Evaluation of the socio-economic impact of the onchocerciasis control programme

I|ORI.D HEAL'IH ORGAN1ZAIIUN OT,GANISATION }IOIIDIALE DE I.A SAT{TE ONCHOCERCIASIS CONTROL PROGRAI'fi{E IN WEST AFRICA PROGRAMI'IE DE LUTTE CONTRE L'ONCIIOCERCOSE EN AFRIQUE DE L'OUEST NATIONAL ONCHOCERCIASIS COMMITTEES Tenth meetlng Cotonou, 3-5 June 1986 NOC10.5 ORIGINAL : FRENCH EVALUATION OF TI{E SOCIO-ECONOMIC IMPACT OF THE ONCHOCERCIASIS CONTROL PROGRAMME oqgggf "" 1. Thls document trles to sum up the acrivlties of the Economlc Development Unit(ECO) slnce the last meetlng 1n Yamoussoukro Ivory Coast. Soci oeconomle evaluat 1on 2. It wl11 be reealled that, together wlth the Natlonal Onchocerclasls Commlttees, an evaluatlon of the lmpact of the Programrue was carrled out, with a cartographle comPonent almed at quantlfytng the land occupancy and a eocloegonomle eomponent almed at meaaurlng the soclal, economlc and populatlon changes 1n the lnltlal Prograume area ten years after lt had been started. Partlal reeults were presented ln aprellmlnary report whlch shows the following trends: a) all the 357r35O km2 where onchocerciasls was rlfe hyperendemleally (115r8OO km2), mesoendemleally (L24,3OO km2) and hypoendemleally (LL7 r55O km2) alongthe watercourses can, after ten years, be consldered to be completely proteet-ed from lt, l.e. the dlseaae no longer constltutes a maJor obstacle to their development; b) the 764,OOO km2 eovered by the Onchoeerclasls Control Programme appear to constltute an economLc challenge beeause of the cllnate and the agronomle value of the lands for the development of cereal and cotton cultlvat-lon as well as for the pronotlon of llveetock productlon (see Table I taken from the prellmlnary report). 3. Thls potentlal ls stlll Insufflciently explolted. The agrleulture ls malnly manual wlth mean densltles of 20.2 tnhabltants per km2, unequally dlstrlbuted to the dlsadvantage of the valleys and lnterfluves whlch are, however, prlvlleged places for settl-ement for crop-growlng and llvestoek produetlon. 4. On the basls of the natural characterlstles of the area6 and the level of equipment on the fa.rms, the potentlal populatlon load of the zone has been estlmated at around 116 lnhabltants per km2, aeeording to the standards establlshed by FAO from the lnternedlate lnput sttuatlon (1). 5. Onchocerclasls ls not the only factor for the underpopulatlon of the endemie areas. The control of the dlsease has, however contrlbuted to the lmprovement of the health condltlons whlch have thereby become favourable for the lmplementatlon of development projects although other dlseases 1lke trypanosomiasls are st111 of concern to the populatlons. (1) FAO doerrment: "CapaeltE potent-lelle de eharge d6mographlque des terres du monde en dEvel (rI)[)r,urent" (1979). rl NOC1O.5 Page 2 Trends observed by the study 6. They are prlnelpally deruographlc, agrlcultural and economlc, reflected by the dynaml.su of the populatlons whJch depende on the development polleies lnstltuted. Theee polleles are marked malnly by the coastal or "landlocked Sahe1lan" charaeter of the countrles consldered. Populatlon mlgratlons 7. They are evldent ln the Programme Area and have been all the more aeeentuated because the lndependences, wlth the sometlmes arbltrary border demarcatlons, dld not take lnto conslderation the geographi.cal dlstrlbutlon of the blg ethnlc SrouPs. Thls ls true of the Lobls between the Ivory Coast and Burklna, the Senoufos between Burklna, Ma11 and the Ivory Coast and the Blesas between Burklna, Togo, Benln and Ghana, etc. 8. Rural-urban mlgratlon Js st111 conslderable ln the Sahellan countrles (Burklna Mall and Nlger). However, the study was lntentlonally foeussed on "rural-rufa1" mlgratlon ln the southern parts of each of these countrles: The ONCHO zones here are characterlzed by abundant agrlcultural potentlalltles and a low populatlon denelty ln the rlver baslns. 