Why sovereignty in PPR vaccination matters for pastoral women: Exploring experiences and perspectives in a qualitative study in the Somali region, Ethiopia

Peste des petits ruminants (PPR) is a viral disease that significantly affects small ruminants, posing a serious threat to the livelihoods and food security of rural communities. Pastoral women are particularly impacted, as they are the primary caretakers of sheep and goats. While managing livestock can empower women, prevailing gender norms may limit this potential. This study aimed to explore women’s experiences in taking on responsibility for animal health and to analyse the challenges and opportunities presented by PPR intervention projects. Eight focus group discussions were conducted with women from three districts in the Somali region of Ethiopia, supplemented by twelve key informant questionnaires and one key informant interview. Qualitative data were analysed using reflexive thematic analysis, while quantitative data were analysed using descriptive statistics. The research findings present one overarching theme: ‘The importance of women’s sovereignty in PPR vaccination,’ along with two main themes. The first theme, ‘Navigating hierarchies and the feminisation of responsibility,’ comprises the subthemes ‘Women in responsibility,’ ‘Cultural norms and masculinities,’ and ‘Men losing track.’ This theme highlights women’s predominant roles in livestock management, household chores, and income generation, while it also explores traditional gender roles and the impacts of men’s khat consumption. The second main theme, ‘Knowledge privilege, dilemmas, and gaps,’ encompasses the subthemes ‘Knowledge for empowerment,’ ‘Dilemmas despite knowledge,’ and ‘Challenges due to training gaps.’ This theme explores women’s empowerment through PPR training, underscores the critical importance of unhindered access to PPR vaccines and effective cold chain maintenance, addresses challenges such as vaccine hesitancy and antimicrobial usage, and stresses the need for community-based training initiatives. The study emphasises a shift from the traditional gendered division of labor toward an increased burden of responsibility on women, a trend that appears to have been reinforced by anti-poverty programs and further intensified by men’s khat consumption. Training in animal health, particularly in PPR vaccination, has been identified as an area where women are eager to engage. To support this, the study recommends adopting ‘train-the-trainer’ and community-based approaches, while ensuring access to resources. These strategies must be gender-responsive to empower women in PPR management and reduce their workloads in the long term. One health impact statement This research highlights the importance of involving pastoral women in managing Peste des petits ruminants (PPR), a viral disease that significantly affects sheep and goats. It also emphasises the risk of overburdening women in poverty reduction efforts and stresses the need for gender-responsive initiatives to reduce their workload in the long term. By empowering women in animal health management through such initiatives, both animal health and the livelihoods and food security of rural communities are improved. This underscores the value of a One Health approach, which integrates human, veterinary, and social sciences to comprehensively address health challenges. The research was made possible through long-standing trust relationships between NGO staff and communities, which facilitated strong community engagement. The qualitative and reflexive approach to data analysis enabled the voices of affected individuals to be heard, allowing for the co-production of knowledge and enhancing the research’s societal relevance.