One Health Approach Necessity in the Control of Highly Pathogenic Avian Influenza: An Integrated Analysis of Decision Makers’ Perspectives in Ivory Coast, Using Peter Checkland’s Soft System Methodology

Abstract

The control of highly pathogenic avian influenza (HPAI) requires an integrated strategy. In Ivory Coast, it is decentralized and included in the health policy (as all tools, including SOPs, for managing disease prevention and control) but would lack a common vision and stable bridges for intersectoral exchanges and major health challenges joint planning. Thus the need to identify levers for action through the key sectoral decision makers’ perspectives in integrated HPAI control. A cross-sectional retrospective qualitative study, respecting ethical considerations, was carried out in May 2023 with national decision makers from the human, animal, environmental and community health sectors in Ivory Coast. Purposive sampling was guided by seven respondents based on the saturation principle. An open-ended, semi-structured interview grid based on the CATWOE components (
C
: Clients,
A
: Actors,
T
: Transformation process,
W
: Weltranschauung,
O
: Owners,
E
: Environment; Smyth D. and Checkland P. en 1975) were used to analyse the surveyed decision makers’ perspectives, using QDA
Miner4Lite
software. Findings showed four emerging perspectives, depending on the decision makers’ profile: (i) Veterinarians advocated a world better prepared to deal with HPAI, with simulation exercises (as one of the four components of the International Health Regulations monitoring framework to enable the lessons learned from a simulated public health event that can be capitalized on while strengthening the response system), joint investigations and training, creation of reactive and autonomous regional centres with enhanced technical facilities; (ii) Poultry industry (private sector) is also moving in the same direction, with the idea of common funds pre-mobilized through poultry farmer contributions to facilitate future compensation; (iii) Physicians prioritized the cross-sector sharing of digitized information in real time, the mutualization of resources and the integration of existing surveillance networks; and (iv) Environmentalists were keen to integrate aspects of other key sectors into their sectoral monitoring tools in order to be more alert and proactive in an ecological dynamic.

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