Waste from livestock (pigs, ruminants, poultry…) and from human are reused for agriculture as fertilizers and aquaculture as feed, contributing to sustainable development and livelihood generation. However animal wastes are usually not managed properly then could affect health and environment. As current practice, animal and human wastes are separately treated or in some places they are mixed for treatment. From a health risk point of view, health risks of human waste are largely known whereas they are not so well known for livestock waste and people usually perceive animal waste as causing lower risks than human waste. Because of the proximity of animal and human wastes, a good practice in livestock and human waste management is needed for the improvement of health and environment. Promoting better water management practices that include waste water and human and animal waste management, the management of agricultural run-off via participatory action research that involve multi-stakeholders and multi-institutions as well as policy makers.

A research group of Hanoi School of Public Health has worked in Hanam for 5 years on human excreta management and health. Research results show that human waste and wastewater management affect health and environment and intervention for improving human waste management is going on (Nguyen-Viet et al. 2009; Tu Vu Van et al. 2010; Pham-Duc et al. 2011; Thu Nga et al. 2011; Minh et al. 2013; Vi Nguyen In preparation; Pham-Duc et al. 2013). Indeed, we conducted a combined assessment of the impact of human excreta and wastewater reuse in agriculture on health, environment and society to propose sustainable and adapted interventions for improving health and environmental sanitation. Thus, health impact was assessed by epidemiological and microbial risk analyses that show that contact with excreta and wastewater contribute to increased health risk as helminth infection and diarrhea incidence. Environmental impact was assessed for sanitation and agriculture systems focusing on nutrient flows which showed that the current sanitation situation cause nutrient discharge pollution, mainly from onsite sanitation system. Perception and behavior on health risk and ability of people to prevent health risk caused was evaluated. People recognize wastewater as smelly with black colour, and the contact with wastewater can cause skin problems (e.g. itching). Farmers think that fish from the Nhue river and vegetables irrigated with wastewater possibly cause diarrhea. Women use protective materials when working with wastewater more often than men do. The reason for this is women spend more time in the field than men and women pay more attention to the skin protection and beauty (Tu et al 2011). We also assessed the household willingness to pay (WTP) at a local scale for construction of bathrooms with a flush toilet in Hanam and to examine the effects of socio-economic factors on the WTP. The proportion of respondents who reported willingness to pay for the interest service was 62.1%. The mean and median of maximum WTP amounts were Viet Nam dong (VND) million 15.6 and VND million 13.0, respectively (min: VND million 2.0; max: VND million 45.0).  About two third of households in the study area were willing to pay for an improvement in their current sanitation arrangements. Both WTP rate and WP amount were strongly influenced by the economic status of households and health knowledge of the study respondents (Minh et al. 2012). Combined management of livestock and human waste emerge as one of the relevant research topic in the context of Hanam, which needs further ecohealth research (Vi Nguyen In preparation).

The research component of FBLI Vietnam aims at using an ecohealth approach to address the impacts of livestock and human waste on health, environment and socio-economics as well as introduce interventions to better manage livestock and human waste, contributing to the improvement of health and well-being of people and environment.

Objectives and research questions

General objective is to study the impacts of human and animal waste management (HAWAM) on health, environment and socio-economics; identify and implement interventions to better manage livestock and human waste, improving the health and well-being of people and environment using an ecohealth approach in Hanam province, Vietnam.

Scientific research objectives

-   Understand the overall situation of agricultural activities (livestock and crop productions) in Ha Nam province.

-   Explore the current handling practices livestock and human waste management in the study sites.

-   Assess the human health impacts of HAWAM.

-   Assess the animal health impacts of HAWAM.

-   Assess the environmental impacts of HAWAM.

-   Assess the impact of HAWAM on economics and social aspects.

Intervention objectives:

-   To develop and implement practical and innovative solutions for better livestock and human waste management to improve health and well-being of people and environment.

