Abstract
BackgroundOne Health is a collaborative, multisectoral, and transdisciplinary approach—working at the local, regional, national, and global levels—with the goal of achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment. Operationalization of the One Health approach is still unclear for various local health systems with their respective targets. In this scenario, the empirical study of intersectoral collaboration between the human and animal health systems provides an opportunity to investigate the appropriate strategies and their enabling factors at the local health system level. Thus, this study documented and validated the innovative strategy for intersectoral collaboration, focusing on effectual prevention and control of zoonotic diseases with its enabling factors for a city in western India, Ahmedabad.MethodsThis case study was conducted in three phases: phase I (qualitative data collection, i.e., vignette interview), phase II (quantitative data collection through modified policy Delphi), and phase III (participatory workshop). The vignette data were handled for content analysis, and the Delphi data, like other quantitative data, for descriptive statistics. The participatory workshop adapts the computerized Sensitivity Model® developed by Vester to analyse the health system dynamics.ResultOut of the possible 36 strategies, this study validated the top 15 essential (must-have) and five preferred (should-have) strategies for the study area. For operationalization of the One Health approach, the enabling factors that were identified through the systems approach are micro-level factors at the individual level (trust, leadership, motivation, knowledge), meso-level factors at the organizational level (human resource, capacity-building, shared vision, decision-making capacity, laboratory capacity, surveillance), macro-level factors at the system level (coordinated roles, relationships, common platform), and external factors outside of the system (guidelines/policies, community participation, a specific budget, political will, smart technology).DiscussionThis study reveals that the micro-level factors at the individual level are potential levers of the health system. More attention to these factors could be beneficial for the operationalization of the One Health approach. This study recommends a systems approach through a bottom-up exploration to understand the local health system and its enabling factors, which should be accounted for in formulating future One Health policies.
Highlights
One Health (OH) is a collaborative, multisectoral, and transdisciplinary approach—working at the local, regional, national, and global levels—with the goal of achieving optimal health outcomes, recognizing the interconnection between people, animals, plants, and their shared environment [1]
Thematic OH strategies derived from the vignette (Phase I) The content analysis indicated 36 different strategies categorized into themes such as legal or policies, clinical aspects including disease-specific ones, collaborations at the managerial level, collaborations at the provider level, collaborations at the community level, and the inclusion of private actors
The set of factors synthesized during the first step of the workshop offers an accumulated and comprehensive perspective about OH’s operationalization with a focus on zoonoses prevention and control
Summary
One Health (OH) is a collaborative, multisectoral, and transdisciplinary approach—working at the local, regional, national, and global levels—with the goal of achieving optimal health outcomes, recognizing the interconnection between people, animals, plants, and their shared environment [1]. OH implementation is recognized as highly politically driven [5] with a top-down approach [10, 11] and with few community-driven initiatives [12, 13] This top-down approach has its disadvantages in the policy process, such as effectiveness with respect to acceptability, local adaptation, and dynamics of change [14]. Operationalization of the One Health approach is still unclear for various local health systems with their respective targets In this scenario, the empirical study of intersectoral collaboration between the human and animal health systems provides an opportunity to investigate the appropriate strategies and their enabling factors at the local health system level. This study documented and validated the innovative strategy for intersectoral collaboration, focusing on effectual prevention and control of zoonotic diseases with its enabling factors for a city in western India, Ahmedabad
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