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Urban livestock keeping in developing cities have an important role in food security and livelihoods, but can also pose a significant threat to the environment and health of urban dwellers. The aim of this study was to identify the different livestock systems in Nairobi, their supply chains and their management and food safety risks. Seven focus group discussions with Livestock production officers in charge of each major Nairobi subcounty were conducted. Data were collected on the type of systems existing for each livestock species and their supply chains, disease management, food safety risks, and general husbandry and gender factors. Supply chain flow diagrams and thematic analysis of the data was done. Results of the study show a large variability of livestock keeping in Nairobi. The majority were small scale with: <5 dairy cows, 1-6 dairy goats, <10 small ruminants, <20 pigs, 200-500 broilers, 300-500 layers, <10 indigenous chickens or <20 rabbits. Beef keeping was mainly described as a 'by the way' system or done by traders to fatten animals for 3 month. Supply chain analysis indicated that most dairy farmers sold milk directly to consumers due to 'lack of trust' of these in traders. Broiler and pig farmers sold mainly to traders, but are dependent on few large dominating companies for their replacement or distribution of products. Selling directly to retailers or consumers (including own consumption), with backyard slaughtering, were important chains for small scale pig, sheep and goat and indigenous chicken keepers. Important disease risk practices identified were associated to consumption of dead and sick animals, with underground network of brokers operating for ruminant products. Qualified trained health managers were used mainly by dairy farmers, and large commercial poultry and pig farmers, while use of unqualified health managers or no treatment were common in small scale farming. Control of urban livestock keepers was reported difficult due to their 'feeling of being outlaws', 'lack of trust' in government, 'inaccessibility' in informal settlements, 'lack of government funding' or 'understaffing'. Findings are useful for designing policies to help to control urban livestock production and minimize its associated health and environment risks. ; Medical Research Council, United Kingdom ; Natural Environment Research Council, United Kingdom ; Economic and Social Research Council, United Kingdom ; Biotechnology and Biological Sciences Research Council, United Kingdom ; Peer Review

Urban livestock keeping in developing cities have an important role in food security and livelihoods, but can also pose a significant threat to the environment and health of urban dwellers. The aim of this study was to identify the different livestock systems in Nairobi, their supply chains and their management and food safety risks. Seven focus group discussions with Livestock production officers in charge of each major Nairobi subcounty were conducted. Data were collected on the type of systems existing for each livestock species and their supply chains, disease management, food safety risks, and general husbandry and gender factors. Supply chain flow diagrams and thematic analysis of the data was done. Results of the study show a large variability of livestock keeping in Nairobi. The majority were small scale with: <5 dairy cows, 1-6 dairy goats, <10 small ruminants, <20 pigs, 200-500 broilers, 300-500 layers, <10 indigenous chickens or <20 rabbits. Beef keeping was mainly described as a 'by the way' system or done by traders to fatten animals for 3 month. Supply chain analysis indicated that most dairy farmers sold milk directly to consumers due to 'lack of trust' of these in traders. Broiler and pig farmers sold mainly to traders, but are dependent on few large dominating companies for their replacement or distribution of products. Selling directly to retailers or consumers (including own consumption), with backyard slaughtering, were important chains for small scale pig, sheep and goat and indigenous chicken keepers. Important disease risk practices identified were associated to consumption of dead and sick animals, with underground network of brokers operating for ruminant products. Qualified trained health managers were used mainly by dairy farmers, and large commercial poultry and pig farmers, while use of unqualified health managers or no treatment were common in small scale farming. Control of urban livestock keepers was reported difficult due to their 'feeling of being outlaws', 'lack of trust' in government, 'inaccessibility' in informal settlements, 'lack of government funding' or 'understaffing'. Findings are useful for designing policies to help to control urban livestock production and minimize its associated health and environment risks.