Dissemination and Policy advocacy objective:

-   Disseminate research outputs to related ministries, institutions, NGOs, local departments, communities, and wider audiences through publications and presentations.

-   To engage policy makers at different levels, and use the study’s results to inform policy changes in HAWAM.

-   To facilitate policy changes in a more participatory and effective way of making research outputs explicit to policy making through a national policy alliance group.

Research questions:

-   What are the broad agricultural intensification changes in Hanam, what the general agricultural system and how this affects human, animal and environmental health?

-   What are the concerns of farmers and related stakeholders on HAWAM?

-   What are the local people and related stakeholders and researchers desire to improve the HAWAM?

-   What are the impacts of current HAWAM in Hanam on animal and human health?

-   What are the environmental impact (nutrient fluxes) of HAWAM and the critical control points of nutrient loads for pollution control in the area?

-   What is the institutional setup (regulation) of waste management and how to address this to improve HAWAM?

-   What are the social and economic impacts of HAWAM?

-   What are the innovative solutions to solve the problems?

Methods and research process

 Revisiting the relevance of, research objectives, and process of ecohealth research

The research objectives and approaches presented above were from the site visit and discussion and workshops with many partners. The research questions were determined as a follow up of a previous research programme of HSPH (NCCR North-South program) (Figure 1). However, from the agreement of FBLI research inception workshop in Kunming, the research team conducted a deeper exploration of the issues at the community level by re-visiting the study sites in Hanam and spent more time with the community to identify their needs for research. With this process, the research topics would likely not change much, but the research team will put the research topic under a larger perspective of research with the participation of relevant stakeholders and to not put the fixed research ideas from previous research project (Figure 1). The team have visited the site again after Kunming meeting and discussed with local stakeholders. Two junior members of the team will spend 2 weeks in December 2012 in the community with supervision of senior members to explore more in-depth local context and identify their needs for research.

 

 

Figure 1: Research process of FBLI Vietnam

Therefore three stays of research assistants and research team in Hanam could establish contact with local communities and authorities as well as collect background information on the district regarding agriculture activities and health status. The group visited 5 communes including Hoang Tay and Nhat Tan that the team knows well the situation. The extended areas of visit allowed us to have a broader view on the situation. In addition, we also visited other districts of Hanam to compare.

Stakeholder workshop with local partner to identify research objective

The workshop was organized to inform stakeholders about the project and more importantly to conduct a rapid assessment of relevant research topics that were identified from a local perspective. A workshop agenda can be seen in the annex.

The workshop could mobilize various 46 participants from agriculture and health sectors as well as farmers from 2 communes where research will take place. Background information on ecohealth, previous research in Hanam and research plan was presented without giving great details of research questions and methods. This stimulated many discussion among stakeholders in group and at plenary. Main outputs of the workshop were the identification of concerns and expectation of stakeholder on research topics on agriculture intensification in general and on animal and human waste management in particular. Main concerns are i) household waste management (organic and inorganic waste), ii) hormone and antibiotic residues from human and livestock, iii) miss-using pesticide, iv) management of animal waste and solid waste, v) water quality (As contamination), iv) livestock diseases and weak veterinary services, v) knowledge and behavior of population with regarding various environmental and health issue.

The workshop also identified that pig and poultry together with rice cultivation and some other crops are main agriculture activities. However the demographic and workforce transition are an issue as most of young people move to work in nearby industrial zones. Other issue on re-enforcement of existing policies or drawbacks of government programs on agricultural interventions to improve the crop productivity or environmental improvement in livestock.

In short, the stakeholder workshop in Hanam could gain a better understanding on the concerns of stakeholders around agriculture intensification. The concerns go beyond animal and human waste management then will guide the research team to better identify research questions. However animal and human waste management and health are still among stakeholders’ preoccupation, which needs to be addressed in a broader context of agriculture intensification and health.

