Local animal health services in rural communities are mainly provided by village animal health workers (VAHW), although the participation and contribution of VAWHs to disease prevention is uncertain. To address this, a desktop review of national VAWH data between 2011 - 2020 also conducted in December 2020, supporting a detailed survey on the involvement of VAHWs in disease prevention programs conducted between February to March 2014. The survey used guided group discussion with VAHWs (n = 198) from the two Cambodian provinces of Kampong Cham and Pursat. This study identified that VAHWs generated less than 22% of their annual household incomes from animal health services. Less than one-third had vaccinated livestock against FMD, with none having vaccinated cattle every six months during the study period, and nearly half of the VAHWs having never vaccinated their own cattle against FMD. As no privately-provided FMD vaccination services occurred in these communities, with all vaccines delivered through the government-subsidised program, the findings confirmed that VAHWs only vaccinated animals against FMD when vaccines were made available by the Government. The desktop review found that the number of VAHWs in 2020 declined by more than 24% since 2017 and the proportion of female VAHWs was consistently low, with a mean of 8.26 (± 1.019). These findings confirm there are considerable weaknesses in the VAHW system in Cambodia, particularly in contributing to FMD control. Cambodian animal health authorities require more effective policies to strengthen the current VAHW system, improving: their services delivery; their retention as ‘active’; their development of more sustainable roles with lower ‘dropout’ rates; and the prolonged gender inequity. With the limited availability of government-subsidised FMD vaccination currently, extension programs that engage VAHWs and farmers in seeking privately funded and delivered FMD vaccination that incorporates appropriate multivalent FMD serotype vaccines of high quality, delivered in small dose vials from a robust cold chain, is suggested. This strategy would assist VAHWs to contribute to the provision of private livestock vaccination services that are likely essential for sustainable FMD prevention and control in Cambodia.

Food-and-mouth disease (FMD) is endemic in Cambodia. The control program for FMD has relied on vaccination, with poor vaccination uptake by smallholder farmers an increasing concern. A study to improve the understanding of farmer knowledge, attitudes and practices of FMD and FMD vaccination was conducted in two Cambodian provinces. The aim was to identify opportunities to improve the disease control programs provided by both the government and private sectors. The survey comprised 300 smallholder farmers using a one-on-one interview technique. Results identified that over two-thirds of the respondent farmers had not vaccinated their cattle over two years. Of those who did, most cattle were vaccinated either once a year or once every three years. A booster had never been administered. FMD outbreaks occurred every year during the study period, with a morbidity rate of over 30%. Isolation of first infected cattle from the household herd was not practiced, with treatment identified as the first preference intervention. Farmers often assisted other farmers to restrain and treat infected cattle both before (57%) and after (43%) their own cattle were infected. This indicated that most farmers did not practice basic biosecurity measures and chose to report FMD outbreaks to the village animal health workers (VAHW), friends, neighbors, and relatives in preference to government officials. It was concluded that poor knowledge of disease transmission and biosecurity, with low FMD vaccination coverage and a focus on treatment, contribute to regular FMD outbreaks in these communities. Improvement of FMD control requires the cooperation of villagers, VAHWs, and village leaders in disease reporting, with either improved funding of government vaccination services or private FMD vaccination service. Training programs for farmers on disease transmission, and the importance of biosecurity and vaccination, including information on the cost-benefits of treatment versus full fee bi-annual FMD vaccination, are required.