Engaging Stakeholders in the Design of One Health Surveillance Systems: A Participatory Approach

Abstract

Many One Health surveillance systems have proven difficult to enforce and sustain, mainly because of the difficulty of implementing and upholding collaborative efforts for surveillance activities across stakeholders with different values, cultures and interests. We hypothesize that only the early engagement of stakeholders in the development of a One Health surveillance system can create an environment conducive to the emergence of collaborative solutions that are acceptable, accepted and therefore implemented in sustainable manner. To this end, we have designed a socio-technical framework to help stakeholders develop a common vision of their desired surveillance system and to forge the innovation pathway toward it. We implemented the framework in two case studies: the surveillance of antimicrobial resistance in Vietnam and that of Salmonella in France. The socio-technical framework is a participatory and iterative process that consists of four distinct steps implemented during a workshop series: (i) definition of the problem to be addressed, (ii) co-construction of a common representation of the current system, (iii) co-construction of the desired surveillance system, (iv) identification of changes and actions required to progress from the current situation to the desired situation. In both case studies, the process allowed surveillance stakeholders with different professional cultures and expectations regarding One Health surveillance to gain mutual understanding and to reconcile their different perspectives to design the pathway toward their common vision of a desired surveillance system. While the proposed framework is structured around four essential steps, its application can be tailored to the context. Workshop facilitation and representativeness of participants are key for the success of the process. While our approach lays the foundation for the further implementation of the desired One Health surveillance system, it provides no guarantee that the proposed actions will actually be implemented and bring about the required changes. The engagement of stakeholders in a participatory process must be sustained in order to ensure the implementation of co-constructed solutions and evaluate their effectiveness and impacts.

A participatory epidemiological and One Health approach to explore the community’s capacity to detect emerging zoonoses and surveillance network opportunities in the forest region of Guinea

“…Their participation to this study may increase the acceptability, the feasibility and the sustainability of the future community-based surveillance system. The participatory and One Health approach allowed the integration of actors from the different health sectors (human health, animal health, ecosystem health) that need to be involved in the surveillance of zoonotic diseases such VHFs [ 51 ]. The inclusion of the ecosystem health sector in disease surveillance systems is relatively new and we identified potential actors and communication channels [ 52 ].…”

“…The results highlighted the fact that community actors face different constraints and communicate with various stakeholders. This situation may delay the report of a suspected case to the relevant institutions and therefore the confirmatory diagnosis and outbreak control actions [ 51 , 61 ]. Our study showed interesting communication channels opportunities in the current health information exchange network to bypass potential barriers to health report.…”

Critical Evaluation of Cross-Sectoral Collaborations to Inform the Implementation of the “One Health” Approach in Guadeloupe

“…We proposed a semi-quantitative method based on the analysis of 13 criteria to assess the OH framework implementation in collaborative initiatives rapidly, whereas some participatory methods were developed to implement OH initiatives, such as disease surveillance, requiring several workshops and more time ( 74 ). If our approach delivers on results quickly, an action plan tailored to each initiative should be defined to improve its efficiency and effectiveness.…”

“…This approach is being increasingly implemented to improve the impact of collaborative projects through easier, more efficient, and more fruitful collaborations. It has also been applied to strengthen stakeholders engagement and cooperation in surveillance systems to better tackle major challenges in public health such as antimicrobial resistance ( 74 ).…”

The Entrepreneurs: Dairy farmer perspectives on finding an industry solution for the surplus calf issue—A participatory case study

“…One example of bringing the voice of different stakeholders to these discussions comes from our companion study on North American public attitudes regarding the issue of surplus calves (and cow calf separation) using an on-line survey (Ritter et al, 2022). In addition, a participatory approach was recently shown by Bordier et al (2021) to be an effective way to engage diverse stakeholders when designing a One health surveillance system to tackle antimicrobial resistance in Vietnam. A similar approach was used in the Netherlands for their pork opportunities project that set out to redesign a more sustainable pig husbandry system (Bremmer and Bos, 2017).…”