9. In Burkina Faso, two Lypes of mlgratory movenents are observed: mlgratlons of the Volta Valleys Developuent Authorlty (AVV) type, 1.e. organlzed, and spontaneous mlgratlons, the ualn departure polnt of both of whleh le the ttossl plateau and general-ly head for the fertile valleys protected froo onshocerclasls. The study revealed a very heavy spontaneous ulgratlon as eompared wlth the organlzed one. ThIs 1s related to the flnanclal and eoclologleal conetralnts of organlzed mlgratlons. It ls, therefore, not surprlslng that ln such a sonEexf the developmenE of the zones and thelr eeologleal balance do not always go Eogefher. Farmers and stockbreeders are those who move z 431( of the vl1lages have a net mlgratlon galn whl1e the reet of the vlllages aeem to be qulte stable. 10. In Ma1l, the mlgratory movements are st1ll spontaneoue ln nature. The aupervlslon lnstltuted here by rhe authorlEles ls almed at ensurlng harnonlous condltlons for these mlgratlons the departure polnts-of whlch reoaln the overpopulated plateaux: the non-OCP reglons whose ellmaflc and hydrol-ogleal gltuatlons are unfavourable: farmers, stockbreeders and flshermen are lnvolved ln these Bovements. Slxty-nlne newly founded vlllages can be noted ln the OCP sub-sectors of Slkasso and Bamako. 11. In Nlger, Nlamey has, by vlrtue of lts sltuatlon, become a stopover polnt for those mlgratlng to the oNCIiO zone. However, most of the vlllages ln the Say reglon stl1l have a net mlgratlon gain: 637" of. the sample vl1lages ae agalnst 9Z wlth a net nlgratlon loss. 12. In the coastal countrles, Benln, Ivory Coast, Ghana and Togo, the ONCHO zones are sltuated ln the north wlth cllmatle condltlons already more favourable than in the onchocerclasls area ln the Sahellan zone. Not only does the southern part of the these countrles contaln the most luportant torrrns but lt also enJoys two ratny seasons which nake lt the preferred destlnatlon of the mlgrants from Ehe countrysldes of the north. 13. In Benln, the growth rate ls betweet 2.7il and 4.21 ln the vlllages where lt was posslble to evaluate lt. These results between 1979 and 1984 appear to be slgnlfleant conslderlng that the vlllages were 1n Inltlally hyperendemlc zones. 14. In Ehe whole of the sample analysed, 542 of the vlllages ln the Ivory Coast, more than 622 of those ln Togo and more than 552 of those ln Ghana have a growth rate equal to or hlgher than 2.72. These dlfferent sltuatlons have been accentuated ln places by the creatlon or the extenslon of game reaervea (Togo). NOC10.5 Page 3 Llveetock and crop produetlons 15. For al-l the OCP eountrles, the bulk of the llvestock ls ln the onchocerclasls- proteeted zone. Thls sltuatlon has been made posstble by a combination of severalfactors, such as the avallabl11ty of water and pasture, low populatlon densltles and the Immlgratlon of stoekbreeders to whlch ean be added the progrees of research, vacclnatlon and the adrnlnletratlon of drugs agalnst eplzootlc dleeases (anlmaL trypanosomlasls) as vell as a relatively more aeceptable humldity. 16. In the Ivory Coast, the number of the head of cattle has doubled ln ten years; ln Benln, one-thlrd of the rural- populatlon poasessea more than 622 of the cattle and about 527" of the sheep and goats. The two reglons ln northern Ghana rear more than three-quarters of the eattLe. 17. In the reglon, the Nlger rlver appears to be an lnportant centre for the exploltatlon of the flsh resources, which ls still a secondary aetlvlty. Just to give a few flgures: IO'OOO tonnea of fish are eaught ln Ntger out of a potentlal estlmated at 2OTOOO tonnes; ln Benln, less than 500 professlonals llve on fishl.ng and thelr product-lon hardly exeeede IrOOO tonnes per year; Ma1l, wlth lts productlon of lOOrOO0 tonnes one-tenth of whtch le exported, seems to be the country that t-urns thls actlvlty to the beet account, this belng due certalnly to the "Bozo" populatlon whose long eontlnental flshlng tradltlon Is known In some of the nelghbouring countries. 