ABSTRACT
Antimicrobial use (AMU) is a major driver of antimicrobial resistance (AMR). An understanding of current practices can lead to better targeting of AMU-reducing interventions. An analysis of the distribution and current usage of veterinary drugs in peri-urban smallholder poultry systems in Kenya was undertaken. A survey among poultry farmers and key informant interviews with agrovet operators and other players in the value chain was conducted in Machakos and Kajiado counties. Interview data were analyzed using descriptive and thematic approaches. A total of 100 farmers were interviewed. The majority (58%) were > 50 years old, and all kept chickens, while 66% kept other livestock. Antibiotics constituted 43% of the drugs reportedly used on the farms (n = 706). These were mostly administered by the farmers themselves (86%) through water (98%). Leftover drugs were stored for later use (89%) or disposed of (11%). Incineration was the main method for the disposal of leftover drugs and empty containers. As described by the key informants (n = 17), the drug distribution chain relied on agrovet shops that were supplied by local distributors and pharmaceutical companies, which, in turn, supplied drugs to the farmers. Farmers reportedly purchased drugs without prescriptions and rarely observed the withdrawal periods. Drug quality was a concern, especially for products requiring reconstitution.
ABSTRACT
Background: The coronavirus disease 2019 (COVID-19) pandemic has had large negative effects on countries' economies and individual well-being throughout the world, particularly in low- and middle-income countries. Pandemic-related changes in behavior and government restrictions in Kenya may have negatively affected food supply chains and household food access; however, the empirical evidence is currently limited. Objectives: The study explored changes in informal milk markets, dairy consumption, and food insecurity among low-income households in urban and periurban Nairobi, Kenya, following the start of the COVID-19 pandemic in the country. Methods: Baseline data on milk sales and consumption were collected in late 2019 from dairy vendors operating in the informal sector and their dairy customers. We conducted 2 longitudinal telephone surveys with the same study participants in July and September-October 2020, respectively. Results: At the first follow-up, the volume of milk sold by informal vendors had dropped by 30% compared with their baseline level, and the volume of milk from informal markets consumed by households decreased by 23%. By the second follow-up, the volume of milk sold and consumed had recovered somewhat but remained lower than the volume observed 1 y prior in the same season. Large reductions in the consumption of other animal-sourced products were also observed. The rate of food insecurity increased by 16 and 11 percentage points in the first and second follow-up periods, respectively, compared with baseline. Conclusions: The evidence, therefore, suggests that the timing of the pandemic and the related restrictions were associated with a decrease in the supply and consumption of milk from informal markets in Nairobi and a decrease in the food security of periurban consumers.
