Convergence model for effectual prevention and control of zoonotic diseases: a health system study on \u2018One Health\u2019 approach in Ahmedabad, India

Sandul Yasobant,Timo Falkenberg,Walter Bruchhausen,Deepak Saxena

doi:10.1186/s12961-018-0398-6

Abstract

The complexity and increasing burden of zoonotic diseases create challenges for the health systems of developing nations. Public health systems must therefore be prepared to face existing and future disease threats at the human–animal interface. The key for this is coordinated action between the human and the animal health systems. Although some studies deal with the question of how these two systems interact during unforeseen circumstances such as outbreaks, a dearth of literature exists on how these systems interact on early detection, prevention and control of zoonotic diseases; assessing this problem from the health system perspective in a developing nation adds further complexity. Systems thinking is one of the promising approaches in understanding the factors that influence the system’s complexity and dynamics of health maintenance. Therefore, this study aims to understand the generic structure and complexity of interaction between these actors within the domain of One Health for the effectual prevention and control of zoonotic diseases in India.The present study will be executed in Ahmedabad, located on the Western part of India, in Gujarat state, using a mixed methods approach. For the first step, zoonotic diseases will be prioritised for the local context through semi-quantitative tools. Secondly, utilising semi-structured interviews, stakeholders from the human and animal health systems will be identified and ranked. Thirdly, the identified stakeholders will be questioned regarding the current strength of interactions at various levels of the health system (i.e. managerial, provider and community level) through a quantitative network survey. Fourthly, utilising a vignette method, the ideal convergence strategies will be documented and validated through policy Delphi techniques. Finally, through a participatory workshop, the factors that influence convergence for the control and prevention of zoonotic diseases will be captured.This study will provide a comprehensive picture of the current strength of collaboration and network depth at various levels of the health system. Further, it will assist different actors in identifying the relevance of possible One Health entry points for participation, i.e. it will not only contribute but will also develop a system convergence model for the effectual prevention and control of zoonotic diseases.

Highlights

The research literature cites an increasing burden of emerging, re-emerging and endemic zoonotic diseases that are attributed to complex linkages at the human–animal–ecosystem interfaces [1, 2]
The One Health approach, which recognizes that the health of people is connected to the health of animals and the environment, is the most appropriate approach for the sustainable management of zoonotic diseases [3], as well as for their prevention and control [4,5,6]
At both the national and global levels, an increasing trend can be witnessed towards One Health approaches in order to tackle the challenges of zoonotic diseases in the most effective way [7,8,9]

Summary

Introduction

The research literature cites an increasing burden of emerging, re-emerging and endemic zoonotic diseases that are attributed to complex linkages at the human–animal–ecosystem interfaces [1, 2]. The One Health approach, which recognizes that the health of people is connected to the health of animals and the environment, is the most appropriate approach for the sustainable management of zoonotic diseases [3], as well as for their prevention and control [4,5,6] At both the national and global levels, an increasing trend can be witnessed towards One Health approaches in order to tackle the challenges of zoonotic diseases in the most effective way [7,8,9]. Available evidence indicates that the collaborative efforts between physicians and veterinarians in communication, sharing of public health knowledge and research settings could do much in managing and controlling zoonoses [17,18,19]

Objectives

Methods