Around 60% of all human pathogens are zoonoses and domestic animals and wildlife are of equal importance as reservoir hosts. Moreover, most emerging infectious diseases are zoonoses and most emerge from wildlife. There have been several recent initiatives to categorize zoonoses and their reservoirs but their socio-economic impact remains poorly defined and previous reviews lacked both poverty and gender perspectives. We present the initial findings of a multi-disciplinary, systematic review commissioned by the Department for International Development (UK) to synthesize best available scientific knowledge about zoonotic disease transmission through direct or indirect domestic livestock/wildlife interaction, with emphasis on risk factors, drivers and trajectories of transmission, and promising interventions for controlling important zoonoses based on managing domestic livestock/wildlife interaction. The review covers: zoonoses transmission and relative importance of the wildlife/livestock route; wildlife pathogens capable of recombining with analogous organisms in domestic livestock; risk factors and drivers for zoonoses transmission at the human/livestock/wildlife interface; historical changes in transmission and trends; livestock production systems as primary drivers of zoonotic disease load in the environment and role of wildlife as amplifiers, spill-over/indicator hosts and reservoirs; socio-economic, institutional and political factors influencing risk of transmission between wildlife and domestic livestock and from wildlife/livestock to people; risk management and control interventions and their success or failure with emphasis on interventions based on managing interaction between hosts (wildlife/livestock/humans). This review summarizes best evidence on livestock/wildlife interactions and zoonoses transmission.

The camel milk trade in Kenya has evolved significantly from a small-scale business undertaken in local villages to its current status involving a large number of different stakeholders supplying urban towns, particularly Nairobi City. Despite the evident growth pattern, the supply of camel milk to Nairobi has largely remained informal, with minimal enforcement of regulations. The aim of this study was to characterise the camel milk system supplying Nairobi and assess its governance, main challenges and the potential food safety risk practices. A value chain analysis framework was used to carry out data collection between August 2014 and July 2015. Qualitative and quantitative data were collected through focus group discussions and key informant interviews with stakeholders operating in different nodes of the value chains. Three milk value chains supplying Nairobi were identified and mapped: the Isiolo chain, the Kajiado chain and the camel milk processing company chain. Overall, the results indicate that 94% of the milk supplied to Nairobi city is informally traded (traded without any effective regulation), while 6% originates from a formal milk processing company. In the informal chains, milk traders (mostly women) were reported to play a pivotal role in the organisation and daily functioning of the chains. The processing company had partly integrated activities and reported exporting 5% of their products to regional and international markets. Food safety themes identified were associated with i) lack of cold chain, ii) gaps in hygiene practices, particularly at farm and market levels, iii) consumption of raw camel milk, and iv) lack of food safety training, among other issues. Low level involvement by government agencies in enforcing stipulated food safety measures were reported in the informal chains, as these concentrate efforts in the regulation of dairy milk chains. Isiolo milk traders were identified as the dominant group, setting milk prices and providing sanctions. The framework and findings obtained can help future research and policy makers to reach informed decision about what to regulate, where to target and importantly how to make the camel milk value chain more efficient and safer.

Introduction: Adequate and balanced nutrition is key for poverty reduction, maternal and child health and the achievement of the Sustainable Development Goals. Malnutrition, particularly micronutrient deficiencies, can be alleviated with nutrient-dense animal-source foods (1). In Nairobi, Kenya, poor informal settlements represent a challenge to the food supply. The purpose of the reported study is to understand the dynamics of: 1) food systems supplying animal source foods using value chain analysis; and 2) consumption patterns of animal-source foods in deprived households. These two components were then linked to facilitate realistic and proportionate interventions and inform food policies. Methods: We conducted two parallel investigations in Nairobi: a cross-sectional nutrition survey in consumers of 205 randomly selected low-income households, in Korogocho and deprived areas of West Dagoretti; and a large-scale characterisation and analysis of the different animal-source food systems of the city. Retailers were the linkage node between consumers and food systems data. In the household survey, dietary (24-hour recall), anthropometric (weight, height and length), and biochemical (haemoglobin) data were collected from non-pregnant women of reproductive age and children (1-3 years). The questionnaire also included quantitative data on animal-source food consumption patterns and choice drivers, and purchase prices that were used to calculate demand elasticities. In the food systems study quantitative and qualitative data were collected using value chain analysis that included constraints, barriers and potential, and the assessment of the involved food safety and nutritional risks. This analysis included: key informant interviews (e.g. government officers), focus groups, interviews of all the stakeholder types along the chains (farmers, abattoir/market owners and workers, transporters, and retailers) and researchers' observations. Linear programming (in Optifood) was used to formulate population-specific food-based recommendations, and model the effect of incorporating different animal-source foods in the diet. Findings and interpretations: Results in children showed 42% were stunted and 74% were anaemic; in women, 7.4% had a low and 29% a high- body-mass index and 26% were anaemic. The linear programming analysis identified specific food-based interventions that would ensure, for example, dietary adequacy for all nutrients except for iron in women, requiring among others increases of intake of milk and other animal sources. The consumption and food systems datasets on animal-source foods were combined to assess availability, affordability, accessibility, preference, and upscaling potential. For example, beef was consumed by most households (81%) at an average of 1.5 times per week. Its demand was principally based on 'taste' and 'nutrition' indicating that consumption would be responsive to nutrition education. The reasons why households did not consume beef were either "price" (71%) and/or 'unknown' (74%). Own-price elasticity of beef was relatively inelastic at -0.68. Food system analysis showed that most beef was destined for higher-income areas Slums were limited to stale, low quality carcases with infrastructure issues producing problems of poor hygiene, food safety and traceability. The combination of approaches and methods provides a holistic picture of the food systems and its limitations, which allows more informed decision on interventions for poor people.

