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# One Health stakeholder and institutional analysis in Kenya

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### Abstract

##### Introduction

One Health (OH) can be considered a complex emerging policy to resolve health issues at the animal–human and environmental interface. It is expected to drive system changes in terms of new formal and informal institutional and organisational arrangements. This study, using Rift Valley fever (RVF) as a zoonotic problem requiring an OH approach, sought to understand the institutionalisation process at national and subnational levels in an early adopting country, Kenya.

##### Materials and methods

Social network analysis methodologies were used. Stakeholder roles and relational data were collected at national and subnational levels in 2012. Key informants from stakeholder organisations were interviewed, guided by a checklist. Public sector animal and public health organisations were interviewed first to identify other stakeholders with whom they had financial, information sharing and joint cooperation relationships. Visualisation of the OH social network and relationships were shown in sociograms and mathematical (degree and centrality) characteristics of the network summarised.

##### Results and discussion

Thirty-two and 20 stakeholders relevant to OH were identified at national and subnational levels, respectively. Their roles spanned wildlife, livestock, and public health sectors as well as weather prediction. About 50% of national-level stakeholders had made significant progress on OH institutionalisation to an extent that formal coordination structures (zoonoses disease unit and a technical working group) had been created. However, the process had not trickled down to subnational levels although cross-sectoral and sectoral collaborations were identified. The overall binary social network density for the stakeholders showed that 35 and 21% of the possible ties between the RVF and OH stakeholders existed at national and subnational levels, respectively, while public health actors’ collaborations were identified at community/grassroots level. We recommend extending the OH network to include the other 50% stakeholders and fostering of the process at subnational-level building on available cross-sectoral platforms.

### Most cited references29

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Concern regarding the use of biological agents--bacteria, viruses, or toxins--as tools of warfare or terrorism has led to measures to deter their use or, failing that, to deal with the consequences. Unlike chemical agents, which typically lead to violent disease syndromes within minutes at the site of exposure, diseases resulting from biological agents have incubation periods of days. Therefore, rather than a paramedic, it will likely be a physician who is first faced with evidence of the results of a biological attack. We provide here a primer on 10 classic biological warfare agents to increase the likelihood of their being considered in a differential diagnosis. Although the resultant diseases are rarely seen in many countries today, accepted diagnostic and epidemiologic principles apply; if the cause is identified quickly, appropriate therapy can be initiated and the impact of a terrorist attack greatly reduced.
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Historical outbreaks of Rift Valley fever (RVF) since the early 1950s have been associated with cyclical patterns of the El Niño/Southern Oscillation (ENSO) phenomenon, which results in elevated and widespread rainfall over the RVF endemic areas of Africa. Using satellite measurements of global and regional elevated sea surface temperatures, elevated rainfall, and satellite derived-normalized difference vegetation index data, we predicted with lead times of 2-4 months areas where outbreaks of RVF in humans and animals were expected and occurred in the Horn of Africa, Sudan, and Southern Africa at different time periods from September 2006 to March 2008. Predictions were confirmed by entomological field investigations of virus activity and by reported cases of RVF in human and livestock populations. This represents the first series of prospective predictions of RVF outbreaks and provides a baseline for improved early warning, control, response planning, and mitigation into the future.
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### Author and article information

###### Journal
Infect Ecol Epidemiol
Infect Ecol Epidemiol
IEE
Infection Ecology & Epidemiology
Co-Action Publishing
2000-8686
20 June 2016
2016
: 6
###### Affiliations
[1 ]Department of Agricultural Economics and Agribusiness, Egerton University, Njoro, Kenya
[2 ]International Livestock Research Institute, Nairobi, Kenya
[3 ]Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
[4 ]University of Basel, Basel, Switzerland
###### Author notes
[* ]Correspondence to: Tabitha Kimani, PO Box 1510-00200 Nairobi, Kenya, Email: mugethikimani@ 123456yahoo.com

Responsible Editor: Barbara Haesler, The Royal Veterinary College, United Kingdom.

###### Article
31191
10.3402/iee.v6.31191
4916260
27330042
c8acdd8d-2cff-4452-b440-79f1d41e3230
© 2016 Tabitha Kimani et al.

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

###### Categories
Original Research Article

Infectious disease & Microbiology
one health,stakeholder,institutionalisation,kenya
Infectious disease & Microbiology
one health, stakeholder, institutionalisation, kenya