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Summary of group discussions and recommendations

Terms of reference for groups A, B and C

Thirty seven participants were divided into three groups and each group was asked to independently consider the following questions in relation to the project proposal

Summary of recommendations of groups A, B and C

The groups discussed the questions and presented their recommendations at a plenary. The principal comment from each group was that the agro-ecosystem health research need to be people-centred using a participatory approach and this needs to be reflected in the objectives, the hypotheses and the assumptions. After detail discussion on the group presentations, the plenary recommended to include a brief statement on purpose of the project and to revise the objectives, the hypotheses and the assumptions in the following manner.

Purpose

The purpose of this research initiative is to assess and improve human health through livestock and natural resource management in the East African Highlands. A community-centred, participatory agro-ecosystem health approach will be used to integrate health, agricultural and environmental domains.

Objectives

Hypotheses to be tested

Underlying assumptions

Terms of reference for groups D, E and F

Thirty seven participants were rearranged into three groups and each group was asked to independently consider the following questions in relation to the proposal

The groups adopted somewhat different approaches in their discussions to deal with the issues. Each group presented its recommendations to a plenary for discussion. The summary recommendations incorporating comments made by participants at the plenary are given below.

Recommendations of working group D

Members: Don Peden (Chair), Gianni Pastore, Alayu Haile, Abiye Astatke, Barry Shapiro, Susan Bureall Edwards, Alula Pankhurst, Hugo Li-Pun, Fitsum Hagos, Jemal Haider, Tej Partap, Workneh Ayalew

The group decided to address conceptual issues and 'gaps' in knowledge before explicitly addressing the eight questions posed for consultation.

Research approach

Appropriate participation by all relevant stakeholders is an essential prerequisite to the success of the proposed research programme. This participation must exist at all levels. The entire process must strive to be inclusive at all levels. Considerable thought and effort will be necessary to develop and apply an effective procedure that ensures effective participation by all stakeholders. Six steps are needed to carry out the research. These are

Gaps in knowledge

A number of gaps in the knowledge and methodology require research. These include

Response to questions in the TOR

1 Scale: Geographic and social

The most important social scale will be the household, but this must be defined in a site-specific context. Within households, all individuals appropriately classified by age, sex etc will be considered along with the interactions among them and the decision-making processes that they use. Aggregates of households will be important. These may or may not fit into a neat nested hierarchy, and the specific classification will depend on the structure and characteristics of the communities selected. Defining communities will be difficult, but it will be important. Groupings of individuals and households may include villages, associations, and peasants' associations. More study will be needed before selecting the most suitable units of study.

In terms of geographic scale, no numeric scales were chosen. However, whatever hierarchy of scales is chosen, it must be suited to the inclusion of households. For the purpose of this proposal, the usefulness of the Ginchi site was questioned even though it was recognised that it may have importance for the ongoing technology development work being conducted by ILRI. The larger Awash watershed was considered to be more suitable and it is expected that several 'communities' will be selected from within it. It is likely that social units may not fit neatly within the geographic scales and boundaries.

If an attempt is made to document adoption of technologies, the research will have to expand the notion of geographic and social scale to include people living outside the formal research study area.

2 Indicators

3 Fit of selected technologies in proposed criteria/scale matrix

Not addressed but see comment on 'design of interventions' above.

4 What measures to be taken for additional data?

Consultation with appropriate stakeholders to establish local priorities, to characterise the locally perceived health and environmental conditions and to determine local indicators will be needed. At all stages the process must be as inclusive as possible. Although the research process must endeavor to become fully participatory, a balance is needed to ensure that essential knowledge of specialists is not ignored.

Clear data management protocols will be needed in the terms of reference that will guide the participation of the partners. Data management must be co-ordinated and appropriate ethical standards followed in the collection, storage, use and dissemination stages.

5 How many sites?

The group recommends that several sites in addition to Ginchi be chosen. The criteria should reflect four or five key variables with one site chosen to represent the extreme range of each variable. Key variables might include population density, highland versus lowland, crop–livestock composition, and human health status. Although the intent is to be able to extrapolate to other areas within the East African highlands, this dissemination process must not fall into the trap of imposing solutions from one village on another one.

