This monograph builds on the findings from Tunisia of a research project Small ruminant health: Improved livelihoods and market opportunities for poor farmers in the Near East and North Africa (NENA) region. The project was implemented jointly by the International Livestock Research Institute (ILRI) and the International Centre for Agricultural Research in the Dry Areas (ICARDA) with the collaboration of national partners in Jordan, Sudan, Syria and Tunisia. The aim of the project was to contribute towards improved of livelihoods of poor farmers in the NENA region through research targeted at improving small ruminant health, leading to increased productivity and enhanced access to local, national and regional livestock markets. The project provided action‐oriented research results at two levels. At the local level, emphasis was on understanding the delivery of animal health and other livestock services to poor farmers as well as the constraints that poor farmers face in accessing local markets. At national and regional levels, the aim was to increase market efficiency and access by poor farmers through research into marketing constraints (e.g. policies, transaction costs) and to decrease the threat of market exclusion/ disruptions due to the occurrence of diseases affecting small ruminants and associated sanitary regulations.