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Article

‘One Health’ Actors in Multifaceted Health Systems: An Operational Case for India

1
Center for Development Research (ZEF), University of Bonn, 53113 Bonn, Germany
2
Global Health, Institute for Hygiene and Public Health (IHPH), University Hospital Bonn, 53127 Bonn, Germany
3
Indian Institute of Public Health Gandhinagar (IIPHG), Gandhinagar 382042, India
4
GeoHealth Centre, Institute for Hygiene and Public Health (IHPH), University Hospital Bonn, 53127 Bonn, Germany
*
Author to whom correspondence should be addressed.
Healthcare 2020, 8(4), 387; https://doi.org/10.3390/healthcare8040387
Received: 20 August 2020 / Revised: 30 September 2020 / Accepted: 2 October 2020 / Published: 7 October 2020
(This article belongs to the Special Issue Healthcare Resource Management in Large-Scale Epidemics)
The surging trend of (re)emerging diseases urges for the early detection, prevention, and control of zoonotic infections through the One Health (OH) approach. The operationalization of the OH approach depends on the contextual setting, the presence of the actors across the domains of OH, and the extent of their involvement. In the absence of national operational guidelines for OH in India, this study aims to identify potential actors with an attempt to understand the current health system network strength (during an outbreak and non-outbreak situations) at the local health system of Ahmedabad, India. This case study adopted a sequential mixed methods design conducted in two phases. First, potential actors who have been involved directly or indirectly in zoonoses prevention and control were identified through in-depth interviews. A network study was conducted as part of the second phase through a structured network questionnaire. Interest and influence matrix, average degree, network density, and degree of centralization were calculated through Atlas.Ti (ATLAS.ti Scientific Software Development GmbH, Berlin, Germany), UCINET (Analytic Technologies, Lexington, KY, USA) software. The identified actors were categorized based on power, administrative level (either at the city or district level), and their level of action: administrative (policy planners, managers), providers (physicians, veterinarians), and community (health workers, community leaders). The matrix indicated that administrative actors from the district level were ‘context setters’ and the actors from the city level were either ‘players’ or ‘subjects’. The network density showed a strength of 0.328 during the last outbreak of H5N1, which decreased to 0.163 during the non-outbreak situation. Overall, there was low collaboration observed in this study, which ranged from communication (during non-outbreaks) to coordination (during outbreaks). The private and non-governmental actors were not integrated into collaborative activities. This study concludes that not only collaboration is needed for OH among the sectors pertaining to the human and the animal health system but also better structured (‘inter-level’) collaboration across the governance levels for effective implementation. View Full-Text
Keywords: One Health; intersectoral collaboration; actors; health system; India One Health; intersectoral collaboration; actors; health system; India
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MDPI and ACS Style

Yasobant, S.; Bruchhausen, W.; Saxena, D.; Falkenberg, T. ‘One Health’ Actors in Multifaceted Health Systems: An Operational Case for India. Healthcare 2020, 8, 387. https://doi.org/10.3390/healthcare8040387

AMA Style

Yasobant S, Bruchhausen W, Saxena D, Falkenberg T. ‘One Health’ Actors in Multifaceted Health Systems: An Operational Case for India. Healthcare. 2020; 8(4):387. https://doi.org/10.3390/healthcare8040387

Chicago/Turabian Style

Yasobant, Sandul, Walter Bruchhausen, Deepak Saxena, and Timo Falkenberg. 2020. "‘One Health’ Actors in Multifaceted Health Systems: An Operational Case for India" Healthcare 8, no. 4: 387. https://doi.org/10.3390/healthcare8040387

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