18. As regards erop productlon, the prlorlty glven to cash crops has, ln all the countrles, resulted ln a marked lncrease ln cotton productlon and an alarmlng decrease ln cereal produetlon. 19. The food erlsls, followlng upon a serles of events (drought, agricultural poll.cles, ete.), whteh ls belng experleneed on the continent has made lt posslble to call the pollcles lnto questlon. They now glve cotton and cereals the same prlorlty. Sueh an approaeh has resulted In a lncreaee ln the productlon of malze, mlllet and sorghum desplte the faLL Ln the produetlon of theee crops ln 1983, caueed by the partieularly severe drought of that year. Interestlng performancea contlnue to be recorded for eotton; ln 10 years, the ylelds have, everywhere ln the OCP area, rlaen from less than 5OO kg/tra to more than a tonne/ha. I,Ihlle the mean natlonal ylelde of the maln cereals are stll1 below a tonne/ha It ls lnterestlng to note the lmpact of the modernlzatlon of farmlng teehnlQUpso Thls ls true of malze whose ylelds reach 1r15O kg/ha under the Volta Valleys Development Authorlty (AVV) ln Burklna, lr8OO kg/tra under the CIDT* ln the Ivory Coast and more than 2rOOO kg/ha ln the Southern Mall proJect. Thls applles also to rlce whlch attalns ylelds of 41000 kg/ha each agricultural season ln the AVV areas ln Burkina, and the ex SODERIZ* and CIDT areas ln the Ivory Coast. Irnpaer of extenslon servlcee and economlc dynamlsm of populatlone 2O. Understood as all the arrangements ruade by the governments of the Partlelpatlng Countrles to ratlonallze the productlon structures (propagatlon of technleal knowledge, cooperatives, llteraey eampaigns, etc.), extenslon servlces have contlnuec to be selectlve. Food crops have benefltted only marginally frorn them. Wlth the exceptlon of rlce here and there, varLetles from dlfferent sources contlnue to constltute the greater part of the seed-crops used by the farmers. The fertlllzere used have never been lntended dlrectly for matze, nlllet or sorghum. Ascess to agrleuLtural credlE ls st111 llmlted. CIDT* : Compagnle lvolrlenne pour le D6veloPpement de Textlles SODERIZ*: Soe16t6 pour 1e D6veloppement de la Rlziculture NOC10.5 Page 4 21. The uoat successful extenelon servlces provlded by the development bodles concern caeh crope, especlally eotton. Here, the use of anlnal tractl.onr hlgh-yleldlng seeds, artlflclil manure as rre11 aB phytosanitary treatnents have resulted ln elgnlflcant results eveywhere (See paragraph 19). 22. patt of the credlt for the good results obralned by the peasants as regards food produetlon ehould be glven to a populatlon that has developed an eeonomle dynanlsn around vlllage assocLatLons and cooperatlves and le based on the extenslon 0ervlces that have been lts drlvlng force.One-third of the famllles that beneflt frOm extenslon eervlcee possess a plough and 852 of them estinate that they are produelng 6010. On the other hand, ot]y 6t of those who do not beneflt from extenelon servlces have a plough and only 361 ot them have observed an lnerease ln thelr productlon. Factors llnlElng the develoPment 23. Desplte the considerable efforte nade here and there ln favour of vlllage water suppLy, dlseases related to bad drtnklng water are efl11 rlfe, llrnltlng con8lderal the dynamlsm of the populatlona ln the reglon. 