpenditures Costperyear(D) Economicvalueofthe information(D)with standarderror Economic valueofthe information(%) #1 40 NA NA 0 0 #2 85 Infrastructures 10,000 4.13 Deworming 1200 1700 Feed 30,000 (±150) Total 41,200 #3 100 Vaccination 200 1.76 Deworming 400 187 Feed 10,000 (±62) Total 10,600 #4 200 NA NA 0 0 #5 500 Vaccination 16,500 8.04 Deworming 13,200 5200 Feed 35,000 (±660) Total 64,700

collectionoffurtherinformationregardingthecontextinwhich stakeholdersoperateandcontributetosurveillance.Thankstothe involvementofrepresentativesfromalllevels,thelimitationsof thecurrentsystemwerehighlighted.Nonetheless,the implemen-tationofparticipatoryapproachesappearedtobetimeconsuming. Timewasrequiredtomakeindividualcontactwithstakeholders,to presenttheprojecttothemandtodefinetheirwillingnessto par-ticipateinthestudy.Italsotooktimetodefineadateandtofind aplacefortheinterview.Anotherconstraintwasrelated tothe playfulaspectsoftheseapproaches,whichmighthaveappeared tosomestakeholderstobelackinginearnestness(mainlyinfocus groups).However,participantsgenerallywelcomedtheevaluation processandtheuseofvisualrepresentationtoolswhichallowed themtoclearlyrepresenttheirperceptionofthesystem.

Relationaldiagramswere a good wayto introduce the pro-cess,allowingparticipantstotalkaboutsomethingtheyknowwell. Nonetheless,theelaborationofthesediagramswasmore compli-catedwith‘isolated’participants.Theydidnotunderstandhowto buildtherelationaldiagramduetotheirlackofcontactwith oth-ers.Theseresultsraisemoregeneralquestionsregardingtheway inwhichsemi-structuredinterviewsshouldbeconductedwhenan overallapproachofthetopicseemstricky.Indeed,inthepresent case,itwasnecessarytoascertaintheabsenceofrelationswith otherstakeholders.Onewaytodosocouldbetoprovide partic-ipantswithexamples,askingthemtoconﬁrmthattheydo not havecontactwithothers.This,however,wouldentailtheriskof directingtheanswersgivenbytheintervieweesorofmakingthem feeluncomfortableandimpedingthesmoothprogressofthe dis-cussion.Also,theinformationprovidedbythesediagramsdidnot allowaclearassessmentofthelevelofsatisfactionregarding rela-tionsbetweenstakeholders.Indeed,thetoolallowedparticipants totalkaboutthefrequency ofcontact withotherstakeholders, butinfactitwouldhavebeenincorrecttoassimilatefrequency ofcontactwiththelevelofsatisfaction.Insomerelationships, con-tactmayberare,butsufﬁcienttosatisfystakeholders.Inthiscase, therewouldbeaneedtoimplementanadditionaltooltoassess thelevelofsatisfaction,throughtheuseofsatisfactiontokenson therelationaldiagramsforexample.

Theflowdiagramsweremoredifficulttoimplementwith ‘iso-lated’ participants also, who had no knowledge either on the surveillancesystemor onthe stakeholdersinvolved init. Once again,itwouldbenecessarytofindawaytoconductinterviews thatwould ascertainthisisolation withoutinducingforced and thereforeunreliableanswers.Moreover,participantsoftenshifted duringdiscussionsfromthereferencingofasuspiciontothatof

aconfirmedASFoutbreak.Whenthisoccurred,thefacilitator cor-rectedparticipantstokeepthemontherighttrack;nevertheless, participantsoftenreiteratedthisconfusion.Pushingparticipants inanotherdirectioncouldhaveraisedsomenegativefeelings,and couldhaveledtoalackofinterestintheinterview.Therefore,some degreeofconfusionbetweensuspicionandoutbreakinanswers couldnotbeavoided.Wemaynotethattheparticipatoryprocess allowstheinterviewertoidentifysuchconfusionsandtotakethese intoaccountintheconclusions,somethingthatwouldbemore difficulttoachievewithapproachesbasedonsystematic question-naire.Theimplementationofproportionalpilingwasunderstood andimplementedbymostparticipants.Nonetheless,participants fromthefarmers’focusgroupsdidnotwanttoimplementit.This mayhavebeenduetoapoorunderstandingofthetool’sobjective, ortothefactthattheyperceiveditas‘achildishgame’.Itmayalso havebeenduetothefactthatoneoftheparticipants,whoisdeeply involvedinCorsicanpolitics,didnotwanttohandlethecounters andmayhaveinfluencedtheothersinthisdirection.

