Schelling E, Greter H, Kessely H, Abakar M F, Ngandolo B N, Crump L, Bold B, Kasymbekov J, Baljinnyam Z, Fokou G, Zinsstag J, Bonfoh B, Hattendorf J, Béchir M
Rev Sci Tech. 2016 Nov;35(2):659-671. doi: 10.20506/rst.35.2.2547.
Valid human and livestock health surveys, including longitudinal follow-up, are feasible among mobile pastoralists and provide fundamental information to agencies for interventions that are responsive to realities and effective in addressing the needs of pastoralists. However, pastoralists are often excluded from studies, surveillance systems and health programmes. The occurrence of preventable and treatable diseases such as perinatal tetanus, measles and tuberculosis are indicative of limited access to health providers and information. It is difficult for health services to include effective outreach with their available financial and human resources. One consequence is that maternal mortality rates among pastoralists are unacceptably high. Environmental determinants such as the quality of water and the pasture ecosystems further influence the morbidity of pastoralists. In the Sahel, the nutritional status of pastoralist children is seasonally better than that of settled children; but pastoralist women tend to have higher acute malnutrition rates. Pastoralist women are more vulnerable than men to exclusion from health services for different context-specific reasons. Evidence-based control measures can be assessed in cluster surveys with simultaneous assessments of health among people and livestock, where data on costs of disease and interventions are also collected. These provide important arguments for governmental and non-governmental agencies for intervention development. New, integrated One Health surveillance systems making use of mobile technology and taking into account local concepts and the experiences and priorities of pastoralist communities, combined with sound field data, are essential to develop and provide adapted human and animal health services that are inclusive for mobile pastoralist communities and allow them to maintain their mobile way of life.
有效的人类和牲畜健康调查，包括纵向随访，在流动牧民中是可行的，并为各机构提供基本信息，以便采取符合实际情况并能有效满足牧民需求的干预措施。然而，牧民往往被排除在研究、监测系统和健康项目之外。围产期破伤风、麻疹和结核病等可预防和可治疗疾病的发生表明，获得医疗服务提供者和信息的机会有限。卫生服务部门很难利用现有的财政和人力资源进行有效的外展服务。结果之一是牧民中的孕产妇死亡率高得令人无法接受。水的质量和牧场生态系统等环境因素进一步影响牧民的发病率。在萨赫勒地区，牧民儿童的营养状况在季节性上优于定居儿童；但牧民妇女的急性营养不良率往往较高。由于不同的具体情况，牧民妇女比男子更容易被排除在卫生服务之外。可以在整群调查中评估基于证据的控制措施，同时评估人和牲畜的健康状况，并收集疾病和干预措施成本的数据。这些为政府和非政府机构制定干预措施提供了重要依据。利用移动技术、考虑当地概念以及牧民社区的经验和优先事项，并结合可靠的实地数据，建立新的综合“同一健康”监测系统，对于开发和提供适合流动牧民社区、包容他们并使他们能够维持流动生活方式的人类和动物健康服务至关重要。