6 Partnerships

Although the present workshop made great advances in bringing diverse people together, some essential stakeholders were absent. The consultation suggested that the Ethiopian Environment Protection Authority, key decision and policy makers, Ministry of Health, and the International Union for the Conservation of Nature must be included. Regional or local government representation will also be important.

7 Is the schedule of activities realistic?

The schedule is not realistic. A long-term planning horizon is needed because it takes time to develop interdisciplinary and participatory research and the impacts will likely be of a long-term nature. Nevertheless, some exciting short-term results will be needed to maintain donor and political interest.

8 What is the minimum budget?

This issue could not be addressed during the workshop. However, it was recognised that rapid feedback to participants and their sponsoring institutions is needed to maintain and increase awareness and support for the concept of improving human well-being through better agro-ecosystem management.

Next steps

Most of the suggested points were captured during the closing session of the workshop. However, it was also suggested that there may be opportunities for researchers to learn from existing data sets and projects. For example, projects that deal with land degradation for natural resource management can be re-examined to re-interpret them in light of human health conditions. It may be possible to gain considerable understanding about correlations between the agricultural and livestock productions systems and the environment with human health.

There is also a need to avoid raising too many expectations until funding is in place for the new proposal.

Recommendations of working group E

Members: David Waltner-Toews (Chair), Robina Biteyi, Douglas Clements, Paschal Osuji, Alemu Gebre Wold, Michael Klaij, Alemu Tadesse, Samson Tafesse, Pradeep Tulachan, Michael Waithaka, Felix Kamau

The group took the terms of reference as a loose guide to debating what appeared to be the most important and substantive challenges facing the research project. The summary below is a synthesis across the two days, rather than a chronology.

Scale and criteria

Units of analysis

There was considerable debate on whether the smallest unit of analysis should be the field/ animal, as implied in the proposal, or the farm/household. In terms of a nested hierarchy, it was agreed that the smallest functional unit was probably the farm/household. Smaller units were analogous to organs in an animal, rather than animals in a herd (i.e. different types of things interact to make up a household).

Definition of household. The group then debated what was meant by a household/farm. All people under one roof? Multiple families in separate houses but with one head of household? What were the options? There was insufficient information in the proposal to refine this definition. The issue appeared to be further complicated by the fact that peasant land-holdings were scattered over a landscape sometimes over different sites. While this did not appear in the proposal, the group thought it should be acknowledged and clarified, as this has considerable implications for interpreting interactions and impacts of interventions on labour, time, energy and land use. It also needs to be accounted for when generalising from sites in Ethiopia to other countries.

After discussions both inside the group and the plenary it seemed to the group that the natural layers in the nested hierarchy above the household level were the peasant association and the Wereda. These rather than ecological boundaries were selected because the intent of the research is to identify beneficial management strategies and therefore it seemed appropriate to select management units.

The group took the three 'dimensions' of human well-being (which was understood to include health and socio-economic states, livestock and the environment) as being a useful way to separate out elements of interest to the research project. Livestock were seen to be part of natural resources, but separated from soil, water and vegetation in order to address specific research questions. Nevertheless, the terminology relating to these categories needs to be standardised and made consistent. The working matrix the group used is given below

Human well-being

Livestock

Environment

Household

 

 

Peasant association

 

 

Wereda

 

 

Criteria

Having established the household as the smallest unit, the group recognised two distinct kinds of indicators at the household level: those that were peculiar to that scale (emergent indicators), and those that could be dis-aggregated. The distinction was seen to be very important. For instance, emergent household indicators of health might be distance to water source, where the children usually defecate, and whether or not the well was capped, given that defecation is probably scattered throughout the farmstead or fields. One might also use aggregate measures such as household income and disease or mortality rates. Although the interest is in the household as a unit, the way in which these latter indicators dis-aggregate provides important information about the health of the household. For instance, how is the income broken down by age and sex? Two households may have the same mortality rate (i.e. the same rating on the aggregate health scale). However, maternal mortality in childbirth, infant mortality, and adult mortality in the field are qualitatively different in terms of the interpretation given to them. In the livestock category, calf morbidity (indicator of future capacity) has different significance for agro-ecosystem health than adult (working animal) morbidity (indicator of current functioning).