Itwasdifﬁculttoimplementtheimpactdiagramsduetothe factthatparticipantsdidnotwanttoidentifythepositiveimpacts producedbyanASFsuspicion.Indeed,someparticipantsdenied thatanypositiveimpactscouldbeidentiﬁedduetothefactthat ‘nothinggoodcanarisefromacrisis’.

Theanalysisofdiagrams,proportionalpilinganddiscussions duringtheinterviewsallowedustodevelopscoringcriteriaforthe previouslyidentiﬁedacceptabilitycriteria.Nonetheless,itwasnot possibletodothisforonecriterion(i.e.,perceptionbyeachactor oftheimportanceandrecognitionofhis/herownrolerelativeto otherstakeholders).Thiselementwasthereforeexcludedfromthe analysisaswecouldnotidentifyanyqualitativedatawithwhich toassessit,makingitimpossibletodevelopevaluationcriteria.

BycombiningCVMwithproportionalpiling,wewereableto assessthefarmers’interestinsanitaryinformationrelatedtoASF. Themethodwaseasytoimplementandparticipantsreadily pro-videdanestimationoffarmexpenditures.Thekindofinformation soughtandthegeographicalareatargetedwereidentiﬁed,thus allowinginformationtobecollectedonthefarmers’perceptionof thedisease.Nonetheless,theuseofonly100countersfor propor-tionalpilinghasledtoatendencytooverestimatetheeconomic valueof the information. Thisoverestimation wasthus greater whenthetotalexpenditureswerehigher.Onewayofimproving thismethodwouldbetoincreasethenumberofcountersinorder togainamoreaccurateestimationofthiseconomicvalue.Itwould alsobevaluabletoidentifysomepointsoffactualcomparisonin order togage the relevance of theﬁnal estimated

(9)

willingness-to-pay. Expendituresoninsuranceproducts couldbeusedas a referenceelement.Indeed, thewillingness-to-payforanimal or farminsurancemaybeinterpretedasameansofriskaversionand wouldallowabetterunderstandingofthefarmers’willingnessto payforsanitaryinformation(Shaiketal.,2006).

Thesemi-quantitativemethoddevelopedtoassesseach

accept-ability criterion, although subjective, facilitated comparisons

betweenthedifferentlevels.TheOASISﬂashmethodisalsobased

onthistypeofsemi-quantitativescoring,butinvolvedonlyasmall

sample ofstakeholders and didnotinclude level 1

representa-tives.Fewparticipantswereinvolvedinthispilotstudy,andthus

somepointsofviewmaybemissing.Nonetheless,resultsfromthis

pilotstudyallowedustocollectrelevantinformation regarding

thecurrentsurveillancesysteminCorsica.Inthefuture,itwould

benecessarytoﬁndabalancebetweenthenumberofstakeholders

tobeincludedandthetimeavailabletoundertakesuchastudy.

Therecommendationsfromtheresearchteamwouldbetoinvolve

atleastﬁfteen representativesfromlevel one(i.e.,farmers and

hunters).

Qualitativeapproachesrelyon‘purposivesampling’to

maxi-mizethediversityofthedatacollected(i.e.,perceptionsandpoint

ofviews)(Bronneretal.,2014).Participantswereselectedinorder

toachievethisdiversity,andtoreachthetheoreticalsaturationof

thedata(Côteand Turgeon,2002).Thisstandard forqualitative

researchwasnotachievedduringthispilotstudybecauseoftime

constraints,andduetothelackofavailabilityofcertain

stakehold-ers.Moreover,participantsfromalllevelswereselectedaccording

totheiravailabilityandalsototheirwillingnesstoparticipateinthe

study.Thismeansthatmostofthepeopleinvolvedinthisstudyhad

aninterestinanimalhealth.Asthiswasapilotstudy,theremay

alsohavebeenbiasesinthewaythequestionswereformulated

andintheguidanceprovidedtostakeholders.Thelackof

involve-mentofsurveillancebeneﬁciaries(i.e.,level1)intheOASISﬂash

evaluationprocessmayalsobeasourceofbiasintheresults.

