Intersectoral collaboration in zoonotic disease surveillance and response: A One Health study in the Greater Accra metropolitan area of Ghana.

The One Health (OH) approach is essential for preventing and managing zoonotic diseases through the promotion of intersectoral collaboration. Integrated surveillance systems enhance resource efficiency, support targeted interventions, and provide a comprehensive understanding of disease dynamics. However, operationalizing OH in resource-limited contexts encounters various obstacles due to systemic limitations. This study explores intersectoral collaboration across sectors engaged in zoonotic disease surveillance and response (ZDSR) in Ghana at the district level, identifying key operational gaps. We performed 46 key informant interviews with actors in the human, animal and wildlife health sectors directly involved in ZDSR. We developed an interview guide informed by WHO's Components of Surveillance and Response Systems for Monitoring and Evaluation Framework and the Evaluation of collaboration in a multisectoral surveillance system (ECoSur) tool. The responses were analyzed using a content analysis approach. The results showed that for district-level surveillance activities, relationships between the human and animal health sectors existed in 87.5 % of districts, albeit weak, while the wildlife sector was absent. Rabies/dog bites, Avian Influenza, Lassa fever and COVID-19 were the primary triggers of intersectoral collaboration. Anthrax, zoonotic tuberculosis and trypanosomiasis saw minimal intersectoral collaboration. Collaborative activities were mostly addressed through reactive and event-driven approaches focusing on case-specific data sharing, alerts in outbreak events, and committee participation. However, core surveillance functions like disease detection, data analysis, and data management practices were performed in siloes. These results highlight the need for adaptable, proactive, and systemic frameworks that enhance intersectoral collaboration for the surveillance of neglected zoonotic diseases in Ghana.