The mean age (SD) of the cattle farmers is 46.9 ± 11.7 years. Almost all the respondents are male (93%) and have some basic education (46%). The average pastoral household has 10 members and almost all the respondents were married (92%). The majority of the farmers (70%) had experience with cattle rearing and raising livestock in general since their childhood. Household cattle holdings ranged between 11 and 400 herds (median = 31). The cattle farmers in the Kwahu Afram Plains South (KAPS) District had significantly larger herd sizes, with about 40% (51/142) having more than 50 cattle herds, compared with 21% (31/145) for those in the Bunkpurugu-Yunyoo (BY) District. More than 90% (261/287) of the cattle farmers also grow crops including cereals (230/261), legumes (114/261), vegetables (49/261) and root tubers (39/261). One-third of the respondents reported experiencing some illness at the time of the study. About 80% (225/287) of the farmers were emotionally attached to their cattle.
Around 85% (240/287) of the cattle farmers lost cattle over a one-year period. The median number of cattle lost per year per farmer was seven (interquartile range = 2 to 9). Proportionately, the cattle farmers lost on average 15% of their total herd size within one year. The main adverse events accounting for the losses to 91% (218/240) of farmers were animal diseases. The other main risk factors for loss were from cattle theft (50%), pasture shortages (27%) and conflicts with other land users (22%) (Figure 2). These losses have economic implications, costing each pastoralist on average about USD 1500, USD 600 and USD 300, to animal diseases, theft and pasture shortages respectively, per year (average value per head of cattle in Ghana = USD 300).
The findings from the qualitative enquiry indicate; the main diseases resulting in losses are Contagious Bovine Pleuropneumonia (CBPP), and Foot and Mouth Disease (FMD). CBPP is reported as the most severe cause of losses. These diseases were widely reported by both veterinary officers and the leaders of farmers in the study districts. As this farmer and veterinary officer remark:
“For that heart disease (CBPP), I do not know. If it just enters your kraal, it takes time before it goes. It is not easy, not one year or two years. If you don’t take care, you will lose a lot. I know a farmer who had about 300 cattle, when this disease affected him. Before he realized, only 100 remained. Sometimes they go out to graze, and before you know it, five of them have died from that sickness; too much!”(Male livestock farmer, 38 years, BY).
“…CBPP kills them a lot. Foot and mouth disease is not much of a problem because only the young ones die from it, because they are unable to suck with the sore in the mouth; for the CBPP, it is serious”(Veterinary Field officer, 39 years, KAPS).
The majority of livestock farmers (170/287) received support from veterinary services to deal with adverse event occurrences. On average, the support interventions received by farmers per year come from two (interquartile range = 0 to 4) different of the following four main sources: veterinary services, friends and family or pastoralist association. The farmers with smaller herds (less than 50 cattle), reported receiving a significantly (p<0.001) higher number of supporting interventions (median = 2, interquartile range = 0 to 4) compared to those with large cattle herds (median = 1, interquartile range = 0 to 2) (see Table 1). The farmers in the BY District also reported significantly higher average level of support available (median = 3, interquartile range = 1 to 4) compared to the farmers in the KAPS District (median = 1, interquartile range = 0 to 2) (p<0.001).
The qualitative findings however, show that veterinary support to farmers is insufficient. The veterinary officers attribute this challenge to inadequate logistics (human and physical resources) and unwillingness of the cattle farmers to utilize vaccination services. Owing to this inadequate service delivery, the farmers resort to buying veterinary drugs from mainly unlicensed dealers and treat cattle diseases themselves. As these farmers’ leaders and veterinary officers indicate:
“…you see especially Bunkpurugu here, the farmers don’t want to vaccinate their animals. Because of that, we are facing many problems like PPR, CBPP, and anthrax…we see CBPP and PPR always. That one is not going at all”(Veterinary Field officer, 27 years, BY).
“Our animals die because of lack of attention from the veterinary officers. Veterinary services are very, very poor. You go to them and they say there is no medicine. So the veterinary services itself is not responding well to the livestock farmer. I cannot tell you the number of times that they even come to check on our animals. It is virtually nil”(Male livestock farmer, 72 years, BY).
“The challenge has to do with personnel. The area is so vast and we are seriously understaffed. The farmers live in areas that are so far apart, so at times, hmmm, it is difficult to get to all of them...We know there are some quacks going round, injecting the animals, but because we are under-staffed, I don’t fight with them” (Doctor of Veterinary Medicine, 51 years, KAPS).
“Sometimes the farmers do not even know how to administer the drugs properly. Everyone just does what they think is right. Some farmers buy medicine in a red and yellow bottle and mix with “Akpeteshie” before injecting the animals. So sometimes, I think we the farmers ourselves kill the animals because the injections are not given properly and we do not even know the right quantity to give. If the drugs are given in excess, the animal may die and people just smoke the meat and send to the market”(Male livestock farmer, 47 years, KAPS).
As the last farmer indicated, selling of diseased cattle for meat on the market to recover losses is one of the adaptive strategies adopted by the livestock farmers to cope with the adverse events they suffer. The veterinary services are unable to regulate the drugs used by farmers in treating animals and to ensure that only wholesome livestock products enter the food chain:
“For most of the farmers, they will sell the dead ones; they will not throw it away. If the animal dies, some of them will smoke the meat nicely and send it to market as bush meat. That is what they do”(Veterinary Field Officer, 39 years, KAPS).
“These diseases that affect our animals, pose a health threat to those in the cities. If the meat is unwholesome and the farmer doesn’t discard it, it will be sent there”(Male livestock farmer, 47 years, KAPS).