Research framework

Given the information from previous discussion and from the inception workshop, we developed a research framework for Vietnam FBLI.

 

 

Figure 2: Framework of FBLI Vietnam research

Figure 2 show the framework of FBLI Vietnam research. The project works at a provincial level of Hanam by conducting research in 2 districts with their 3 communes. Two communes of Hoang Tay and Le Ho from Kim Bang district, and another commune from another district (probably Duy Tien or Ly Nhan where agriculture intensification is pronounced is to be selected). 450 households from 3 communes will be enrolled in the integrated studies on health, environment and socio-economics and culture. A set of methods comprising epidemiology, risk assessment, material flow analysis, and socio-economic sciences will be used.

 

Integrated assessments of health, environment and socio-economic impact of livestock and human waste management

A comprehensive study on the impact of human and animal waste management on human, animal health, and socio-economics in Hanam will be conducted. This integrated assessment will involve 5 study packages namely Community-based assessment (CBA), human health impact, animal health impact, environment, and socio-economics. Figure 3 shows how different methods of research are fit and combined as well complement each other.

 

 

Figure 3: Linkage of FBLI Vietnam component and methods

Community-based Assessment

The aim of community-based assessment help to measure the extent of a known situation and identify what is known and done by stakeholders relating human and animal waste management; suggest an intervention strategy in light of specific local circumstances and the cultural factors that influence them and plan activities better suited to the respective stakeholders involved; establish the baseline (reference value) for use in future assessments and will help measure the effectiveness of the activities of the project’s interventions.

The following specific methods are described for each research objective:

Objective 1: Measure the extent of a known situation and identify what is known and done about various subjects relating human and animal waste management

Methods

The focus groups with community members will have to be like a social gathering where people tell stories. This may be a way of addressing the issue of pulling the story lines together. The first few weeks in the commune will have to include just spending time with the community and engaging in the activities that they are involved everyday, especially agricultural activities. The purpose of this is to establish some rapport with potential participants, but also to incorporate participant observation, which may require us to adapt our approach in implementing our research planning. The purposes of this initial time in the community are:

• Identify who has influence in aspects of livestock and crop productions, community life and decision making or different mass organizations in the community (e.g. who makes decisions within households, the village, etc.)
• Identify how to develop stories for the intervention plan, instead of relying on the researchers to develop them (e.g. what are the elements of storytelling within the study sites (Hoang Tay, Le Ho commune?). These will be used to develop the research implementation plan because in order for them to be useful, the participants and community members of the research implementation need to understand connect with, and be interested in the research implementation.

This initial time in the community is a scoping phase to identify the appropriate tools for data collection for the research plan, identify the people or groups of people that will engage in the process, and gain a deeper understanding of the community. It is intended to guide a process for research planning where community members can take ownership of the process. We will likely use informal conversations during household and community visits and write field notes to collect information and then test some participatory rural appraisal (PRA) tools.

PRAs tools such as seasonal calendar, decision-making matrix, problem drawing, ranking, in-depth interviews and focus group discussions with pig/poultry farmers, animal health practitioners, health care practitioners, local authorities and government officers will be will be applied. In addition, observation checklists will be designed to observe the livestock farmers’ practices.

The requirement and selection of local participants: we will start using chain sampling to identify potential participants. This sampling technique is a way of finding key informants or critical cases through a person’s network of acquantances. The communal health workers will be contacted with participants in-person. After the scoping phase, as we meet more community member, participants will be selected purposively, depending on their influence, in an effort to make research implementation a sustainable process.

The expected  numbers of focus group and conducting time are described in Table 1.

 

Commune	Commune People Committees members	Community members	Conducting time follows the process
Hoang Tay	1	3	4 times/group
Le Ho	1	3	4 times/group
Chuyen Ngoai	1	3	4 times/group

 

Each focus group meeting, including 6 – 8 persons. The focus group meeting will be followed up step-by-step of the process: i) identify driving force; ii) ranking driving force; iii) develop research implementation; iv) discuss implication of research implementation, planning  for possible next steps.

