Making progress on One Health policies and programmes: Perspectives on community engagement and gender equity in four West African countries

Introduction: Gender equity and community engagement are increasingly recognised as important for the implementation of equitable One Health (OH) actions, yet no published studies examine how these are operationalised in policies and programmes. We analyse policy content and stakeholder perspectives on community engagement and gender equity in OH policies and programmes in Guinea, Liberia, Nigeria and Sierra Leone.
Methods: Mixed methods encompassed: content analysis of OH documents (7 core and 9 supporting); key informant interviews (KIIs) with policy stakeholders (n = 47) and focus group discussions (FGDs) with community members (n = 34 FGDs) to examine perspectives on gender and engagement. Inductive and deductive
analyses were conducted, and interpretation of findings were discussed at all-team meetings to enhance validity.
Results: All countries have national OH strategic plans. All except Liberia contain substantive mention of community engagement, but only Sierra Leone provides any operational details. No country operationalises gender equity in their OH policies, although Sierra Leone has taken steps towards this and has a Gender Equality Act.
Across all countries, policy stakeholders highlighted community engagement as indispensable to OH implementation but showed little urgency in tackling challenges and completely overlooked gender equity, which highlights a critical gap. Community members revealed how community engagement in OH is gendered across all contexts. Cultural norms often limited women's full participation, though this improved over time, while women's lower literacy
limited their leadership roles and ability to report disease cases, with Nigeria an exception.
Trust emerged as fragile but foundational to OH engagement. In all countries, community trust was mediated by chiefs, elders, and religious leaders, but trust in surveillance activities could be lost when government response or action to OH reporting was lacking.
Conclusions: Gender-equitable community engagement is a structural necessity for effective One Health programmes. Our research has shown that there is potential for OH actions to be transformed at the community level through strong, inclusive engagement with women as equal partners.