One health rapid qualitative assessment: Exploring local governance gaps in Tanzania.

The One Health Approach (OHA) is globally recognized as essential for addressing complex health threats such as antimicrobial resistance (AMR). However, translating national commitments into coordinated subnational practice remains a major governance challenge. This paper presents the OH Rapid Qualitative Assessment (OH-RQA) as a rapid, resource-efficient diagnostic tool for analyzing subnational implementation. Using five analytical dimensions (thinking, planning, working, sharing, and learning) the OH-RQA examines how practitioners and implementers at the local level understand and apply the OHA. We applied the OH-RQA in two Tanzanian regions in the context of AMR, collecting data through focus group discussions and semi-structured interviews with district officials in human, animal, and environmental sectors. Findings reveal persistent gaps between national OHA strategies and local governance practices, including limited cross-sectoral coordination, inconsistent awareness of national AMR priorities, and structural barriers to integrated action. Officers identified absent policy mandates, insufficient guidance from higher administrative levels, lack of training and incentives, and the exclusion of OHA from most job descriptions as key obstacles. By providing a scalable, structured, qualitative diagnostic framework focused on local practice, the OH-RQA supports targeted recommendations for strengthening subnational AMR governance. Beyond Tanzania, it offers a transferable approach for rapidly assessing OH implementation across diverse crisis governance contexts, including pandemic preparedness, climate adaptation, and cross-border health threats.