Nationally and locally-initiated One Health approach in controlling rabies in West Kalimantan, Indonesia.

Abstract

Rabies is one of the prioritized zoonoses in Indonesia and West Kalimantan is one of the rabies-endemic provinces in the country. This study aimed to evaluate a locally-initiated One Health approach to implement rabies prevention and control programs in Pontianak City and Sanggau District (through a bottom-up approach), and the central government initiated a program in Ketapang District (through a top-down approach). Data were collected using three focused group discussions involving public health and animal health/veterinary sectors from each district or city. This study collected data from the rabies control program in West Kalimantan from 2014 to 2020. The evaluation results of the rabies prevention and control program in Pontianak City and Sanggau District that used the local initiative approach were considered effective in reducing the number of rabies cases in these areas, and they overcame the challenges, for example, limited resources, in this area. Pontianak City and Sanggau District initiatives' approach was a bottom-up policy. Thus, this program had better sustainability than the One Health approach in the Ketapang District, which used a top-down implementation. The approach in Ketapang District was also considered adequate to reduce the number of rabies cases in the area. However, the reshuffle of animal health officers and health workers in 2020, which was not followed by training on One Health for the new officers, became a challenge in implementing One Health in Ketapang District. National and local initiatives' One Health approach implemented by Ketapang District, Sanggau District, and Pontianak City involved multiple sectors and was considered effective in preventing and controlling rabies in these areas. However, the sustainability of this program in the Ketapang District requires commitment and support from the local government.