One Health Approach through interactive Urban Health Governance Framework in a Smart city, India

Yasobant Sandul; Walter Bruchhausen; Deepak B. Saxena

摘要

Objective The present study aims to operationalize one health approach through local urban governance system in a rapidly urbanized Indian city, Ahmedabad, India. In Ahmedabad (proposed Smart city), Gujarat, India: 1. To understand the pattern of zoonotic diseases in reference to urban governance system 2. To develop a conceptual One Health Governance framework with reference to zoonotic diseases 3. To assess the key indicators for convergence for inter-sectorial professional collaborations in One Health Introduction Smart governance refers to the emergence of joint action by the health and non-health sectors, public and private actors and citizens. Although, there are growing literature on governance and its potential impact on health, major challenges on collective action across sectors have been witnessed in developing countries like India. In the same line, the current forms of Global Health Governance fa?ades operational issues and does not sufficiently meet the needs at local levels. In light of these perceived shortcomings, the local governance becomes subject of interest and should be debated especially with reference to global urbanization. Rapid and unplanned urbanization followed by the combination of high population density, poverty and lack of infrastructure have more side effects and fostering conditions for communicable diseases to flourish. Evidence suggests that new megacities could be incubators for new epidemic and zoonotic diseases, which can spread more rapidly and become worldwide threats. In India, Ministry of Urban Development initiated the concept of converting few major cities into “Smart City” in 2015-16. However, one of the major critiques of available smart city guideline is that it has no such focus on prevention of emerging and/or re-emerging zoonotic diseases. The emergence and/or re-emergence of zoonotic diseases should be considered as potential threats for these upcoming Smart Cities and hence, should be addressed by one health approach (health and non-health sectors, public and private actors) through an appropriate local governance strategy. With rapid urbanization and healthcare transformation in India, the operationalization of one health approach might become a major challenge, because of, the absence of the systematic effect at the national level and urban cities are riven between central, state and municipal authorities in terms of health policy, planning, health needs etc. There is also lack of information sharing or collaborations between the health and non-health sectors, public and private actors at the city level. Understanding these challenges can offer important lessons for strengthening both local urban governance and One Health. Methods For Objective-1: To understand the pattern of zoonotic diseases in reference to urban governance system 1. Is there existing literature indicates the importance of governance system in prevention of zoonotic diseases in urban settings Urban Governance System & Zoonotic diseases (Systematic Review) 2. Is prevalence of zoonotic disease vary in accordance with change of local urban governance (Outcome: Prevalence of Zoonotic diseases & Exposure: Governance Index for last 10 years) For Objective-2: To develop a conceptual One Health Governance framework with reference to zoonotic diseases 1. Is there evidence of existing One Health Governance framework exists One Health Governance Framework (Systematic Review & SWOT Analysis) 2. To map the urban agencies working for zoonotic diseases Institutions for zoonotic diseases (Mapping) 3. Is convergence possible for One Health in prevention of Zoonotic diseases (Policy Maker, System-level professionals Qualitative Key Informant Interviews) For Objective-3: To assess the key indicators for convergence for inter-sectorial professional collaborations in One Health 1. Is developed governance framework operational at field level- KAP among Healthcare providers, Veterinarians, Environmental specialists 2. Is there possibilities of convergence at field level for One health in prevention of zoonotic diseases (Qualitative Key Informant Interviews) Results This is first of kind unique study to come up with a local urban governance convergence approach for “One Health” for the upcoming Smart city Ahmedabad, which may further be scaled up to other smart cities of India. Conclusions Urban Health governance framework for a smart city to develop an one health approach.

机译：目的本研究旨在通过印度快速城市化的印度艾哈迈达巴德市的地方城市治理系统来实施一种健康方法。在印度古吉拉特邦的艾哈迈达巴德（拟建的智慧城市）：1.参照城市治理体系了解人畜共患疾病的模式2.参照人畜共患疾病制定概念性的单一卫生治理框架3.评估以下方面的关键指标：单一健康中部门间专业合作的趋同引言智慧治理是指卫生和非卫生部门，公共和私人行为者以及公民共同采取行动。尽管关于治理及其对健康的潜在影响的文献越来越多，但在印度等发展中国家，却见证了跨部门集体行动的重大挑战。同样，全球卫生治理的当前形式掩盖了运营问题，不能充分满足地方层面的需求。鉴于这些公认的缺点，地方治理已成为人们关注的主题，应该就全球城市化进行辩论。快速和无计划的城市化，再加上人口密度高，贫穷和基础设施匮乏，带来了更多的副作用，并为传染病的繁荣创造了条件。有证据表明，新的特大城市可能成为新的流行病和人畜共患疾病的孵化器，它们可以更快地传播并成为世界范围的威胁。在印度，城市发展部在2015-16年度提出了将几个主要城市转变为“智慧城市”的构想。但是，对可用智能城市指南的主要批评之一是，它没有将重点放在预防新兴和/或再出现的人畜共患疾病上。人畜共患疾病的出现和/或再出现应被视为对这些即将到来的智慧城市的潜在威胁，因此，应通过适当的地方治理以一种卫生方法（卫生和非卫生部门，公共和私人行为者）来应对战略。随着印度快速的城市化和医疗保健转型，一种医疗保健方法的实施可能会成为一项重大挑战，因为在国家一级缺乏系统性影响，而中央，州和市政府之间的医疗保健也被城市所吸引政策，规划，卫生需求等。城市一级的卫生与非卫生部门，公共和私人行为者之间也缺乏信息共享或协作。理解这些挑战可以为加强地方城市管理和“一个健康”提供重要的经验教训。用于目标1的方法：参考城市治理体系1来了解人畜共患疾病的模式1。是否有文献表明，治理体系对于预防城市环境中的人畜共患疾病具有重要意义城市治理体系和人畜共患病（系统评价）2 。人畜共患疾病的患病率是否根据当地城市治理的变化而有所不同（结果：人畜共患疾病的患病率和暴露程度：最近十年的治理指数）对于目标2：建立一个人畜共患疾病的概念性的“健康治理”框架1.是否有证据表明存在一个健康治理框架？一个健康治理框架（系统评价和SWOT分析）2.绘制为人畜共患疾病工作的城市机构的地图人畜共患疾病的机构（制图）3.在美国，一个人的健康是否有可能融合预防人畜共患疾病（政策制定者，系统级专业人员定性关键信息访问者）对于目标3：评估“一个医疗机构”中跨部门专业合作的趋同关键指标1.是否在现场级别实施了完善的治理框架-医疗保健提供者，兽医，环境专家之间的KAP？2.在现场是否存在趋同的可能性预防人畜共患疾病的一种健康水平（定性关键信息访问）结果这是首项独特的研究，针对即将到来的智慧城市艾哈迈达巴德，提出了针对“一种健康”的地方城市治理融合方法，该方法可能会进一步扩展到印度其他智慧城市。结论智慧城市的城市卫生治理框架将开发一种健康方法。

One Health Approach through interactive Urban Health Governance Framework in a Smart city, India

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