Livestock keeping in urban areas is a source of livelihoods for poor urban families, but it also poses public health challenges. Purpose This included mapping of value chains for products from commercial layers (CL) and indigenous layers (IL) kept in peri-urban areas of Nairobi City, prioritization of barriers to entry into layer farming and assessment of disease and food safety management. Methods Data on interaction between people and poultry products, barriers to entry and disease and food safety management were collected through key informant interviews, focus group discussions (FGD) and administration of questionnaires. Twelve FGD were conducted and 250 questionnaires administered to individual farmers. Additional data was obtained from retailers of poultry products and government officers. Results The CL farms kept between 100 and 1,000 birds per flock while for IL farms, flock sizes were between 1 and 50 birds. CL farms obtained day old chicks from distributors of large and small-scale hatcheries and from hawkers, while IL farms obtained chicks from small-scale hatcheries and neighbouring farms. Products from these farms were eggs, spent hens and poultry manure. Eggs from CL farms were sold to shops, consumers and hawkers, while those from IL farms were sold to neighbours, bakeries and restaurants, while some were consumed at home. Spent layers were sold to brokers, neighbours and households. Poultry manure was used on crop farms and as feed for dairy cattle. The barriers to entry included poor quality feeds, poultry diseases, seasonality and scarcity of water and land. The diseases included coccidiosis, Newcastle disease and respiratory problems and these were managed by personnel from "agrovets", while in slums sick birds were slaughtered and consumed. Furthermore, hawkers and personnel from restaurants and shops were reported to lack training in food safety. Conclusion and relevance Risk for zoonoses exists along poultry value chains and hence with increasing urbanization in developing countries, investigation of food systems in cities should adopt this framework to better understand public health risks.

Purpose: Research on livestock food systems in developing countries remains limited, yet this context needs to be understood to investigate the epidemiology of zoonoses. The aim of this study was to use a value chain framework to characterize the broiler and indigenous chicken meat systems of Nairobi and their food safety risks. Methods: Using such a framework for food safety characterisation at system level is novel and has significant potential in developing countries. Data collection involved 18 focus group discussions and 236 interviews with various poultry meat value chain stakeholders in Nairobi. Analysis included chain mapping and identification of governance and food safety challenges. Results: The study identified 10 chain profiles, characterising the broiler and indigenous chicken systems, and production-retailing continuum. Food safety risks identified were related to lack of biosecurity, cold chain and access to water, poor cleaning and hygiene practices, consumption of sick animals, significant environmental contamination of by-products, and lack of inspection at farm slaughter. Large companies dominated the governance of the broiler system through the control of day-old chick production. Overall government control was relatively weak leading to minimal official regulatory enforcement. Large companies and brokers were identified as dominant groups in market information dissemination and price setting. No dominant group was identified for indigenous chicken profiles, farming being at household level for local consumption, with quasi non-existent regulations. Lack of industry association was system-wide, creating a barrier for access to capital. Other system barriers included lack of space and expertise, leading to poor infrastructure and limited ability to implement effective hygienic measures. Conclusions and relevance: Optimal food safety and disease control strategies should consider the structure of the poultry meat system and stakeholder interactions to ensure effective programmes. This study provides a new perspective for epidemiologists and public health officers to address food safety risks in full understanding of the food system context.

