Pathways to One Health: Enhancing Inter-Sectoral Collaboration in Pakistan.

One Health is an integrative approach aiming to achieve optimal health outcomes by recognizing the interconnection between humans, animals, and the environment. This study explores the understanding, perspectives, hurdles, and implications of intersectoral collaboration within Pakistan's human health system, focusing on One Health principles. A qualitative phenomenological approach was employed, involving 17 key informant interviews with purposively selected stakeholders from public health, agriculture, veterinary medicine, agriculture and environmental science. Thematic analysis was conducted to generate themes. There are varying levels of understanding and awareness of One Health principles, with some showing strong comprehension; while, others showed significant knowledge gaps. Barriers such as institutional silos, fragmented policies, and limited resources were identified for operationalizing the intersectoral collaboration requisite for One Health. Successful collaborative initiatives demonstrated the potential of One Health in achieving significant health outcomes. Meaningful engagement of stakeholders and capacity building emerged as critical needs, with recommendations for continuous in-service training centered on One Health principles. Unified policies, strengthened institutional support, and continuous capacity building will enhance One Health agenda. Overarching governance and decentralized decision-making processes can promote consistency and cooperation across sectors for advancing One Health initiatives and effectively addressing complex human health challenges in Pakistan.