Sheep and goats constitute a vital asset for smallholder farmers throughout East Africa; however, numerous obstacles still hinder small ruminant productivity. This review sought to pinpoint the main limitations in small ruminant farming and propose feasible and sustainable approaches to address them. Out of 54 qualifying studies, the majority originated from Ethiopia (n = 44), with only six from Tanzania and four from Uganda. In Ethiopia and Tanzania, disease was the most prevalent constraint (n = 28 and n = 3, respectively), while in Uganda, limited access to veterinary care was the primary challenge (n = 4). Other frequently reported issues across all three countries included scarcity of quality breeding animals, lack of livestock records, and the absence of structured marketing systems. Among the diseases, ectoparasites, gastrointestinal infections, orf, and sheep/goat pox were most commonly associated with production losses. Farmers in several studies suggested solutions such as better access to veterinary inputs and drugs, improved record maintenance, and easier acquisition of quality breeding stock. Community-driven participatory plans were also emphasized to enhance awareness of animal health management, pasture use, and husbandry practices. The review underscored significant knowledge deficiencies, the demand for additional research—particularly in Tanzania and Uganda—and the necessity of integrated approaches to address interrelated production barriers.
