摘要：Objective The present study aims to operationalize one health approach through local urban governance system in a rapidly urbanized Indian city, Ahmedabad, India. In Ahmedabad (proposed Smart city), Gujarat, India: 1. To understand the pattern of zoonotic diseases in reference to urban governance system 2. To develop a conceptual One Health Governance framework with reference to zoonotic diseases 3. To assess the key indicators for convergence for inter-sectorial professional collaborations in One Health Introduction Smart governance refers to the emergence of joint action by the health and non-health sectors, public and private actors and citizens. Although, there are growing literature on governance and its potential impact on health, major challenges on collective action across sectors have been witnessed in developing countries like India. In the same line, the current forms of Global Health Governance façades operational issues and does not sufficiently meet the needs at local levels. In light of these perceived shortcomings, the local governance becomes subject of interest and should be debated especially with reference to global urbanization. Rapid and unplanned urbanization followed by the combination of high population density, poverty and lack of infrastructure have more side effects and fostering conditions for communicable diseases to flourish. Evidence suggests that new megacities could be incubators for new epidemic and zoonotic diseases, which can spread more rapidly and become worldwide threats. In India, Ministry of Urban Development initiated the concept of converting few major cities into “Smart City” in 2015-16. However, one of the major critiques of available smart city guideline is that it has no such focus on prevention of emerging and/or re-emerging zoonotic diseases. The emergence and/or re-emergence of zoonotic diseases should be considered as potential threats for these upcoming Smart Cities and hence, should be addressed by one health approach (health and non-health sectors, public and private actors) through an appropriate local governance strategy. With rapid urbanization and healthcare transformation in India, the operationalization of one health approach might become a major challenge, because of, the absence of the systematic effect at the national level and urban cities are riven between central, state and municipal authorities in terms of health policy, planning, health needs etc. There is also lack of information sharing or collaborations between the health and non-health sectors, public and private actors at the city level. Understanding these challenges can offer important lessons for strengthening both local urban governance and One Health. Methods For Objective-1: To understand the pattern of zoonotic diseases in reference to urban governance system 1. Is there existing literature indicates the importance of governance system in prevention of zoonotic diseases in urban settings Urban Governance System & Zoonotic diseases (Systematic Review) 2. Is prevalence of zoonotic disease vary in accordance with change of local urban governance (Outcome: Prevalence of Zoonotic diseases & Exposure: Governance Index for last 10 years) For Objective-2: To develop a conceptual One Health Governance framework with reference to zoonotic diseases 1. Is there evidence of existing One Health Governance framework exists One Health Governance Framework (Systematic Review & SWOT Analysis) 2. To map the urban agencies working for zoonotic diseases Institutions for zoonotic diseases (Mapping) 3. Is convergence possible for One Health in prevention of Zoonotic diseases (Policy Maker, System-level professionals Qualitative Key Informant Interviews) For Objective-3: To assess the key indicators for convergence for inter-sectorial professional collaborations in One Health 1. Is developed governance framework operational at field level- KAP among Healthcare providers, Veterinarians, Environmental specialists 2. Is there possibilities of convergence at field level for One health in prevention of zoonotic diseases (Qualitative Key Informant Interviews) Results This is first of kind unique study to come up with a local urban governance convergence approach for “One Health” for the upcoming Smart city Ahmedabad, which may further be scaled up to other smart cities of India. Conclusions Urban Health governance framework for a smart city to develop an one health approach. References [1] World Health Organization. Governance for Health in 21st Century. Available from: http://www.euro.who.int/__data/assets/pdf_file/0019/171334/RC62BD01-Governance-for-Health-Web.pdf [Last Accessed on December 2016] [2] Dodgson R, Lee K, Drager N. Global Health Governance: a Conceptual Review. London: London School of Hygiene and Tropical Medicine; 2002. [3] Burris S. Governance, Microgovernance, and health. Temple Law Rev. 2004;77:334–362. [4] Hein W. Global health governance and national health policies in developing countries: conflicts and cooperation at the interfaces. In: Hein W, Kohlmorgan L, eds. Globalization, Global Health Governance and National Health Policies in Developing Countries: an Exploration Into the Dynamics of Interfaces. Hamburg: Deutschen Uebersee-Instituts; 2003:33–71. [5] Navarro V, Muntaner C, Borrell C, et al. Politics and health outcomes. Lancet. 2006; 368(9540):1033-7.
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