Thisstudyconﬁrmedtheﬁndingsofotherstudieswhichshowed

thatparticipatorymethodsandtoolsplayanimportantrolein

help-ingresearchersanddecisionmakerstoreconnectwithfarmers,and

togainabetterunderstandingofdiseasesfromalocalperspective

(CatleyandAdmassu,2003).Nonetheless,duetothefactthat

par-ticipatoryapproachesaremostlyusedindevelopingcountries,itis

notcurrentlypossibletocomparetheresultsstemmingfromthis

studywiththoseofotherresearchprojects.Resultsobtainedfrom

thisﬁeldworkmightthusproviderealinsightsintostakeholder

perceptions.Thecommunicationoftheseresultstodecision

mak-ersshouldcontributeimprovedsurveillanceandcontrolstrategies

(Catley etal., 2012).Indeed,this pilotstudy canbeconsidered

asadevelopmentalevaluation,withlearninggoalsandnot

judg-mentones(Dozoisetal.,2010).Thistypeofevaluationhasbeen

recognizedasawayofsupportingadaptivelearning,leadingto

adeeperunderstandingofstakeholders’problems,resources,and

thebroadercontext(Dozoisetal.,2010).Theuseofparticipatory

methodsandtoolsintheevaluationprocessledtothe

empower-mentofstakeholders,thusimprovingboththeiracceptanceofthe

evaluationandtheirfeelingofownership.Thiscouldimprovethe

sustainabilityofhealthinterventions(Calbaetal.,2014).Several

authorshighlightthat,besidesitschallenges,participatory

eval-uationcanbeseen asa veryusefulapproach totheevaluation

ofhealth preventionprograms as‘it strengthenscapacities and

alliancesamongparticipants,fosterscommitmenttohealth

pro-gramprinciplesandhasalsoprovedtobeausefuldecisionmaking

tool’(RiceandFranceschini,2009;Nitschetal.,2013).

Althoughacceptabilityrepresentsanimportantconcerninthe

evaluationprocess,limitationsexistregardinghowthisattribute

shouldbeconsideredandevaluated(Aueretal.,2011).The

partic-ipatoryapproachesdevelopedinthisstudyallowedthedifferent

elementsbehindtheacceptabilitydeﬁnitiontobeassessed.Since

the information from all levels is critical for effective disease

surveillance(Tsaietal.,2009),wemayconsiderthatthedata

col-lectedwiththisapproachgaverisetorelevantrecommendations

fortheCorsicancontextthatcanbeimplementedtoimprovethe

currentsurveillancesystem.

Moreover,economicevaluationshouldbeanintegral partof

theevaluationofanimalhealthsurveillancesystems,evenifthis

islikelytobeadifﬁcultparttoachieve(Dreweetal.,2012;Drewe

etal.,2015).Thebeneﬁtsassessment,includingnon-monetary

ben-eﬁts, mustbepartofaneconomic evaluationprocess. Thisis a

criticalpointfordecisionmakerswhoneedtomakechoicesbased

onlimitedordiminishingresources(Dreweetal.,2012).Usinga

CVMmethodtoassessnon-monetarybeneﬁtscouldﬁlltheexisting

gapsregardingtheeconomicevaluationofsurveillancesystems.

Nonetheless,themethodimplementedthroughthispilotstudystill

requiressomeadjustmentinordertobetterassessthe

stakehold-ers’interestinsanitaryinformation,andthustoengagetheminthe

surveillancesystem.

9. Conclusion

Socio-economicevaluationattributesarerarelyconsideredin

theevaluationofanimalhealthsurveillance;thismaybedueto

thelackofmethodsandtoolsavailablefortheirassessment.The

present work providesaninitial step in thedirectionof ﬁlling

thesegaps.Themethodology developed,basedonparticipatory

approaches, allowed us to assess the acceptability of the ASF

surveillancesysteminCorsica,andtocollectinformationrelative

tothenon-monetarybeneﬁtsofthissurveillanceforfarmers.

