Qualitative Assessment of One Health Operationalization at the Central Level and in Two Border Districts of Sierra Leone.

Zoonotic diseases with epidemic potential pose a serious public health threat in Sierra Leone, where the One Health (OH) approach has been adopted to strengthen multi-sectoral preparedness and response. This study assessed the operationalization of OH in responding to such diseases at the central level and in two districts, Kambia and Kailahun, using content analysis of semi-structured interviews, focus group discussions and key documents. Manifest and latent analysis generated themes, including coordination and collaboration, surveillance and reporting, human resource capacity, communication, funding, and community engagement and awareness. Our study found that at the central level, OH sectors showed strong coordination, a functional surveillance system, established communication platforms and relatively strong capacity. District and community levels, by contrast, showed weak coordination, fragmented surveillance and limited communication, along with low animal health (AH) workforce capacity and OH awareness. Community level AH workers lacked an integrated approach to preventing, detecting and reporting zoonotic disease risks. Across all levels, OH activities lacked dedicated funding and relied solely on partner support, with the AH sector facing notable workforce shortages. OH, implementation was markedly weaker at district and community levels than at the central level, a disparity largely attributable to the absence of dedicated funding. Despite these gaps, the OH approach holds considerable potential for mitigating and managing zoonotic disease risks in Sierra Leone.