24. The success of the onchocerclasls control ls too recent to effaee lts psyehologlcal lmpact on the populatlone. Twelve per cent of the Persona ln the saople declared that they were sufferlng fron the dlsease. Their economle perfornancea were affected by lt: they were much lower than the mean recorded. Land occuDansv and access to the land 25. The result of such a dYnamlsm ls: a) an lncrease ln the areas under cultivatlon ln the dlre.etlon of the Ehalwe.gs. Thle lncrease dependa both on the agrarian dlverslEles and on the levels of productlon lntenslflc,atlon (eee Table 2); the development of new modes of land occupancy, governed by a more or less successful lnteractlon of the dlfferent authorlElee (tradltlonal, natlonal 1-and leglelatlons) whieh manage the land and accese to lt; moreover, the habltatlonal areae have been modlfled Sreatly (new vlllagea' mlgrant populatlons that have come spontaneously or have been settl€d by an exienslon servlces structure) and banks lnhablted by srockbreeders are found here and there (Leraba, t{hlte Volta). b) c) NOc10. 5 Fl ts E H a !r C) R F F3 EFtJ 't igu)aE.; r-Bhd Fli:JH Ea zFdO}r1Ff hi t3HFJOH tl ohn d Lrl 8 hJ l-oEr a L.F c+ s, c/ tsP P.d oHt B op It Fi B H P. otro o F' ot, o x H o U'(t op s,tr tr ts 3 o 5 ct oa o o F*, ct o cf o ci s, Ho s, o oI o ,l 5oo F a F:l E c)ou)3v23oP{P.oP' cl-|oOlrF:IP.ct.ooPoqNOPr+oIfOB((ttre, r(, B o ct 0) cl' 8 t o+ o 5+ts r,H c) FJ o)C, FUo 0s o5 .r5o\ur5\nruoo-lHo ooaoaaN)@oo@\r.l o H a cfg) d P o o c)E H o &, N\xLNN):rJ5' .-.J H S \o \rt --I oatoaa\no\@.\los a P. cl-g, d Ho Or -l \O o\ O\ \O\O fU 5 O\ o\ -.Jlaaaaa <$co-{co-l o(nI'J F .faa)ccrts.PctO i\,(t+ P o ur \x \rt \N v.r v{HO\\N1rO{ ataaaa5oO\vtCDO\ rD FJ @ i: P. c|. A,d P o { oa ci- B t-, P.o s, E td oa o5 f\) \N \N rN f\) 5HS0\,r\'lStaaaaaO\--.JS5@\x U) t- P. ct '1'dF o vl-1 \oo\!nov{C),\)?\O\P attaaao--lo\oo\\o --T-$ar-, t c+a!trc/P.HclO 0,cr/ +H o H I p{ 8,3 cta HFro l-,5-B .j0)H.5fi:d o *0qots. oa5 o iJOu@L. BE. '(+ o _9.FP.o5 Act-o lf-Fio cf oaF, d-5 dlJ(< P.Ecfl-. lr-stO o u, 0c oP I-J s, rlH F:(DPFJ o dH .^I,o\ (,O r'"5z d z Jq 'D r-J s, TABLE 2 ' LAND (,ccupANcy AND ITs DyNAl.{rcs srNCE THE srART oF THE pRocRA}rME Study area I 2 3 20.7t 8,77 56t 331 L627, r78 4 0.82 r. 3z 2l 4.8 9.1 9.7 5 6 I 8 I Red Volta, Ghana Rlght bank, south of IloN Red Volca, Chana Lefc b6nk, sourh of lloN Red VoIta, Burklna Faso North of ll'N, rtghc bank Red Volra, left bank Burklna Faao, north of ll.U lllrltr Volta, rlght bank,Uurlllt.t l'aco, Blssa Yhtrr Volta, left bankNorth of !{o9Bl country,Burllno Fauo, tncludlng AVV lJhlte Volta, yerlba, Eurllua Faso lJhtre Volta, rlght banklncludlng AVV 271 r3.3Z 207 4st (a) (b) (a) (b) (c) (c) 24.57, tr.8t 7 2.4 37 + + + + la 8Z L4Z (c) (d) (c) (c) o r2z 2.6 0.5 2a r9z 65.82 232 42t 221 L7l L45Z 2L8l o 2532 7 L47, 340t 8. 4Z r0.lz r2. I 21. lz 38.21 + + + + ToraI lJhlre Volta Eougourlba/Black Volta _Eurklna Faso^ lncludlng(eouth of IloN) Dagara 81r1for t{t tIe Lobl 9.22 30. r 2952 L2.22 7 .52 6Z 13.42 ll.5z (e) L2.9 10.72 r5.42 12.42 732 t8z, r5I 7.82 6.3 6.62 r. 5z 0. 8z + + + + Coooe - Burklna Faeo South of lloN Black VoIEa, Sauandenl KeraLle, Salnt-plerre North of Il"N -- Western Leraba Sourh of Il"N - Burktna Faso Leraba, rlght bank Ivory CoaeE, aouth of ll"N Leraba, Ivory Coast, central (f) 2,42 (g) 3.lz (h) 4. I L27, 16. I 251 3847 17 8t 5002 6.01 5. st 6Z + + + 3.6 2.3 0.7 (c) (c) (c) r3. I 8Z l0z 2562 2362 r 2002 LL,2Z rl.6I 26.32t t + + 2) Percen of abl l"f?Igrh@ (5) Rlgld rou(6) Lax" ros la. cultlvated area 2a. Cultlvatcd area (a) 1960-1984(b) 1978-1984(c) L972-L9BJ(d) 1972-L984 (") r974-I983 ( f ) 1956-1981(e) I952-198r ( h) r952-r981 t N0c10.5 - i. \z percencaSe f utllized land/Area avallable f" fSS/.-iI itl) Global tncreage ln utiltzed ronJ in-Z(4) Annual increase ln utl_llzed land (7) Discontlnuous land occupancy rrlthout rou, ln vlllagesJ91 lde! ulrh iootgrarton oi non_r,"rtr""(y, LdeE ylth lnterpoaed settlcEent of naelvea Source: 1985 Survey and J. p. llervour et al. (19g4).