title: The Added-Value of Using Participatory Approaches to Assess the Acceptability of Surveillance Systems: The Case of Bovine Tuberculosis in Belgium.
abstract: OBJECTIVE
  Bovine tuberculosis (bTB) surveillance in Belgium is essential to maintain the officially free status and to preserve animal and public health. An evaluation of the system is thus needed to ascertain the surveillance provides a precise description of the current situation in the country. The evaluation should assess stakeholders' perceptions and expectations about the system due to the fact that the acceptability has an influence on the levels of sensitivity and timeliness of the surveillance system. The objective of the study was to assess the acceptability of the bTB surveillance in Belgium, using participatory tools and the OASIS flash tool ('analysis tool for surveillance systems').
  
  
  METHODS
  For the participatory process, focus group discussions and individual interviews were implemented with representatives involved with the system, both from cattle and wildlife part of the surveillance. Three main tools were used: (i) relational diagrams associated with smileys, (ii) flow diagrams associated with proportional piling, and (iii) impact diagrams associated with proportional piling. A total of six criteria were assessed, among which five were scored on a scale from -1 to +1. For the OASIS flash tool, one full day meeting with representatives from stakeholders involved with the surveillance was organised. A total of 19 criteria linked to acceptability were scored on a scale from 0 to 3.
  
  
  CONCLUSIONS
  Both methods highlighted a medium acceptability of the bTB surveillance. The main elements having a negative influence were the consequences of official notification of a bTB suspect case in a farm, the low remuneration paid to private veterinarians for execution of intradermal tuberculin tests and the practical difficulties about the containment of the animals. Based on the two evaluation processes, relevant recommendations to improve the surveillance were made. Based on the comparison between the two evaluation processes, the added value of the participatory approach was highlighted.
authors.affiliation: CIRAD, UPR AGIRs, F-34398 Montpellier, France.|Research Unit of Epidemiology and Risk Analysis applied to Veterinary Sciences (UREAR-ULg),Fundamental and Applied Research for Animal and Health (FARAH), Faculty of Veterinary Medicine, University of Liege (ULg), Liège, Belgium.
authors.forename: Clémentine
authors.initials: C
authors.lastname: Calba
authors.affiliation: CIRAD, UPR AGIRs, F-34398 Montpellier, France.|CIRAD, UPR AGIRs, 10900 Bangkok, Thailand.|Kasetsart University, 10900 Bangkok, Thaïlande.
authors.forename: Flavie Luce
authors.initials: FL
authors.lastname: Goutard
authors.affiliation: DG Control Policy, Federal Agency for the Safety of the Food Chain (FASFC), Brussels, Belgium.
authors.forename: Luc
authors.initials: L
authors.lastname: Vanholme
authors.affiliation: Tropical Veterinary Institute, Faculty of Veterinary Medicine.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Antoine-Moussiaux
authors.affiliation: French Agency for Food, Environmental and Occupational Health Safety (ANSES), Lyon, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Hendrikx
authors.affiliation: Research Unit of Epidemiology and Risk Analysis applied to Veterinary Sciences (UREAR-ULg),Fundamental and Applied Research for Animal and Health (FARAH), Faculty of Veterinary Medicine, University of Liege (ULg), Liège, Belgium.
authors.forename: Claude
authors.initials: C
authors.lastname: Saegerman
mesh_terms: D000818:Animals; D000835:Animals, Wild; D001530:Belgium / Q000453:epidemiology; D002417:Cattle; D011159:Population Surveillance / Q000379:methods*; D014380:Tuberculosis, Bovine / Q000453:epidemiology*