Optimizing Rabies Control Program in Bali: An Ecohealth Approach

M.D. Winda Widyastuti

Present at EcoZD Annual MeetingBangkok , 10-12 December 2011

Indonesian Team Members

• Anak Agung Gde Putra

• Iwan Willyanto

• Edi Basuno

• Soelih Estoepangestie

• Arie Rukmantara

• M.D. Winda Widyastuti

• Sunandar

• Andri Jatikusumah

• Riana Aryani Arief

• Chaerul Basri

Buffalo 1884 (Esser) Dog 1889 (Penning)

Human 1894 (E. V. de Haan) until 2011 24 of 33 provinces infected

Rabies

EnvironmentDog ↔ Human

Ecology virus

Topography Habitat sharing Food source availablity

Dog Imunity Behaviour Fecundity Demography

Human Socio-Culture

Historically free (Statblaad 1926)

November 2008Bali is unique

To help government in optimizing rabies control

program in Bali

Field Studies Community Engagement

Data:Rabies Control Program

Dog Demography Dog BehaviorDog Fecundity

Data:Socio-Culture background in

relation with Dog-Human relationship

Increasing public awareness & community

participation

Objective

Animal Human Health

Socio-Culture

Education

ObjectiveObjective

Technical Decision Maker

Formal & Informal Leader

Technical Field Officials

Community/Concern CitizenSchool Teacher

Methods

Studies

Community Engagement

InterviewField ObservationFocus Group Discussion

Focus Group DiscussionPresentation

Interactive DiscussionMedias (film, song, poster, leaflet)

Training (class teaching, scenario-simulation) Monitoring – evaluation

Dog Demography Study (1)

Dog : Human Dog Sex Ratio ( M : F )

Denpasar 1 : 24 1 : 1 (Urban)Gianyar 1 : 35 3 : 1 (Sub-urban)Karangasem 1 : 14 3 : 1 (Rural)

Dog Demography Study (2)

Dog Demography Study

Dog Fecundity Study (1)

Feb

Augst

41% females giving a birth

• Average puppies / birth = 4 heads• 164 puppies = 87 Ma, 77 Fem • Puppy mortality = 18,3% (30 hds) 14 Ma, 16 Fem

+ 134 dogs

1,34 X

N0 (100 dogs)

N1 ( 234 dogs)

Dog Fecundity Study (2)

11

Dog Fecundity Study (3)

Dog Fecundity Study (4)

Dog Behaviour Study (1)

Average of Rest Activity Duration (minutes) on Adult Male and Female in Daily

Dog Behaviour Study (2)

Average of Dog-Human Contact per Hour based on Age and Sex 

Dog Behavior Study (3)

Dog Behavior Study (5)

Abang Village-Rural

Dangin Puri - Urban

Dog Behavior Study (5)

Banjar Dinas(Klian Banjar) Banjar Dinas

(Klian Banjar)

Village(Kepala Desa)

Village(Kepala Desa)

Sub-DistrictSub-District

DistrictDistrict

ProvinceProvince

Majelis Madya Desa Pekraman(Chairman)

Majelis Madya Desa Pekraman(Chairman)

Majelis Desa Pekraman (Bendesa)

Majelis Desa Pekraman (Bendesa)

Banjar Adat(Klian Adat) Banjar Adat(Klian Adat)

Lingkungan / Tempekan Lingkungan / Tempekan

Majelis Utama Desa Pekraman(Chairman)

Majelis Utama Desa Pekraman(Chairman)

Social control(awig-awig, oral

agreement)Sangkep Meeting

Social-Culture Study

(1) Majelis Alit Desa Pekraman(Chairman)

Majelis Alit Desa Pekraman(Chairman)

Socio-Culture Study (2)

Keeping Dog Management

(%)

Socio-Culture Study (3)

21

Availabilty of Traditional Rule(%)

Community Engagement (1)

1. School Community Student + Teachers

2. Banjar Community

Sibetan Village

(animal + human rabies case)

Melinggih Kelod Village

(animal case + bite rabies case to human)

SCHOOL

SCHOOL

(1) School Community

•Elementary + Junior High School•2 step program - Pre-post test evalu•Classes presentation, movie, singing,

scenario, interactive discussion

≥ 40% targeted students increase their knowledge

???.... Event competition...?

Connecting to livestock & health

service office, village leader

(2) Banjar Program

Identification of Village

Characteristics

Identification of Village

CharacteristicsSosialization / Information

Transfer Proccess

Sosialization / Information

Transfer Proccess

Selection for Rabies

Cadres

Selection for Rabies

Cadres

Training for Rabies Cadres

Training for Rabies Cadres

Monitoring - Evaluation &

Program Adjusment

Monitoring - Evaluation &

Program Adjusment

•Banjar Status (Dog Registration,

Update Rabies Cases, Knowlegde Change, Behavior Change)•Cadres Activities(Sosialization, dog registration, case repport follow-up)

FGDPresentation

Movie

(FGD +Banjar Head Approach)

•Father, Mother, Youth•Head of banjar, gov officer, teacher, community

*Mother –Father-Youth Community* Topography, rural-suburban* Community behavior

*classes presentation, scenario-simulation, next plan* Rabies, pet- ownership responsibility, cadres & communication technique, dog registration program

1

2

3

4

5

Next Plan

• Continuing on-going program: Dog Fecundity Study (until Jan 2012), Dog Behavior Study (until Dec 2012), Dog Demography Study (until March 2012), Community Engagement (until August 2012)

• Result presentation to government (provincial livestock services) – advocation & legitimation

• Paper & Film Publication

Expected Outputs and Outcomes

• Report (of each study or activity to ILRI; project report to ILRI and Indonesian Gov)

• Film publication• Paper publication• Behavior changes of our boundary partners

(presented on Outcome Mapping)

Perspectives

• Dog ecology information could be used in general for Indonesia, but should be adjusted in specific area if needed

• Social cultural characteristics must be specified for each local area related with perception and community behavior on keeping dog

• Community engagement on rabies control program with an ecohealth approach could be used as model for other area in Bali specifically, but must be adjusted in other area based on specific culture and behaviour of the community

• Our project shows that zoonotic diseases could not be approached from one or two aspects alone; a holistic approach is needed to be effective and efficient

Terimakasih Thank You

Thank You