A quantitative data will also be collected for the assessment. Questionnaires will be developed and it will be field tested and revised accordingly. The questionnaire will be used to collect data on the the current handling practices of waste management. Additionally, practices of the respondents will be observed by checklists.

The quantitative assessment will be carried out in 3 communes in Ha Nam province before and after the interventions. The 450 livestock farmers in 6 villages of 3 communes will be targeted. A structured questionnaires will be prepared and obtained information, including i) Socio-demographic characteristics (age, sex, education, occupation); ii) Agricultural activities (livestock and crop productions…); iii) Handling practice of waste management (human waste, animal waste, domestic waste and agriculture waste); iv) Involvement of local authorities and local stakeholders in management of wastes in the community; v) The human health and animal health problems and environmental impacts related to agricultural activities; vi) Social, cultural and economic effect to agricultural activities.

Objective 2: Suggest an intervention strategy in light of specific local circumstances and the cultural factors that influence them and plan activities better suited to the respective stakeholders involved.

Methods: The information on possible intervention regarding livestock and human waste management and the data obtained from the CBA will be used to formulate and develop the strategy on pig and poultry waste management in the study communities. 

Intervention activities will be identified and suggested based on a process using PRA tools to ensure the participation and spontaneousness of all stakeholders. Pig/poultry farmers and all partners involved will participate and discuss to find out intervention models for changing the behavioral patterns of the study commune. To encourage the behavior change of the farmers a cost benefit analysis will be provided and demonstrated to the farmers.  This analysis will show in term economic aspect for the farmers. The information need to be obtained is the understanding motivation of the farmer risk of pig and poultry waste for their health, animal health and environment health. Farmers will need to see a reason to change their behavior, especially if they perceive that the changes will cost them money for no direct benefit.

Objective 3: Provide recommendations regarding the livestock and human waste management to policy makers.

Methods: The result from intervention will be disseminated to the policy makers and key stakeholders.  Dissemination of the result will undertake from the initial process of the study until the formal dissemination result of the study into various stakeholders.  During the research process, multiple stakeholders will be engaged and consulted. 

Brochure and press conference could be done to stimulate community awareness and support. In terms of result dissemination to scientific groups, the publication in domestic and international journal will inform wider audiences. In the end policy brief will be widely circulated to the media reaching general audiences. 

Health Impact Assessment of Waste Management

Quantitative microbial risk assessment related to livestock and human waste management

Health impact assessment associated with livestock and human waste management. This will be based on the development of an epidemiology and quantitative microbial risk assessment (QMRA) as well as the microbial contamination in water of livestock and human waste management system. The method of QMRA will be applied from (Haas et al. 1999; Ferrer et al. 2012). QMRA estimates transmission risks of a selected pathogen in a specific exposure pathway. It estimates risks difficult to measure with epidemiological approaches and is therefore a useful complement to epidemiological investigations. Towards a safe management of livestock and human waste management and identify the options for treatments to achieve the local acceptable risk.

Objective: This research aims at assessing the health risks related to one specific pathway of transmission of HAWAM in Kim Bang district, Ha Nam province, using the quantitative microbial risk assessment (QMRA) method.

Expected outcome: the study is the understanding of typical pathogens occurring in, the main exposures of population to livestock and human waste management the characterization of health risks associated to the selected pathway of transmission of livestock wastes. This outcome allows proposing appropriate treatment options and practices as barriers to reduce health risk of livestock wastes.

Main components of QMRA: QMRA method includes the following four main steps: (i) hazard identification, (ii) exposure assessment, (iii) dose-response assessment, and (iv) risk characterization

Hazard identification is the first QMRA step. It represents the identification of pathogenic organisms of potential significance to human health. From earlier study E. coli, G. lamblia, and C. parvum were identified as hazards for further assessment. Critical exposure points will be identified by using our current knowledge of the livestock and human waste management in the study sites.