The group looked in some detail at the first category of indicators for environmental integrity (soils). While some members of the group were quite happy with them, others pointed out that they were not functionally useful for farmers. The group asked if the farmers had their own indicators and were informed that farmers can classify soils by fertility, based on prior productivity, and can estimate fertiliser needs. The group then debated the broader question as to the end-use of the indicators, and the importance of having easily measurable, useful indicators at the household level. It was pointed out that some of these 'indigenous knowledge-based' indicators, such as the farmers' soil classification, may integrate several more specific researcher-based indicators, and therefore simplify general system model building. A particular kind of roof or house-type, for instance, might generally be correlated with increased wealth, better health etc.

The research project team should take the time to set out the indigenous indicators already known and which emerge during various participatory exercises and to correlate them both with each other and with other indicators, which may be of greater interest to researchers.

Steps in a research process

The group considered what might be appropriate steps in a research process to achieve the objectives discussed on the first day. The concensus was on the following:

  1. characterisation of the study areas. This includes a literature review as well as interviews with key informants, traditional birth attendants and others to get a full, rich picture of the sites. It was felt that the proposal lacked depth and/or focus in the health and socio-economic descriptions. The group further felt that this could be done by identified partners—that is, a health or socio-economic partner could be asked to do the characterisation of the research areas; this would both be a test of commitment and ensure that the review was done properly from a given perspective

  2. responsible collaborators needed to be identified early in order that Step 1 could be done right and to ensure that key variables were not left out

  3. since indicators are related to goals (i.e. health is measured in relation to expectations), the project needs to identify whose goals are being met. The project needs to decide who the appropriate stakeholders are. What about marginalised and disadvantaged groups? Who are they? Women, poor people? Should they be targeted? If so, this needs to be made clear from the start so their goals become part of the assessment

  4. an initial set of indicators may be derived from previous research in the area or similar areas. These should be considered as guidelines for later work

  5. work with community stakeholders at various levels needs to be done in order to derive functional indicators and relate them to indicators derived for research purposes

  6. work with community stakeholders to explore solutions and options; this will build on information from ILRI and others. Technology options may be proposed to the farmers/communities at this point

  7. both researchers and stakeholders need to develop their own systemic understanding of the situation. Then farmers, peasant organisations and Wereda decision-makers may introduce interventions at this time, in keeping with the best understanding of the system. The systems models will have allowed for predicted effects on various indicators and these then need to be monitored to determine if the models were an adequate description, or if key interactions were missing (See Waltner-Toews's presentation at the workshop for a description of this process in general).

(Note: experience in other sites such as Kenya suggests that many of the steps set out above are beyond research control, and happen simultaneously, and that researchers need to ensure that everything is done and probably revisited at various steps rather than trying to control the time order.)

Some issues arising out of the group discussion about the research steps and the proposal

  1. With regard to participatory action research, the methods and procedures to be used to ensure appropriate representation need to be incorporated into the proposal. Need to get a 'professional' to address this.

  2. Need a section in the proposal addressing the ethical issues and how they will be dealt with. This includes things like confidentiality, informed consent etc. Include the forms and procedures as part of the proposal.

  3. Need to have a clear section addressing gender and equity issues. This should be done by someone who has the training to do this and should clearly address both possible positive and negative consequences, based on previous research and current understanding of the study areas.

  4. Need to specify clearly in the proposal who the local collaborators are and what their roles in the project are. What are the roles, if any, for local NGOs and CBOs (Community-based organisations)?

  5. Need to address how some of the specificities of the research area (e.g. land tenure/ fragmentation in the Ethiopian highlands) might affect the ability to generalise to other sites.

  6. Should indicate in the proposal how this fits into the larger ILRI initiative to create a network of such projects to develop comparative studies.

Further comments

The group spent some time discussing possible sources of disagreement both in the project design and in the research system being studied.

A fundamental source of conflict arises from different views on the nature of the research. Health assessment is a description of the state of the system which may then be used to persuade decision-makers; this requires consultation, but perhaps not full participation. The assessment of technology interventions usually falls into this mode. This is conventional research and its role in general understanding is not in doubt. However, it inevitably runs into the problem of 'selling' research results to farmers and policy makers, whose complex many-faceted agendas and goals were not part of the assessment.

