Perez Arredondo Ana Maria, Yasobant Sandul, Bruchhausen Walter, Bender Katja, Falkenberg Timo
Center for Development Research (ZEF), University of Bonn, Germany.
Faculty of Agriculture, University of Bonn, Germany.
One Health. 2021 May 31;13:100272. doi: 10.1016/j.onehlt.2021.100272. eCollection 2021 Dec.
Intersectoral collaborations are an integral component of the prevention and control of diseases in a complex health system. On the one hand, One Health (OH) is promoting the establishment of intersectoral collaborations for prevention at the human-animal-environment interface. On the other hand, operationalising OH can only be realized through intersectoral collaborations. This work contributes to broadening the knowledge of the process for operationalising OH by analysing the governance structures behind different initiatives that tackle health problems at the human-animal-environment interface. The cases taken as examples for the analysis are the control and response to rabies and avian influenza under "classical OH", and the management of floods and droughts for insights into "extended OH". Data from Ghana and India were collected and compared to identify the key elements that enable ISC for OH. Despite the case studies being heterogeneous in terms of their geographic, economic, social, cultural, and historical contexts, strong similarities were identified on how intersectoral collaborations in OH were initiated, managed, and taken to scale. The actions documented for rabies prevention and control were historically based on one sector being the leader and implementer of activities, while avian influenza management relied more on intersectoral collaborations with clearly defined sectoral responsibilities. The management of the impact of flood and droughts on health provided a good example of intersectoral collaborations achieved by sectoral integration; however, the human health component was only involved in the response stage in the case of Ghana, while for India, there were broader schemes of intersectoral collaborations for prevention, adaptation, and response concerning climate change and disaster.
跨部门合作是复杂卫生系统中疾病预防与控制不可或缺的组成部分。一方面，“同一健康”（OH）正在推动在人类 - 动物 - 环境界面建立跨部门合作以进行预防。另一方面，只有通过跨部门合作才能实现“同一健康”的运作。这项工作通过分析在人类 - 动物 - 环境界面解决健康问题的不同举措背后的治理结构，有助于拓宽对“同一健康”运作过程的认识。作为分析示例的案例是“经典同一健康”下狂犬病和禽流感的防控，以及洪水和干旱管理以深入了解“扩展同一健康”。收集并比较了来自加纳和印度的数据，以确定实现“同一健康”跨部门合作的关键要素。尽管这些案例研究在地理、经济、社会、文化和历史背景方面存在差异，但在“同一健康”跨部门合作如何启动、管理和扩大规模方面发现了强烈的相似之处。记录的狂犬病预防和控制行动在历史上基于一个部门作为活动的领导者和实施者，而禽流感管理更多地依赖于具有明确界定部门责任的跨部门合作。洪水和干旱对健康影响的管理提供了通过部门整合实现跨部门合作的良好示例；然而，在加纳的案例中，人类健康部分仅参与应对阶段，而对于印度，在气候变化和灾害的预防、适应和应对方面有更广泛的跨部门合作计划。