“We do not eat the cattle if it dies of diseases. So we have to sell at very low prices, sometimes 700 Ghanaian Cedis (USD 128). You lose a lot due to this”(Male livestock farmer, 38 years, BY).
Despite the immense contribution of a lack of sufficient veterinary staff to decreased livestock farmers’ access to veterinary services, some of the impediments are purely financial. The veterinary officers report having to pre-finance the purchase of veterinary drugs and consumables they use in treating livestock and thereafter charge the livestock farmers for the services delivered.
“Sometimes when you call the doctor, he will say his fuel, car, etc. cost him, and then charges you a higher amount that I cannot afford. That is how they are. Sometimes it is just a problem with one animal. For this, you will waste all that money?” (Male livestock farmer, 49 years, BY).
“…somebody (farmer) will call you to come and treat the animals. Then you go to these places to vaccinate or treat and he will not give you the money. Another day, he will not call you. He will call another veterinarian, even though he owes you, he will just change the veterinarian…So the next time you call me, I will not go” (Veterinary Field Officer, 27 years, BY).
“Sometimes they (farmers) agree with you to administer the drugs on credit. Thereafter, the payment becomes a problem...So, next time if you call me, I won’t bother to go and do the work for him, because it will affect me. I have taken money from my small income to buy the drugs to work for you and you do not want to pay me the money back?” (Veterinary Field Officer, 39 years, KAPS).
The study found that the majority of the cattle farmers (60%) have poor mental health. The mean mental health score was 45.7 (SD = 5.7) out of a possible 63. The livestock farmers performed better on the anxiety sub-scale of the mental health assessment. Even though the average mental health levels were not statistically different between the study districts, the livestock farmers in the KAPS District had relatively better mental health than the livestock farmers in the BY District (see Additional file 3). To assess the determinants of poor mental health among the cattle farmers, multivariable logistic regression analysis of the factors independently associated with mental wellbeing was performed.
The mental health of the cattle farmers is influenced significantly by the age of the livestock farmer, the farmers’ emotional attachment to their livestock, the number of stressful events experienced and the proportion of livestock lost as well as the farmers’ health status (Table 2). As shown in Table 3, the cattle farmers had poorer mental health with increasing age: farmers who are 50 years or older had 2 times the odds of having poor mental health compared to those less than 50 years old [COR = 2.08 (95% CI = 1.27 – 3.42), p<0.01]. The cattle farmers that were emotionally attached to their cattle were 3 times more likely to have poor mental health compared to those not emotionally attached to their cattle [COR = 2.98 (95% CI = 1.67 – 5.33), p<0.001]. The proportion of cattle lost was also highly significant in predicting the mental health of the farmers. The mental health of the farmers worsened with increasing levels of loss. Farmers who lost less than 10% of their herds (low loss) were still 3 times more likely to have poor mental health compared to those with no losses in the year [COR = 2.97 (95% CI = 1.40 – 6.28), p<0.01]. Losing between 10 and 25% of cattle was associated with 3.14 times the odds of having poor mental health [COR = 3.14 (95% CI = 1.53 – 6.42), p<0.01]. Finally, the odds of having poor mental health was 6.7 times greater if the farmers lost more than 25% of their cattle in a year than if they did not lose any [COR = 6.69 (95% CI = 2.71 – 16.5), p<0.001]. Similarly, the mean number of adverse events experienced over a five-year period was significant in predicting farmers’ mental health. The findings show that experience of each additional adverse event increased the odds of having poor mental health by 30% [COR = 1.31 (95% CI = 1.13 – 1.52), p<0.001] (Table 3).
After adjusting for the livestock farmers’ age and childhood history of cattle rearing, a farmers’ sex, health status, level of attachment to cattle and the number of adverse events experienced, as well as proportion of livestock lost, significantly predicted the mental health of the farmers (p<0.001). The adjusted odds ratio for having poor mental health associated with one increase in the number of adverse events experienced is 1.31 (95% CI, 1.10 to 1.57). Also, losing more than 25% of the cattle herd increased the odds of having poor mental health four-fold after adjusting for other significant predictors [AOR = 4.02 (95%CI = 1.51 – 10.7), p<0.01]. Male farmers have a 74% reduction in the odds of having poor mental health after adjusting for all other univariate predictors [AOR = 0.26 (95%CI = 0.07 – 0.96, p<0.05]. The adjusted odds for having poor mental health when a farmer is emotionally attached to livestock is 1.98 (95% CI = 1.02 – 3.84, p<0.05). After adjusting for other univariate predictors, the odds of having poor mental health is 2 times as great when a livestock farmer reported ill-health, as if they did not [AOR = 2.13 (95% CI = 1.15 – 3.95), p<0.05].
Table 4 below illustrates the model selection iteration to determine the most efficient linear model predicting the mental health of cattle farmers. The best model had five independent variables and accounted for 23% of the variance in mental health (Model 6). After controlling for the socio-demographic characteristics, number of support sources available, and farmers’ experience with raising livestock, the cattle farmers’ mental wellbeing was negatively influenced by the proportion of cattle lost, number of adverse events experienced, report of ill health by the farmers, and farmers’ emotional attachment to livestock. Whereas a unit increase in a farmers’ herd size, was associated with an improvement in their mental wellbeing [F (5, 281) = 17.19, p<0.001, R2 = 0.23] (Table 4). For Models 2, 3, 4, 5 and 6, it is also important to note that elimination of other variables in the subsequent models did not result in significant changes in the strength of the relationship (slope) and the statistical significance of the individual predictor variables compared to Model 1.