Exposure assessment is to determine the exposure of the populations to the pathogen (transmission route). The intensity and duration of exposure will be defined. This step requires an estimation of the amount of E. coli, G. lamblia, and C. parvum in livestock waste in each of the exposure points, as well as the amounts of ingested/contacted materials per exposure. This information will be obtained from the surveys. The concentration of E. coli, G. lamblia, and C. parvum in waste samples will be obtained in analysis at the laboratory. QMRA modeling required the quantity of water or soil ingested daily during the people’s activities in relation to livestock waste management. We use literature information as estimations for these values. While voluntary daily consumption of water can easily be obtain the quantity of involuntarily ingested water and/or soil during various farming activities is difficult to measure.

(iii) Dose-response analysis: is the link between the level of microbial exposure and the adverse health effect using dose-response model which is given for each pathogenic organism. In this study, the dose-response model use for G. lamblia and C. parvum infection is an exponential model whereas a β-Poisson model is used for E. coli

(iv) Risk characterization integrates the outcomes obtained in steps 1 to 3 characterizes the types and magnitudes of the public health risk and evaluates the variability and uncertainty. This working step including the following procedures: Based on the concentrations of E. coli, G. lamblia and C. parvum in the samples, risk of infections (mean, and 5^th and 95^th percentiles) will be estimated for each exposure scenarios in the study sites. The results will be plotted in a graph for visual appraisal. Factors of uncertainty and variability will be identified and discussed and effective measure for risk minimization in the studied region will be proposed. Deterministic and probabilistic approaches using Monte Carlo simulations will be used for risk characterization.Finally, the infection risk will be converted to risk of disease and disability adjusted life years (DALYs) which will be compared between exposures and pathogens.

Epidemiology study related to HAWAM

This epidemiological study will be designed once impact indicators have been developed. However, the study will be conducted at the district level as indicated in Figure 2 with the inclusion of 3 communes. Both indicators for human and animal health will be identified The purpose of the epidemiological study is to identify and assess risk factors for helminth infection and diarrheal disease among people living in the study area; and also animal morbidity and fatality. The data will be collected including, i) General information, including geographical, demographical, socioeconomic status, latrine availability, animal husbandry, wastewater drainage system, environmental condition and water source, the detailed process of management of human and livestock waste; ii) The prevalence of helminth infections and diarrheal disease; iii) Animal morbidity and fatality will be recorded.

The first cross-sectional survey of households will be conducted. The purpose of the baseline survey is to identify the study population as well as to collect the general information, including demographical and socioeconomic data of the study households. Data collection will be used an interview questionnaire. The number of households enrolled into this baseline survey will be calculated by using a formula of determination of sample size for estimating proportions with estimate to standard error of 0.05 with 95% confidential interval; and expect prevalence of households have livestock husbandry is 50%. Total of households will be involved in this baseline survey are 450.

Selection of households and study population

According to a total sample size of 450 households, each commune will be surveyed 150 households. In each of the communes the list of households of each village will be obtained from the communal people’s committee. Then the household enrolled in the survey from each of the selected communes will be systematically and randomly sampled from the list. In case the head of household refuses to participate or absent (after three visits, where the interviewer return after one hour each time) or an elderly person whose mental state made it difficult to ask and answer questions, that particular household is not included and the next household on the list will be selected.

The main respondents are head of household, or the spouse of the head of the household, or adult people permanent living in the same household. Before the survey can be implemented, all of the participants understand the purposes of the study as well as benefits and the risk and assures confident information obtained from the survey, also they are willing to participate and sign the patient consent form.

