Agricultural extension has been undergoing major changes. Changing policies, declining public funding, new thinking and approaches, climate change and other environmental factors pose major challenges to public sector extension services. Pre-packaged, crop and region-biased extension approaches often failed to help remote and resource poor farmers to cope with rapidly changing realities. This has necessitated the search for alternative approaches. One such alternative, plant health clinics, has been developed and tested by the CAB International led Global Plant Clinic Alliance in many countries since 2001. Operated by staff of local organisations in locations that are easily accessible to farmers, plant clinics accept any crop problem. They provide regular, relevant and practical advisory services on plant health management. Clinic records generate useful information on priority problems and changing status of pests and diseases. The plant health clinic approach has been widely introduced in Africa under a CAB International initiative, Plantwise. In Uganda, a pilot scheme began in 2005 and has expanded to 19 regularly operating plant clinics. Kenya established 24 plant clinics between mid-2010 and September 2011, while Rwanda started with five clinics in 2011.

The clinics are run by a range of organisations, each adapting the basic model according to local circumstances but consistent with guidelines and principles established by CAB International. The approach demonstrates a number of strengths and benefits but is not without challenges. This paper discusses the lessons and experiences gained in Kenya, Rwanda and Uganda, and the implications for improving future practices and policies for plant health advisory services.