Inordertofurtherassessitsapplicability,theproposedmethod

shouldbeappliedindifferentcontexts,targetingothersurveillance

systemswithdifferentobjectives.

Conﬂictofinterest

Allauthorsdeclarethattheyhavenoconﬂictsofinterest

rele-vanttothispaper.

Acknowledgements

ThisreviewwasperformedundertheframeworkoftheRISKSUR

project,fundedbytheEuropeanUnionSeventhFramework

Pro-gramme(FP7/2007–2013)underthegrantagreementno310806.

WewouldliketoextantourthankstoDrCasabianca(LRDEresearch

unitDirector,INRACorte),OscarMaestrini(INRACorte),andtoall

participantsfortheirimplicationinthiswork.Wearegratefulto

AnitaSaxena DumondforreviewingtheEnglish.Wewould like

tothankstheASForceproject(EC,FP7-KBBE-2012-6,Projectno

311931)fortheirhelpfulcollaborationsinCorsica.

References

Auer,A.M.,Dobmeier,T.M.,Haglund,B.J.,Tillgren,P.,2011.TherelevanceofWHO

injurysurveillanceguidelinesforevaluation:learningfromtheAboriginal Community-CenteredInjurySurveillanceSystem(ACCISS)andtwo institution-basedsystems.BMCPublicHealth11,744.

Bradley,J.E.,Mayﬁeld,M.V.,Mehta,M.P.,Rukonge,A.,2002.Participatory

evaluationofreproductivehealthcarequalityindevelopingcountries.Soc.Sci. Med.55,269–282.

Bronner,A.,Hénaux,V.,Fortané,N.,Hendrikx,P.,Calavas,D.,2014.Whydofarmers

andveterinariansnotreportallbovineabortions,asrequestedbytheclinical brucellosissurveillancesysteminFrance?BMCVet.Res.10,93.

Calba,C.,Goutard,F.L.,Hoinville,L.,Hendrikx,P.,Lindberg,A.,Saegerman,C.,Peyre,

M.,2015.Surveillancesystemsevaluation:asystematicreviewoftheexisting

approaches.BMCPublicHealth15,448.

Calba,C.,Ponsich,A.,Nam,S.,Collineau,L.,Min,S.,Thonnat,J.,Goutard,F.L.,2014.

Developmentofaparticipatorytoolfortheevaluationofvillageanimalhealth workersinCambodia.ActaTrop.134,17–28.

Casabianca,F.,Picard,P.,Sapin,J.,Gauthier,J.,Vallée,M.,1989.Contributionà

(10)

laluttecontrelemaladied’AujeszkyenRégionCorse.JournéesRecherches PorcinesFrance21,153–160.

Catley,A.,Admassu,B.,2003.Usingparticipatoryepidemiologytoassessthe

impactoflivestockdiseases.In:FAO-OIE-AU/IBAR-IAEAConsultativeGroup MeetingonContagiousBovinePleuropneumoniainAfrica,12–14November 2003,FAOHeadquarters,Rome,Italy.

Catley,A.,Alders,R.G.,Wood,J.L.,2012.Participatoryepidemiology:approaches,

methods,experiences.Vet.J.191,151–160.

Corbin,J.M.,Strauss,A.,1990.Groundedtheoryresearch:procedures,canons,and

evaluativecriteria.Qual.Sociol.13,3–21.

Costard,S.,Mur,L.,Lubroth,J.,Sanchez-Vizcaino,J.,Pfeiffer,D.,2013.Epidemiology

ofAfricanswinefevervirus.VirusRes.173,191–197.

Côte,L.,Turgeon,J.,2002.Commentliredefac¸oncritiquelesarticlesderecherche

qualitativeenmédecine.Pédag.Méd.3,81–90.

Delabouglise,A.,Antoine-Moussiaux,N.,Phan,T.,Dao,D.,Nguyen,T.,Truong,B.,

Nguyen,X.,Vu,T.,Nguyen,K.,Le,H.,Salem,G.,2015.Theperceivedvalueof

passiveanimalhealthsurveillance:thecaseofhighlypathogenicavian

inﬂuenzainVietnam.ZoonosesPublicHealth,http://dx.doi.org/10.1111/zph.

12212.