In Nairobi, with 3.1 million consumers and 30,000 pigs, the pork system may represents a major source of zoonotic pathogens. Yet, this system and its public health risks have not been described. The study used value chain analysis, a well-known method in economics, to investigate zoonosis and food safety risks practices in the Nairobi pork food system. A cross-sectional study of the Nairobi pork system collected data through 25 focus group discussions and 436 individual interviews with farmers, traders, abattoir owners, large companies' managers, retailers, government officers and consumers. Data were analysed to identify, describe and quantify the main pork chain profiles, their associated zoonosis and food safety risks practices and their link to governance, the distribution of benefits and barriers to improving the system. Six pork chain profiles were identified with the 'large integrated company' profile accounting for 62% of pork marketed through abattoirs. Pigs in slums were channelled directly to consumers and butchers or through less integrated markets. Main zoonosis and food safety risk practices for city pig keepers were: handling and consumption of sick pigs; and swill and scavenging feeding. In less integrated abattoirs these risks were: lack of traceability, cold chain systems and adequate cleaning and sterilising practices and equipment. For the retailers, there was a lack of hygiene linked to poor infrastructure, scarcity of water and cleaning practices. Large companies govern the high end market for pork where barriers to improvements were less. In the lower end poor profit margins and unequal benefit distribution led to issues on around investments in infrastructure, cold chains and human capacity building plus difficulties with meeting feeding and animal health costs. Conclusions This study identified the main zoonoses and food safety risk practices and the people involved in risk taking activities to help future control programmes in the Nairobi pork system. The integration of value chain and analysis of risks practices proved useful and represent the way forward for epidemiologist working in developing countries.

In Nairobi the pork food system may represent a major source of zoonotic pathogens. Yet, the system and its public health risks have not been described. The study address this gap by identifying and understanding food safety risks practices in the Nairobi pork food system using a value chain approach. A cross-sectional study of the Nairobi pork system collected data through focus group discussions and individual interviews with farmers, traders, abattoir owners, large companies' managers, retailers, government officers and consumers. Data were analysed to identify, describe and quantify the main pork chains, their food safety risk practices and explore their link with chain governance, distribution of benefits and barriers to improving the system. Main food safety risk practices for 'city pig keepers' were: handling and consumption of sick pigs; and swill and scavenging feeding. Pigs in slums were channelled directly to consumers and butchers or through less integrated markets. In 'less integrated abattoirs', risk practices were: lack of traceability, cold chain and adequate cleaning and sterilising practices and equipment. These, with chains of pork from on-farm slaughtering, governed the lower end market. One 'large integrated company' accounted for 83.6% of pork marketed through abattoirs and governed the high-end market where barriers to improvements were less. Among retailers, there was a lack of hygiene due to poor infrastructure, scarcity of water and deficient cleaning practices. Poor profit margins and unequal benefit distribution in the lower-end market hinder investments in infrastructure, cold chains and human capacity building and make it difficult to meet feeding and animal health costs. This study identified the main food safety risk practices and the people involved in risk-taking activities in the Nairobi pork system. The understanding obtained on chain governance, barriers and system inequalities associated to these risks provide a foundation to design effective control strategies.

