Building a functional national One Health platform: the case of Tanzania.

BACKGROUND: The USAID Preparedness and Response (P&R) project's publication on Multisectoral Coordination that Works identified five dimensions most critical to creating effective and sustainable One Health platforms: political commitment, institutional structure, management and coordination capacity, technical and financial resources, and joint planning and implementation. This case study describes Tanzania experience in using these dimensions to establish a functional One Health platform. The main objective of this case study was to document the process of institutionalizing the One Health approach in Tanzania. METHODS: An analysis of the process used to establish and institutionalize the MCM in Tanzania through addressing the five dimensions mentioned above was conducted between August 2018 and January 2019. Progress activity reports, annual reports and minutes of meetings and consultations regarding the establishment of the Tanzania national One Health platform were examined. Relevant One Health publications were studied as reference material. RESULTS: This case study illustrates the time and level of effort required of multiple partners to build a functional multi-sectoral coordinating mechanism (MCM). Key facilitating factors were identified and the importance of involving policy and decision makers at all stages of the process to facilitate policy decisions and the institutionalization process was underscored. The need for molding the implementation process using lessons learnt along the way -- "sailing the ship as it was being built" -- is demonstrated. CONCLUSIONS: Tanzania now has a functioning and institutionalized MCM with a sound institutional structure and capacity to prevent, detect early and respond to health events. The path to its establishment required the patient commitment of a core group of One Health champions and stakeholders along the way to examine carefully and iteratively how best to structure productive multisectoral coordination in the country. The five dimensions identified by the Preparedness and Response project may provide useful guidance to other countries working to establish functional MCM.

Institutionalizing One Health: From Assessment to Action.

A One Health approach is critical to strengthening health security at country, regional, and global levels. However, operationally its uptake remains limited. Recent momentum in assessing capacity to effectively prevent, detect, and respond to disease threats has resulted in identification of gaps that require dedicated action. This article highlights relevant tools, standards, and guidance to assist countries and institutions in meeting the collective vision articulated at the 2018 Prince Mahidol Award Conference on "Making the World Safe from the Threats of Emerging Infectious Diseases." Taking stock of assessment findings, resources, priorities, and implementation initiatives across human and animal health, environment and disaster risk reduction sectors can help expand participation in global health security, target risk drivers, and form synergies for collective action and shared gains for both emerging and endemic disease challenges. In addition to health security gains, a multisectoral, One Health approach can drive benefits for wider health sector and global development goals.

Emphasis behaviors in maternal and child health : focusing on caretaker behaviors to develop maternal and child health programs in communities / Emphasis behaviors in maternal and child health : focusing on caretaker behaviors to develop maternal and child health programs in communities

A multidisciplinary team of medical and behavioral specialists developed a list of sixteen emphasis behaviors that, if practiced by caretakers, could improve maternal and child health in communities. Criteria for identifying the emphasis behaviors included their impact on multiple disease areas, demonstrated relationship with mortality and morbidity, impact on the most important public health problems in developing countries, measurability, and their feasibility and cost effectiveness. The emphasis behaviors fall under five categories: (1) reproductive health practices, (2) infant and child feeding practices, (3) immunization practices, (4) home health practices, and (5) care-seeking practices. It is suggested that health managers choose which emphasis behaviors to focus on in their programs by reviewing existing community-based data. Following this selection process, they can develop and implement strategies appropriate for the local context, as well as monitor and evaluate results

Communication for child survival / Communication for child survival

This manual presents a systematic public health communication methodology for child survival programs. It is meant for health and communication professionals who wish to use communication strategies to improve child health in the developing world. The manual provides a detailed description of: (1)Public health communication and its role in child survival programs; (2)Three disciplines which have significantly influenced public health communication - social marketing, behavior analysis, and anthropology; (3)Three stages of the methodology - planning, intervention, and monitoring/evaluation, and; (4)Methods for assuring the continued application or "institutionalization" of a public health communication strategy. The strategy as applied to child survival has been tested in U.S. Agency for International Development (AID) sponsored projects in more than 10 countries. Examples used here are drawn largely from those countries in which the methodology was applied under two AID projects: the Mass Media and Health Practices Project (MMHP) and the Communication for Child Survival Project (HEALTHCOM). The goal of public health communication strategies is to bring about changes in health-related practices and, in turn, in actual health status. Results obtained from these projects demonstrate the possibility of such success