Center for Development Research (ZEF), University of Bonn, Bonn, Germany.
University of Cologne, Köln, Germany.
Health Res Policy Syst. 2018 Dec 19;16(1):124. doi: 10.1186/s12961-018-0398-6.
The complexity and increasing burden of zoonotic diseases create challenges for the health systems of developing nations. Public health systems must therefore be prepared to face existing and future disease threats at the human-animal interface. The key for this is coordinated action between the human and the animal health systems. Although some studies deal with the question of how these two systems interact during unforeseen circumstances such as outbreaks, a dearth of literature exists on how these systems interact on early detection, prevention and control of zoonotic diseases; assessing this problem from the health system perspective in a developing nation adds further complexity. Systems thinking is one of the promising approaches in understanding the factors that influence the system's complexity and dynamics of health maintenance. Therefore, this study aims to understand the generic structure and complexity of interaction between these actors within the domain of One Health for the effectual prevention and control of zoonotic diseases in India.The present study will be executed in Ahmedabad, located on the Western part of India, in Gujarat state, using a mixed methods approach. For the first step, zoonotic diseases will be prioritised for the local context through semi-quantitative tools. Secondly, utilising semi-structured interviews, stakeholders from the human and animal health systems will be identified and ranked. Thirdly, the identified stakeholders will be questioned regarding the current strength of interactions at various levels of the health system (i.e. managerial, provider and community level) through a quantitative network survey. Fourthly, utilising a vignette method, the ideal convergence strategies will be documented and validated through policy Delphi techniques. Finally, through a participatory workshop, the factors that influence convergence for the control and prevention of zoonotic diseases will be captured.This study will provide a comprehensive picture of the current strength of collaboration and network depth at various levels of the health system. Further, it will assist different actors in identifying the relevance of possible One Health entry points for participation, i.e. it will not only contribute but will also develop a system convergence model for the effectual prevention and control of zoonotic diseases.
人畜共患病的复杂性和日益增加的负担给发展中国家的卫生系统带来了挑战。因此，公共卫生系统必须做好准备，应对人类与动物接触界面上现有的和未来的疾病威胁。关键是人类和动物卫生系统之间的协调行动。虽然有些研究涉及到这两个系统在疫情等意外情况下如何相互作用的问题，但关于这两个系统如何在早期发现、预防和控制人畜共患病方面相互作用的文献很少；从发展中国家的卫生系统角度评估这一问题增加了进一步的复杂性。系统思维是理解影响系统复杂性和健康维护动态的因素的一种有前途的方法。因此，本研究旨在了解“同一健康”领域中这些行为者之间的一般结构和相互作用的复杂性，以有效预防和控制印度的人畜共患病。
本研究将在印度古吉拉特邦西部的艾哈迈达巴德市进行，采用混合方法。第一步，通过半定量工具为当地情况确定优先的人畜共患病。其次，利用半结构化访谈，确定和排名来自人类和动物卫生系统的利益攸关方。第三，通过定量网络调查，向确定的利益攸关方询问卫生系统各个层面（即管理、提供者和社区层面）的互动当前强度。第四，利用情景描述法，通过政策德尔菲技术记录和验证理想的收敛策略。最后，通过参与式研讨会，捕捉影响人畜共患病控制和预防收敛的因素。
本研究将全面了解卫生系统各个层面的合作现状和网络深度。此外，它将帮助不同的行为者确定参与同一健康的可能切入点的相关性，即它不仅将做出贡献，还将为有效预防和控制人畜共患病开发一个系统收敛模型。
