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Community-based plant clinics should be part of a health system for plants, say agriculture experts Solveig Danielsen and Frank Matsiko.

Food security, the production of safe food and the provision of quality products for domestic and export markets are all dependent on the ability to grow healthy plants. But pests and diseases destroy millions of tons of crops every year across the world, preventing families, communities and nations from fully exploiting their potential to produce food and create wealth.

Timely access to information and advice about how to manage plant health problems can make the difference between success and failure. Since 2003, 12 countries in Africa, Asia and Latin America, have introduced community-based plant health clinics as a way of providing this advice to small-scale farmers.

Plant clinics have spread rapidly because they offer a cheap and practical alternative to more conventional approaches that can help only limited numbers of farmers. They operate in easily accessible public places and are widely used to identify the causes of plant health problems and to find solutions.

Effective plant healthcare requires a permanent and responsive system, so the clinics need to be well integrated with other services, including technology and knowledge providers. The biggest challenges to achieving this are overcoming the 'project mentality' and the limits imposed by constraining institutional structures.

Government strategy

Uganda is one of five African countries, along with the Democratic Republic of Congo, Kenya, Rwanda and Sierra Leone, that operates plant clinics. In 2006 it established four pilot clinics, with technical and financial support from the Global Plant Clinic of CABI (Centre for Agricultural Bioscience International). The clinics were based in three districts (Mukono, Iganga and Soroti) and run by district extension staff and local non-governmental organisations.

A recent study in Uganda, carried out by the University of Copenhagen in Denmark, Uganda's Makerere University and CABI, examined how the four plant clinics operate with a view to improving their performance and organisation. It showed that the plant clinics had a wide outreach (in terms of both farmers and crops) and had a potential role in local pest and disease vigilance. As a result, plant clinics are now included in the pest and disease control programme of Uganda's Ministry of Agriculture, Animal Industries and Fisheries.

A health system for plants

But establishing plant clinics is not enough — they need to be connected as part of a more integrated plant health system, as there is a limit to what an individual community clinic can do. With human health, for instance, community-based health workers can dress wounds and treat common fevers and diarrhoea, but they cannot do complicated surgery or carry out laboratory tests to aid diagnosis.

Similarly, individual plant clinics need to be part of a bigger health system to benefit from all the available technical support. They also need to be linked to input suppliers so they can provide the right treatments and seeds to farmers. Just as human healthcare depends on good access to pharmacies, plant clinics in Nicaragua are now being integrated with 'plant pharmacies' so they can offer good seed, biological products and low-toxicity pesticides.

Although the plant clinics are based on existing structures and human resources, the shift towards a plant health system has huge implications for the people and institutions involved. The Ugandan experience has revealed important achievements as well as major obstacles to wider change.

Poorly connected

In the pilot period, Uganda's plant clinics received more than 2,000 queries from hundreds of farmers about a wealth of problems and crops. The inclusiveness and outreach of the clinics and the direct accountability between clinic staff and their clients were good, but the plant clinics were poorly connected to the other parts of the system.

Links between plant clinics and input suppliers were found to be vague or non-existent. There is no functioning referral system between the plant clinics and diagnostic laboratories, for example, and all attempts to establish links between research institutions and the plant clinics have failed so far. There is considerable plant health expertise in Uganda, but it is under-used and largely inaccessible to farmers and extension agents.

Another limitation is that the plant clinics faced unexpected competition from Uganda's National Agricultural Advisory Services (NAADS) programme. Some of the plant doctors also worked on NAADS projects, but instead of trying to integrate and complement NAADS activities with the plant clinics, they treated them as independent projects.

Project mentality

It is not easy to change ways of working in Uganda. The incentive systems and institutional structures limit the creativity and flexibility of staff. There is little reward for those who try to 'think outside the box'. Activities are driven by projects and current development rhetoric rather than long-term visions for agricultural transformation and institutional strengthening. Projects address a narrow range of topics for a defined group of people over a specific period of time, and there is a widespread notion that 'nothing happens without a project'.

Breaking down barriers between institutions is notoriously difficult. The dominating project mentality undermines efforts to create lasting, systemic change. These problems are not unique to Uganda, of course, but there are differences in the way they are tackled.

Sierra Leone has established plant clinics and shows strong commitment and creativity in their implementation. Is it because the project landscape is less crowded than in Uganda? The needs of Sierra Leone are huge in terms of capacity, institutions and funding, but dynamic individuals are free to take action and pursue new ideas.

Plant clinics were embraced in Sierra Leone because they are cheap and gave the Ministry of Agriculture a much-needed opportunity to show it can deliver. Necessity is the mother of invention; constrain people in projects and they tend to conform.

Flexible working

Community-based plant clinics have the potential to help farmers and contribute to making agriculture a successful business, especially in resource-poor countries where advisory services are often scarce, underfunded and beyond the reach of millions of smallholders. Plant clinics provide an opportunity to coordinate the efforts of extension, research, government regulation and input supply, to reach more people and to use existing resources more efficiently.

However, delivering good plant healthcare is different from executing a project. It requires those involved, including policymakers and donors, to adopt new ways of planning and working that pay attention to performance and outputs and allow more flexibility and creativity in operations. The focus must be on the long-term goals of creating responsive and accountable systems. Only then can plant clinics truly fulfil their potential.

Link to 'A New Vision of Plant Health Services for World's Poor' by Eric Boa

Link to work paper 'The introduction of mobile plant clinics to Uganda: First results and lessons learned 2005 – 2010'

Solveig Danielsen is an associate professor at the Centre for Health Research and Development at the University of Copenhagen, Denmark. She leads a research project on plant health systems in Uganda.

Frank Matsiko is head of the Department of Agricultural Extension Education at Makerere University, Uganda. He is in charge of the department's courses in rural sociology and group dynamics.

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