Interviews and observational check list

A structured-questionnaire will be used to obtain information about the general information, including demographical (age, gender), occupation, education for all household members and to assess the socioeconomic data of the study households, including water supply, latrine availability, wastewater drainage system, environmental condition, animal husbandry, the detailed process of management of human and animal excreta. In addition, the engagement of household members in the hygiene practices involves will be also identified. The questionnaire and observational check list are translated in Vietnamese. The principal researcher checks the filled out and randomly spot checks 20% of number of the questionnaires as a means of quality assurance. Each interview lasts approximately 45 minutes.

The second and third cross-sectional survey will be conducted after 6 months and one year implementation of the project at the same study sites. The purpose of the surveys is to assess the effectively project implementation. The data collection will also be used structured-questionnaire and observational check list as similar use in the first cross-sectional survey.

Environmental impact assessment related to HAWAM

Objectives: The main objective of this research is to assess the nutrients (Nitrogen (N) and Phosphorus (P)) flows related to livestock waste management using the material flow analysis (MFA).

Specific objectives are:

• To understand and describe the nutrient fluxes (Thu Nga et al. 2011) in Kim Bang district with regards to livestock and human waste management.
• To identify critical control points (Nguyen-Viet et al.)
• Parameters (model inputs) represents as probability distributions, so taking into account the data reliability. The type and characteristics of the probability distribution is either defined based on existing data, or estimated on the basis of the parameter type and expert knowledge. 
• The model is developed so as to minimize the number of parameters. Moreover, equations containing parameters difficult to assess are reformulated so as to eliminate these parameters.
• Uncertainty of flows (model outputs) should also be determined. Propagation of uncertainty can be estimated by Monte Carlo simulation. The Monte Carlo method can determine variable uncertainty on the basis of parameter uncertainty. The principle consists in generating model parameter values randomly within the parameter uncertainty distribution specified initially. Variable values are subsequently calculated based on the generated parameter values. An uncertainty distribution for the variable can be determined based on the calculated variable values. 
• A sensitivity analysis is conducted in order to identify the parameters mainly influencing the variables (material flows). This does not only support the development of effective measures but also provides insight into parameters requiring a more accurate assessment to reduce flow uncertainty.
• Determination of the flows is an iterative process: a rough parameter assessment is conducted prior to designing data collection plans. This procedure helps to focus on a reduced number of sensitive parameters and thus to optimize data collection plans.
• The first rough parameter estimate can be based on literature data, data from statistical offices and database or results from expert interviews.
• Use of formal expert elicitation techniques allows filling data gaps where data is too scarce to characterize a process but where expert knowledge allows obtaining a fair estimate of the model parameters.
• A set of plausibility criteria is established representing parameters, variables (flows or stock change rates) or relationships between parameters or between variables (e.g. N/P ratios).
• Plausibility criteria ranges are determined based on reliable data sources.
• Plausibility is assessed by comparing model input parameters or model outcomes with the plausible ranges.
• If the quality of the model input parameters or model outcomes is judged insufficient by the results of the plausibility assessment, a more accurate assessment of the most sensitive parameters is carried out (more differentiated literature review, surveys and field measurements).
• Calculation of the flows is repeated after each new parameter assessment until the required quality is reached.
• Literature and secondary data review
• Define a preliminary MFA system with main processes and mass flows
• Data collection: Primary data (survey, interview, observations) and secondary data review.
• Validate MFA system
• Establish first MFA model
• Conduct uncertainty analysis and obtain first output results
• Define parameters which need to be assessed more accurately
• Define data acquisition plan
• Re-assess parameter value
• Conduct sensitivity and uncertainty analysis
• Calibrating MFA model
• Analysis MFA model (Critical control points (CCPs), main pollution sources…)
• Scenario development, interpretation and documentation
• In small-scale pig manure management, farmers commonly store pig manure mixed with some added matters (e.g. rice straw, rice husk, lime, kitchen ash, weeds, and tree leftovers). The manure heaps are typically covered with a layer of clay (mud) to reduce the smell and to prevents flies, dogs or chickens to destroy the heaps. The storage period varies between 1-3 months depending on the crop growth time and needs for fertilizer. Approaches to enhance hygienic safety while ensuring that nutrient contents remain high will be tested and include i) addition of super phosphate or lime or ash to increase the pH; ii) addition of ash, rice straw, and/or bananas leaves (all commonly available in the community) to reduce moisture; iii) to increase anaerobic decomposition by covering the heaps with mud; iv) to further protect the heap from dogs or chickens with a brick wall; v) to protect against damage by rainwater.
• For large-scale farms, these are extended to include the biogas systems also used to treat human and animal wastes.