Health promotion (that is, research which seeks to promote health and sustainability) requires participation of those who will make decisions about outcomes. This is because health is related to expectations and the expectations of the decision-makers (farmers, policy-makers), which are based on their own perceptions of problems, opportunities and constraints, therefore need to be an integral part of the research process. Many researchers feel uncomfortable with this kind of activist research, and this should be acknowledged.

The group wondered about the wisdom of using both conventional and health promotion/participatory methods in the same communities. The full implications of this need to be thought through somewhat more clearly.

Beyond disagreements within the research approaches, there will be conflicts in the systems being studied themselves. As Gianni Pastore pointed out earlier, there are inevitable conflicts between different perspectives and across scales. From a research and promotion point of view, these need to be clarified and dealt with.

Some group members felt that the third dimension on the cube (effectiveness, integrity, efficiency, efficacy, equity) can be used as a guide to determine if key system characteristics are left out and/or to identify sources of conflict. (See Checkland and Scholes 1990, referred to in David Waltner-Towes's paper for definitions of some of these terms). For instance efficacy is defined as the ability of the holon (houshold, PA etc) to meet its own internal needs. Clearly, the major source of conflicting interpretations for efficacy indicators will be related to different systems perceptions by, for instance, husbands, wives and children. Understanding and resolving these conflicts requires participatory methods, as there is no scientifically optimal solution.

Effectiveness is the ability of the holon to meet the needs of the larger holon within which it is nested. Thus, this involves determining what the expectations are of the PA with regard to its member households, or of the regional government with regard to land under the control of various PAs. In these cases there will be, first of all, internal conflicts (i.e. the expectations of the larger region for the farmers' needs) to be negotiated among those with different perceptions. This is usually the realm of politics, and involves reconciling differences among health, agricultural, and environmental policies. Effectiveness indicators can be determined externally to the holon being considered. Thus, we might ask what the national expectations for productivity, water management etc are for the Awash watershed. This requires consultation with national authorities, but not participation with local farmers.

There will also be cross-level conflicts since there is a unified regional or PA policy, though this may not be compatible with farm/household policies.

Conflicts with regard to efficiency measures will usually be embedded in conflicting perspectives of the same situation. Are we talking about economic or biological efficiency? With regard to which indicators (men's income? women's? children's? household? Nitrogen? phosphorus? Water?).

With regard to this discussion, integrity appears to be more related to the potential for health (with what natural, social, economic and human capital is the farm or area endowed? Are these resources expandable?—e.g. increasing human capital through education, or social capital through organisational strategies, both of which may offset natural resources deficiencies).

Finally, the group discussed the need to identify the rules for resolving conflicts. For instance, efficacy conflicts within households are usually resolved according to cultural norms, and effectiveness conflicts through political channels. Researchers need to ask if they believe in goals or norms which may over-ride local norms. For instance, we may believe that present cultural norms for intra-household decision-making are inequitable, favouring men over others. Or we may believe that the political rules are too dictatorial and infringe on local democratic or human rights.

It is not up to researchers to change the rules of decision-making in their study subjects. Nevertheless, it is important both to acknowledge our own biases, and to raise awareness in the community of their rules for decision-making, so that their rules are consciously chosen rather than simply accepted as given. This, it seems, would be inherent in the very idea of development and is certainly a part of agro-ecosystem health as it is for any health (i.e. increased self-awareness is an indicator of better intellectual health). In the case of agro-ecosystem health research, this critical self-awareness of biases becomes part of the learning process for both researchers and study subjects. It may therefore be useful to include somewhere in the research proposal allowance for a sociology or applied philosophy student (as was done in the Guelph AESH project) to examine the rules and biases of both researchers and subjects; this would then become an essential part of assessment of the agro-ecosystem health framework itself (Hypothesis 1 in the original proposal).

