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Table 1 Top fifteen essential strategies and top five preferred strategies validated through the modified policy Delphi process for the operationalization of One Health in the prevention and control of zoonotic diseases in Ahmedabad, India

From: Systemic factors for enhancing intersectoral collaboration for the operationalization of One Health: a case study in India

Essential One Health strategies Cross-sectoral information and data sharing is recommended within the human and animal health system with an emphasis on the joint data analysis and an early alert system for zoonoses (1, 2, 3, 4, 6, 7, 10, 11, 13, 14, 18)
Public health act or clinical establishment act for all the clinics (human/animal) in the city emphasizing reporting diagnosed conditions to the public health system (4, 6, 7, 9, 10, 14, 18)
Strengthening the local capacity of laboratories for screening and diagnosis of zoonotic diseases (6, 9, 15, 16)
Developing guidelines for disposal of all dead animals irrespective of disease condition for the city (1, 4, 6, 11, 12, 15)
Enhancing and strengthening the prophylactic vaccination of all types of animals, especially for rabies prevention (1, 2, 5, 6, 7, 8, 10, 11, 14, 15, 16, 17, 18)
Promoting better hygiene and preventive practices among the community, especially for flu prevention (1, 4, 5, 6, 7, 11, 14, 17, 18)
Resource sharing with the human/animal health system for improving service delivery and establishing surveillance (1, 2, 3, 5, 6, 7, 8, 11, 12, 13, 14, 16, 18)
The reporting pattern for prioritized zoonotic conditions should be established, and regular monitoring of the same is recommended (4, 5, 6, 9, 10, 11, 14, 16, 17, 18)
Sharing of knowledge among the medical and the veterinary professions through a common platform, including the joint training programs (1, 4, 7, 13, 14, 16, 18)
A common One Health clinical body that is answerable for every situation related to zoonoses management and its prevention (1, 4, 5, 6, 7, 8, 11, 13, 14, 15, 16, 18)
Developing informed education and communication (IEC) materials for zoonoses prevention across the clinical setting of both systems to educate their respective patients (4, 13, 16, 17, 18)
Cross-communication among the frontline workers at the grass-roots level and cross-sectoral information sharing with appropriate officials for any abnormal occurrence (4, 5, 16, 17, 18)
Sensitization of the community along with knowledge and awareness on prevention and control of zoonoses (4, 5, 6, 11, 14, 16, 17, 18)
Formulation of a One Health community cell at the grass-roots level with help of frontline health workers and community members (4, 5, 6, 11, 14, 16, 17, 18)
Financial incentive packages for the inclusion of private providers into the public health delivery system and for reporting the symptoms and/or diagnosed zoonotic conditions to the system (4, 6, 8, 9, 10, 11, 14, 16, 18)
Preferred One Health strategies Urban zoonoses and/or One Health committees, like at the district and state level, should be developed for the city level (1, 2, 3, 4, 5, 6, 7, 8, 11, 12, 13, 14, 15, 16)
The city should develop animal treatment centres and hostel facilities where stray animals can be inspected and vaccinated regularly (4, 5, 6, 11, 14, 16)
In the clinical and primary healthcare setting, a detailed history taking for a provisional diagnosis of zoonotic conditions should be emphasized (4, 6, 8, 13)
Financial incentives to animal handlers to report any disease or any abnormal condition(s) of their animals to the public health system (4, 10, 17)
Enhancing collaboration among professional bodies like the Indian Medical Association, Indian Veterinary Association, etc. (1, 6, 7, 13)
  1. Numbers in parentheses indicate the serial numbers of factors (see Table 2) responsible for the respective strategy