Are we adequately evaluating subsidized veterinary services? A scoping review.

Abstract

The World Health Organization (WHO) and the World Organization for Animal Health (OIE) both recognize the importance of veterinary services in controlling zoonotic diseases, in preventing human injury, and in protecting the welfare of non-human animals. Furthermore, both organizations recommend regular evaluations of veterinary programs. Accordingly, we conducted a scoping review to collate the available peer-reviewed evaluations of subsidized small animal veterinary services in terms of the effects on animal and public health. We summarized the evaluation methods used, identified key journals in this disparate literature, and identified gaps in knowledge. CAB Abstracts, PubMed, and Scopus were searched, yielding 1441 records published between 2009 and 2016 for initial screening. After examining titles and keywords, abstracts, and finally full articles, we identified 32 relevant papers that evaluated 27 distinct programs. The global distribution was broad, with half of the papers evaluating programs in Africa or Asia, all of which were rabies vaccination programs targeting dogs. Three program evaluation categories were identified: zoonotic disease prevention (9 papers), animal welfare and control (9 papers), and One Health promotion (14 papers). Nearly three-quarters (72%) of the papers used more than one method for collecting data. The most common data sources were questionnaires (22 papers) and administrative records, such as medical charts (21 papers). The most common indicators used for animal health-related program assessments were the number of animals reached by the program (27 papers) and any changes in animal population demographics (22 papers). These indicators were found in all three types of program evaluations (i.e., zoonotic disease prevention, animal welfare/control, and One Health promotion). For public health-related program assessments, the most common indicators consisted of determining barriers to a veterinary program's success (13 papers), followed by costs of a program (11 papers), changes in perceived threats or nuisances (11 papers), and community knowledge of a zoonotic disease (11 papers). The small number of papers identified in this review, n = 32, underscores that comprehensive evaluations of subsidized veterinary services are uncommon in the peer-reviewed literature. Yet, when performed, such evaluations can help guide program delivery and future research. Given the high stakes and the high costs of subsidized veterinary services, greater efforts in program evaluation are warranted.