McPherson Anna, Hill Peter S, Kama Mike, Reid Simon
School of Public Health, The University of Queensland, Brisbane, Australia.
Fiji Centre for Communicable Disease Control, Ministry of Health and Medical Services, Suva, Fiji.
Int J Health Plann Manage. 2018 Mar 30. doi: 10.1002/hpm.2521.
Fiji has a high burden of leptospirosis, with endemic infection and epidemic outbreaks with high mortality, often associated with flooding and cyclones. As a zoonosis, leptospirosis control requires interventions in sectors beyond the usual control of health-in Fiji, the dairy and sugar industries, and water and sanitation and rodent control in communities. This paper presents the findings of qualitative research to inform policy around governance for a One Health multisectoral approach to leptospirosis control.
Key informants from relevant government agencies and industry organizations were interviewed in late 2014, and the interviews analyzed and triangulated with documentary analysis.
The analysis identified 5 themes: perceptions of the impact of leptospirosis, governance processes, models for collaboration, leptospirosis control, and preferred leadership for leptospirosis management. Data were limited, with poor communication between ministries, and limited awareness of leptospirosis outside outbreaks. Collaboration during outbreaks was positive but not sustained in endemic periods. Mechanism for enhanced collaboration was developed for endemic and outbreak situations.
The findings informed a One Health governance approach to leptospirosis, framed within a National Strategic Plan, with a specific National Action Plan for Leptospirosis. The process provides a research based One Health template for application to other zoonotic diseases.
斐济钩端螺旋体病负担沉重，存在地方性感染以及死亡率高的疫情暴发，且往往与洪水和飓风相关。作为一种人畜共患病，控制钩端螺旋体病需要在常规卫生控制之外的其他部门采取干预措施——在斐济，涉及乳制品和制糖业，以及社区的水与环境卫生和鼠害控制。本文介绍了定性研究的结果，以为围绕钩端螺旋体病控制的“同一健康”多部门治理方法的政策提供信息。
2014年末对相关政府机构和行业组织的关键信息提供者进行了访谈，并对访谈内容进行了分析，同时结合文献分析进行三角互证。
分析确定了5个主题：对钩端螺旋体病影响的认知、治理过程、合作模式、钩端螺旋体病控制以及钩端螺旋体病管理的首选领导方式。数据有限，各部委之间沟通不畅，疫情之外对钩端螺旋体病的认识有限。疫情期间的合作是积极的，但在地方性流行期间未持续。针对地方性流行和疫情情况制定了加强合作的机制。
研究结果为在国家战略计划框架内针对钩端螺旋体病的“同一健康”治理方法提供了信息，并制定了具体的钩端螺旋体病国家行动计划。该过程为应用于其他人畜共患病提供了一个基于研究的“同一健康”模板。