Desvaux,S.,LePotier,M.F.,Bourry,O.,Hutet,E.,Rose,N.,Anjoubault,G.,Havet,P.,

Clément,T.,Marcé,C.,2014.Pesteporcineafricaine:étudesérologiquedansles

abattoirsenCorsedurantl’hiver2014.Bull.Epidémiol.63,19.

Dozois,E.,Blanchet-Cohen,N.,Langlois,M.,2010.DE201:APractitioner’sGuideto

DevelopmentalEvaluation.TheJ.W.McConnellFamilyFoundationandthe

InternationalInstituteforChildRightsandDevelopmenthttp://www.

mcconnellfoundation.ca/en/resources/publication/de-201-a-practitioner-s-guide-to-developmental-evaluation.

Drewe,J.,Hoinville,L.,Cook,A.,Floyd,T.,Gunn,G.,Stärk,K.,2015.SERVAL:anew

frameworkfortheevaluationofanimalhealthsurveillance.Transbound. Emerg.Dis.62,33–45.

Drewe,J.,Hoinville,L.,Cook,A.,Floyd,T.,Stärk,K.,2012.Evaluationofanimaland

publichealthsurveillancesystems:asystematicreview.Epidemiol.Infect.140, 575–590.

EuropeanCommission,2011.CommissionImplementingDecisionof15December

2011amendingDecision2005/363/ECconcerninganimalhealthprotection

measuresagainstAfricanswinefeverinSardinia,Italy.http://eur-lex.europa.

eu/legal-content/EN/TXT/PDF/?uri=CELEX.32007D0012&from=EN(accessed 29.04.15.).

German,R.R.,Lee,L.,Horan,J.,Milstein,R.,Pertowski,C.,Waller,M.,2001.Updated

guidelinesforevaluatingpublichealthsurveillancesystems.MMWR recommendationsandreports.Cent.Dis.ControlPrev.50,1–35.

Glaser,B.,Strauss,A.,1967.TheDiscoveryofGroundedTheory.Strategiesfor

QualitativeResearch.TransactionPublishers,Hawthorne,New-York,pp.271.

Guest,G.,Bunce,A.,Johnson,L.,2006.Howmanyinterviewsareenough?An

experimentwithdatasaturationandvariability.FieldMethods18,59–582.

Hendrickx,S.,ElMasry,I.,Atef,M.,Aref,N.,ElZahraaKotb,F.,ElShabacy,R.,Jobre,

Y.,2011.AManualforPractitionersinCommunity-basedAnimalHealth

Outreach(caho)forHighlyPathogenicAvianInﬂuenza.TheInternational LivestockResearchInstituteandtheFoodandAgricultureOrganizationofthe UnitedNations,pp.77.

Hendrikx,P.,Gay,E.,Chazel,M.,Moutou,F.,Danan,C.,Richomme,C.,Boue,F.,

Souillard,R.,Gauchard,F.,Dufour,B.,2011.OASIS:anassessmenttoolof

epidemiologicalsurveillancesystemsinanimalhealthandfoodsafety. Epidemiol.Infect.139,1486–1496.

Hoinville,L.,Alban,L.,Drewe,J.,Gibbens,J.,Gustafson,L.,Häsler,B.,Saegerman,C.,

Salman,M.,Stärk,K.,2013.Proposedtermsandconceptsfordescribingand

evaluatinganimal-healthsurveillancesystems.Prev.Vet.Med.112,1–12.

Hoischen-TaubnerS.,BieleckeA.,SundrumA.,2014.Differentperspectiveson

animalhealthandimplicationsforcommunicationbetweenstakeholders.In:

SchobertHeike,RiecherMaja-Catrin,FischerHolger,AenisThomas,Knierim

Andrea(Eds.)FarmingSystemsFacingGlobalChallenges:Capacitiesand

Strategies,8–16.

Johnson,N.,Lilja,N.,Ashby,J.A.,Garcia,J.A.,2004.Thepracticeofparticipatory

researchandgenderanalysisinnaturalresourcemanagement.Nat.Res.Forum 28,189–200.

Kariuki,J.,Njuki,J.,2013.Usingparticipatoryimpactdiagramstoevaluatea

communitydevelopmentprojectinKenya.Dev.Pract.23,90–106.

Louviere,J.J.,Hensher,D.A.,Swait,J.D.,2003.Environmentalvaluationcasestudies.