The dairy value chain of Nairobi is comprised, in its majority, of small-scale independent enterprises that operate within a complex interlinked system. In this complexity, the coordination and power structures of the system may have major influences on the management of dairy food safety. Therefore, the aim of this study was to investigate the governance structure and challenges faced by stakeholders throughout the Nairobi dairy value chain and assess their potential implications on food safety. Qualitative data were collected through focus group discussions and key informant interviews based on a dairy value chain mapping framework previously developed. Thematic analysis enabled identification of governance themes, key challenges and analysis of their implications on food safety. Themes were organized depending on their association with farmers (informal settlement or peri-urban), dairy cooperatives, dairy traders, processing companies, retailers or government officers. The identified governance themes included: i) weak linkage between government and farmers, ii) inadequate compliance with government regulations by traders and retailers, iii) emphasis on business licenses and permits for revenue rather than for food safety, iv) multiple licensing resulting in high business cost and lack of compliance, v) fragmented regulation, vi) unfair competition and vii) sanctions that do not always result in compliance. The key challenges identified included, among others: i) inadequate farmer support, ii) harassment of traders and retailers and iii) high business costs for traders, retailers, dairy cooperatives and large processors. The implication of governance and challenges of food safety were, among others: i) inadequate extension services, ii) insufficient cold chain, iii) delivery of adulterated and low milk quality to bulking centers, iv) inadequate food safety training and v) lack of policies for management of waste milk. The range of issues highlighted are based on stakeholders' perceptions and reflects the complexity of the relationships between them. Many of the governance themes demonstrate the linkages that are both beneficial or confrontational between the formal and informal sectors, and between industry and regulatory authorities, with possible direct food safety consequences. Findings obtained provide indications to decision-makers of potential governance areas that could help improve efficiency and food safety along the dairy value chain. ; Medical Research Council, United Kingdom ; Biotechnology and Biological Sciences Research Council, United Kingdom ; Natural Environment Research Council, United Kingdom ; Economic and Social Research Council, United Kingdom ; Peer Review

In the Mekong Delta of Vietnam, poultry farmers use high amounts of antimicrobials, but little is known about the drivers that influence this usage. We aimed to identify these drivers using a novel approach that combined participatory epidemiology (PE) and Q-sorting (a methodology that allows the analysis of the subjectivity of individuals facing a common phenomenon). A total of 26 semi-structured collective interviews were conducted with 125 farmers representative of the most common farming systems in the area (chickens, meat ducks, and mobile grazing ducks), as well as with 73 farmers' advisors [veterinarians, veterinary drug shop owners, and government veterinarians/commune animal health workers (CAHWs)] in five districts of Dong Thap province (Mekong Delta). Through these interviews, 46 statements related to the antimicrobials' perceived reliability, costs, and impact on flock health were created. These statements were then investigated on 54 individuals (28 farmers and 26 farmers' advisors) using Q-sorting interviews. Farmers generally indicated a higher propensity for antimicrobial usage (AMU) should their flocks encounter bacterial infections (75.0-78.6%) compared with viral infections (8.3-66.7%). The most trusted sources of advice to farmers were, in decreasing order: government veterinarian/CAHWs, their own knowledge/experience, veterinary drug shop owners, and sales persons from pharmaceutical and feed companies. The highest peak of AMU took place in the early phase of the production cycle. Farmers and their advisors showed considerable heterogeneity of attitudes with regards to AMU, with, respectively, four and three discourses representing their views on AMU. Overall, farmers regarded the cost of AMU cheaper than other disease management practices implemented on their farms. However, they also believed that even though these measures were more expensive, they would also lead to more effective disease prevention. A key recommendation from this finding would be for the veterinary authorities to implement long-term sustainable training programs aiming at reducing farmers' reliance on antimicrobials.

International organizations and national governments in resource-scarce settings regularly support programs for the control of animal diseases with the aim of improving smallholder food security. However, the impact of such disease control programs on smallholder food security remains unclear. Mixed methods designs that integrate the collection, analysis and interpretation of qualitative and quantitative data in a single study, are increasingly being used to achieve deeper explorations of complex topics. We propose a mixed methods design to assess the four pillars of food security and coping strategies among smallholders. The methodology is illustrated with a case study in the context of a transnational program for the control of Foot and Mouth Disease (FMD) in the Andean region, involving interviews with 632 smallholders in three countries. Quantitative data were analysed using multivariate analysis to describe smallholders' profiles. Food Consumption Score (FCS) was calculated for each household. The qualitative phase involved developing themes to characterise these smallholders' experiences using Thematic Analysis. Food acquisition capacity and coping strategies varied greatly across smallholders. Only nine (1.4%) of households had a FCS below the acceptable threshold, however, food stability was compromised across study areas. Household production, financial capacity, household demographics and food prices were the main factors influencing variation in food consumption. The case study presented here illustrates the use of a mixed methods approach to assess the four dimensions of food security and categorise key differences across smallholders during a single visit.