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Abstract
Many One Health surveillance systems have proven difficult to enforce and sustain, mainly because of the difficulty of implementing and upholding collaborative efforts for surveillance activities across stakeholders with different values, cultures and interests. We hypothesize that only the early engagement of stakeholders in the development of a One Health surveillance system can create an environment conducive to the emergence of collaborative solutions that are acceptable, accepted and therefore implemented in sustainable manner. To this end, we have designed a socio-technical framework to help stakeholders develop a common vision of their desired surveillance system and to forge the innovation pathway toward it. We implemented the framework in two case studies: the surveillance of antimicrobial resistance in Vietnam and that of Salmonella in France. The socio-technical framework is a participatory and iterative process that consists of four distinct steps implemented during a workshop series: (i) definition of the problem to be addressed, (ii) co-construction of a common representation of the current system, (iii) co-construction of the desired surveillance system, (iv) identification of changes and actions required to progress from the current situation to the desired situation. In both case studies, the process allowed surveillance stakeholders with different professional cultures and expectations regarding One Health surveillance to gain mutual understanding and to reconcile their different perspectives to design the pathway toward their common vision of a desired surveillance system. While the proposed framework is structured around four essential steps, its application can be tailored to the context. Workshop facilitation and representativeness of participants are key for the success of the process. While our approach lays the foundation for the further implementation of the desired One Health surveillance system, it provides no guarantee that the proposed actions will actually be implemented and bring about the required changes. The engagement of stakeholders in a participatory process must be sustained in order to ensure the implementation of co-constructed solutions and evaluate their effectiveness and impacts.
Highlights
The One Health concept calls for systemic approaches to better understand and manage complex health problems
We have developed and applied a socio-technical framework, which is intended to be implemented during a series of workshops. It consists of four steps: (i) definition of the problem to be addressed based on participant expectations, (ii) coconstruction of a common representation of the system in place, (iii) co-construction of the desired surveillance system, (iv) identification of changes and actions required to progress from the current situation to the desired situation and construction of the innovation pathway (Figure 1)
In Vietnam, the participatory process was implemented during three half-day workshops between December 2018 and January 2019
Summary
The One Health concept calls for systemic approaches to better understand and manage complex health problems. This requires the bridging of activities carried out in the human, animal, and environmental health sectors, mobilizing the different professions and decision-making scales, and establishing interdisciplinary approaches that bring together biomedical, environmental, and social sciences [1]. The approach highlights potential improvements of surveillance in terms of epidemiological and economic performance. It is expected to improve knowledge of health events and their management, while reducing the costs associated with surveillance activities and interventions [4,5,6]. A wide range of technical, organizational, and sociological factors is impeding the sustainable implementation of One Health surveillance [7,8,9,10,11,12]
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