Procedure of MFA

The MFA tool developed by (Montangero 2006) comprises the description of the approach and of the different methods applied as part of this approach as well as the model describing goods and nutrient flows within the environmental sanitation system of a region and database. The tool also integrates in the MFA method concepts for uncertainty analysis and plausibility assessment.

In our site study (e.g. livestock waste management), depending on the secondary data, main process and the sub-process of the system will be defined, as well as links between them and boundary of the MFA system. Moreover, following literature review and expert knowledge, the formulation of balance and model equations, and plausibility criteria of each process will be established.

Assessment of parameter values (probability distributions) is the next step. Determination of flows/stocks (probability distributions) and sensitive parameters (sensitivity analysis) in order to identify the parameters mainly influencing the variables (material flows).

This does not only support the development of effective measures but also provides insight into parameters requiring a more accurate assessment to reduce flow uncertainty. Plausibility is assessed by comparing model input parameters or model outcomes with the plausible ranges.

 

 

 

Figure 4: Procedure of an MFA

The MFA approach is based on the following elements:

· Parameters (model inputs) represents as probability distributions, so taking into account the data reliability. The type and characteristics of the probability distribution is either defined based on existing data, or estimated on the basis of the parameter type and expert knowledge.

· The model is developed so as to minimize the number of parameters. Moreover, equations containing parameters difficult to assess are reformulated so as to eliminate these parameters.

· Uncertainty of flows (model outputs) should also be determined. Propagation of uncertainty can be estimated by Monte Carlo simulation. The Monte Carlo method can determine variable uncertainty on the basis of parameter uncertainty. The principle consists in generating model parameter values randomly within the parameter uncertainty distribution specified initially. Variable values are subsequently calculated based on the generated parameter values. An uncertainty distribution for the variable can be determined based on the calculated variable values.

· A sensitivity analysis is conducted in order to identify the parameters mainly influencing the variables (material flows). This does not only support the development of effective measures but also provides insight into parameters requiring a more accurate assessment to reduce flow uncertainty.

· Determination of the flows is an iterative process: a rough parameter assessment is conducted prior to designing data collection plans. This procedure helps to focus on a reduced number of sensitive parameters and thus to optimize data collection plans.

· The first rough parameter estimate can be based on literature data, data from statistical offices and database or results from expert interviews.

· Use of formal expert elicitation techniques allows filling data gaps where data is too scarce to characterize a process but where expert knowledge allows obtaining a fair estimate of the model parameters.

· A set of plausibility criteria is established representing parameters, variables (flows or stock change rates) or relationships between parameters or between variables (e.g. N/P ratios).

· Plausibility criteria ranges are determined based on reliable data sources.

· Plausibility is assessed by comparing model input parameters or model outcomes with the plausible ranges.

· If the quality of the model input parameters or model outcomes is judged insufficient by the results of the plausibility assessment, a more accurate assessment of the most sensitive parameters is carried out (more differentiated literature review, surveys and field measurements).

· Calculation of the flows is repeated after each new parameter assessment until the required quality is reached.

Research plan and preparatory stage for MFA

· Literature and secondary data review

· Define a preliminary MFA system with main processes and mass flows

First field survey

· Data collection: Primary data (survey, interview, observations) and secondary data review.