Recommendations of working group F

Members: Charlotte Neumann (Chair), John McDermott, Mamadou Diedhiou, Thomas Gitau, Barry Smit, Bon E. Cummings, Jeroen Dijkman, Asgelil Dibabe, Tekalign Mamo, Mohammad Jabbar, Robin Reid, Tsegaye Demissie, Takele Gebre

The group felt that the 'big process' had to be known before they could discuss the following issues in detail: site selection, schedules and time tables, budget, criteria and indicator selection.

The scope of the project was summarised as a dynamic system of three inter-related and interacting domains

Indicators

Criteria for and identification of indicators occupied much of the discussion. In reviewing Table 1 of the proposal document, the group felt that system descriptors e.g. soil type, slope steepness, topography, were mixed in with true indicators e.g. attributes that change over time with changes in the system, and that the two had to be distinguished.

Approach to selection

Community descriptors: These should be selected by the key researchers and should relate closely and likely influence the indicators (confounders or intervening variable).

General indicators: These should be non-site specific and selection should be expert-driven.

Specific indicators: These should be prioritised by the community. These will be selected and constructed jointly by both the community and by the experts, but starting with those prioritised by the community. The two groups must work jointly.

Scale-appropriate indicators within a study site

Scales governing indicator selection are: household/farm including intra-household focus on demography (sex, age, physiologic status); community (village level), watershed, ecozone e.g. highlands.

Several possibilities for delineating communities exist based on functional, locational, human, administrative, political considerations. The following considerations should be taken into account

Criteria for construction of indicators

The process for construction of criteria should include the following

Suggestions for operational linkages with partners

Formal processes for linkages and partnerships between and among institutions will be needed. However, even greater importance will be linkages between and among individuals or small groups. Candidate institutions or entities (agencies, governmental or non-governmental etc) need to commit individuals who are to be involved on a permanent ongoing basis with a back-up person designated in absence of the lead person.

The formation of a steering committee was recommended to accomplish the following

Team coordinator

It is strongly recommended that this critically important position be filled by a broad-minded individual with interdisciplinary working experience who is pragmatic, innovative and has the vision necessary to link all the domain related issues.

Gaps noted in the proposal

The background section needs a literature review inputs and rationales for the following areas

Human well-being, health, nutrition

Particularly needed is how human well-being interacts with the environment and with agriculture/livestock, examples of possible positive and negative interactions should be given and a simple model or diagram drawn. A thumbnail sketch of the common health and nutrition problems in the highland area is needed. The impact of HIV/AIDS on agriculture should be included if possible.

Gender

The literature and background on gender issues as these interact with health, nutrition, environment and agriculture and social, economic factors are sorely missing. This section should be written by an 'expert' and not given superficial treatment (tokenism or 'window dressing'). Areas of household decision-making, income generation and its control, work, time allocation, reproductive risks need to be included.

Social-cultural input

Factors, structures and how they operate within the three domains are absent in the background material.

Community expertise

A section is needed on methodology and approaches to community participation and working with communities in partnership.

The areas described above should be written by 'experts' who are recruited as part of the team or at least by 'experts' who are engaged to fill in the gaps in the proposal preparation.

The need for linkages among various AESH projects was stressed.

Domain areas and expertise that must be strengthened

Although the existing roster of scientific expertise is good there are serious weaknesses and gaps. These are in the following areas: environment; human well-being which includes community and public health, preventive/promotion health oriented; nutrition which is community oriented and applied and includes nutrition education, biochemical nutrition will be used as validation tool; social science, community participation approaches, gender issues.

Funding

  1. A core fund is needed to co-ordinate and jumpstart the initial process

  2. Funds are needed to support special expertise to deal with issues as they arise.

The expertise badly needed are gender, community health (public health), community participation and community-based approaches, sociology.

Possible funding sources include: USAID missions, Winrock International, BMZ, Rockefeller Foundation.

Possible partner institutions

The list of suggested institutions is useful but opportunities should be left for partnership to develop, expand and respond to needs. As a start, suggested institutions are: Ethiopian Environmental Protection Authority, universities, Ministry of Agriculture, Ministry of Health, Ethiopian Health and Nutrition Research Institute, AMREF, UNICEF, NGOs e.g. Save the Children, Christian Children's Fund, World Vision, Plan International, USAID, GTZ, SIDA, Winrock International, African Leadership Education for Women in Agriculture.

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