In:StatedChoiceMethods:AnalysisandApplications.CambridgeUniversity Press,pp.329–353.

Mariner,J.,Hendrickx,S.,Pfeiffer,D.,Costard,S.,Knopf,L.,Okuthe,S.,Chibeu,D.,

Parmley,J.,Musenero,M.,Pisang,C.,2011.Integrationofparticipatory

approachesintosurveillancesystems.Rev.Sci.Technol.30,653–659.

Moennig,V.,2000.Introductiontoclassicalswinefever:virus,diseaseandcontrol

policy.Vet.Microbiol.73,93–102.

Mur,L.,Atzeni,M.,Martínez-López,B.,Feliziani,F.,Rolesu,S.,Sanchez-Vizcaino,J.,

2014a.Thirty-ﬁve-yearpresenceofAfricanswinefeverinSardinia:history,

evolutionandriskfactorsfordiseasemaintenance.Transbound.Emerg.Dis.,

http://dx.doi.org/10.1111/tbed.12264.

Mur,L.,Martínez-López,B.,Costard,S.,delaTorre,A.,Jones,B.A.,Martínez,M.,

Sánchez-Vizcaíno,F.,Mu ˜noz,M.J.,Pfeiffer,D.U.,Sánchez-Vizcaíno,J.M.,2014b.

ModularframeworktoassesstheriskofAfricanswinefevervirusentryinto theEuropeanUnion.BMCVet.Res.10,145.

Nitsch,M.,Waldherr,K.,Denk,E.,Griebler,U.,Marent,B.,Forster,R.,2013.

Participationbydifferentstakeholdersinparticipatoryevaluationofhealth promotion:aliteraturereview.Eval.Progr.Plan.40,42–54.

Pahl-Wostl,C.,2002.Participativeandstakeholder-basedpolicydesign,evaluation

andmodelingprocesses.Integr.Assess.3,3–14.

Peyre,M.,Hoinville,L.,Haesler,B.,Lindberg,A.,Bisdorff,B.,Dorea,F.,Wahlström,

H.,Frössling,J.,Calba,C.,Grosbois,V.,Goutard,F.,2014.Networkanalysisof

surveillancesystemevaluationattributes:awaytowardsimprovementofthe evaluationprocess.In:InternationalConferenceonAnimalHealthSurveillance (ICAHS),LaHavane,Cuba.

Pretty,J.N.,1995.Participatorylearningforsustainableagriculture.WorldDev.23,

1247–1263.

Pretty,J.N.,Guijt,I.,Thompson,J.,Scoones,I.,1995.ParticipatoryLearningand

Action:ATrainer’sGuide.InternationalInstituteforEnvironmentand Development,pp.267.

Rice,M.,Franceschini,M.C.,2009.Theparticipatoryevaluationofhealthy

municipalities,citiesandcommunitiesinitiativesintheAmericas.In:Health PromotionEvaluationPracticesintheAmericas.Springer,pp.221–236.

Sawford,K.E.,2011.AnimalHealthSurveillanceforEarlyDetectionofEmerging

InfectiousDiseaseRisks.PhdThesis.DepartmentofMedicalScience. UniversityofCalgary,Calgary,Alberta,pp.247.

Shaik,S.,Barnett,B.J.,Coble,K.H.,Miller,J.C.,Hanson,T.,2006.Insurability

conditionsandlivestockdiseaseinsurance.In:Koontz,S.R.,Hoag,D.L., Thilmany,D.D.G.,Grannis,J.W.J.L.(Eds.),TheEconomicsofLivestockDisease Insurance:Concepts,IssuesandInternationalCaseStudies.CABIPublishing, pp.53–67.

Torre,A.D.L.,Bosch,J.,Iglesias,I.,Mu ˜noz,M.,Mur,L.,Martínez-López,B.,Martínez,

M.,Sánchez-Vizcaíno,J.,2013.AssessingtheriskofAfricanswinefever

introductionintotheEuropeanUnionbywildboar.Transbound.Emerg.Dis.62 (3),272–279.

Tsai,P.,Scott,K.A.,Pappaioanou,M.,Gonzalez,M.C.,Keusch,G.T.,2009.Sustaining

GlobalSurveillanceandResponsetoEmergingZoonoticDiseases.National AcademiesPress.