· Validate MFA system

Second field survey

· Establish first MFA model

· Conduct uncertainty analysis and obtain first output results

· Define parameters which need to be assessed more accurately

· Define data acquisition plan

· Re-assess parameter value

Finishing step

· Conduct sensitivity and uncertainty analysis

· Calibrating MFA model

· Analysis MFA model (Critical control points (CCPs), main pollution sources...)

· Scenario development, interpretation and documentation

Socio-economic research on livestock waste management

The methods of cost benefit analysis and willingness to pay for new management options will be developed. However, the team is considering the priority of each component related to the budget. It is not completely sure that we will cover all the methods proposed.

Selection of HAWAM options

The consideration will be the reduction of environmental and health risk of the management options balanced to the livelihoods of the concerned communities. Good practices applied in the community, collected during a rapid appraisal study in different livestock keeping systems of Vietnam, shall be further assessed for their effectiveness in reducing hazards. Special focus is also on the contrasted perceived human and environmental health risks of wastes. We favor such an approach because already applied good practices in the community by few members show that they are feasible in the context of their livelihood. Shown effective good practices are promoted more widely. The selection and evaluation process may not be straight forward, but we will pay much attention to document well good practices and some can be assessed later.

Method: This activity will shape the assessment tool. The tool will be developed in close collaboration with end users. Data on livestock (number of animal) and human (population), type of farms, type of sanitation technologies (e.g. latrines, septic tank, and biogas) as well as waste management, nutrient content in waste, will be collected and samples analyzed for pathogen and chemical residuals. Model of MFA and QMRA will be developed. They are gender-sensitive. A prioritization of good practices will be done by ranking of experts.

Main data and surveys will be done at the study sites to feed the model of the tool and conclude the options for livestock waste management.

Based on the above techniques at different scales, we will develop a tool to assess the environmental impact on nutrient recycling (nitrogen and phosphorous) by using MFA and to consider epidemiological health impacts and microbial contamination of water with a QMRA framework.

Impact pathway

A national policy alliance group (see KT component of FBLI) will be founded to interact with research team on how research can impact best the policy on the topic of agriculture intensification in general and HAWAM in particular. Therefore connection, informing and policy advocacy with policy stakeholders  who have been identified (see below) will need to be done at a regular basis or punctual.

At the local level, it is facilitate policy changes in a more participatory and effective way of making research outputs explicit to policy making through a national policy alliance group.

Research team

We have built a team which is multi-disciplinary, multi-institutional and have a common interest in ecohealth as in initially required by the RCG members. A veterinarian from the community will be recruited to lead the animal health research part.

Table 1: Research team of FBLI Vietnam

 

Name	Expertise and Function	Institution
Prof. Le Vu Anh	Epidemiology, Project Director	HSPH
Dr. Nguyen Viet Hung	Country team leader	HSPH
Dr. Dinh Xuan Tung	Agricultural economic expert	NIAS
Dr. Pham Duc Phuc	Public Health expert, team coordinator	NIHE/HSPH
Ms. Tran Thi Tuyet Hanh	Environmental Health expert	HSPH
Dr. Tran Minh Hang	Anthropological expert	VASS
Mr. Bui Huy Tung	PhD student	HSPH
Ms.Nguyen Mai Huong	Research assistant	HSPH
To be recruited from community (DVM)	Veterinary	Hanam province

 

Stakeholders and boundary partners

Key stakeholders in the animal waste management include farmers, local organizations (women unions, farmers association...), government agencies at different levels, in particular district and central level (Ministry of Health and Ministry of Agriculture and Rural Development), NGOs and other private sectors.

Reference

Ferrer A, Nguyen-Viet H, and Zinsstag J (2012). Quantification of Diarrhea Risk Related to Wastewater Contact in Thailand. EcoHealth 9:49-59.

Haas CN, Rose JB, and Gerba CP (1999). Quantitative Microbial Risk Assessment. John Wiley & Sons, INC, New York.

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