02886nas a2200229 4500000000100000008004100001260002500042653001200067653001300079653001700092653003100109653001500140653002500155653002700180100001300207700001100220245013100231856007500362300001100437520219400448022001402642 2026 d c07/2026bElsevier BV10aSomalia10aZoonoses10aEpidemiology10aParticipatory Epidemiology10aOne Health10aCommunity engagement10aDisease prioritisation1 aMumin FI1 aMor SM00aElevating community voices in One Health: a participatory study applying the Community Zoonoses Prioritisation tool in Somalia uhttps://www.thelancet.com/action/showPdf?pii=S3050-5011%2826%2900100-8 a1 - 173 a
(Agro-)Pastoral communities in Somalia face zoonotic risks due to close human–livestock contact and high exposure to vectors and contaminated water sources, yet they have been structurally excluded from national health planning. We applied the Community Zoonoses Prioritisation (CZP) tool to identify and rank community-prioritised zoonoses, assess alignment with national priorities and test feasibility and utility in a fragile, conflict-affected setting.
Between April and October 2024, we conducted 40 gender-segregated CZP exercises, engaging a convenience sample of 480 (agro-)pastoral participants (240 men, 240 women) across four purposively selected regions of Somalia (Bari, Sool, Middle Shabelle, and Gedo). Communities were guided through a six-step procedure involving general health problems mapping; zoonoses listing; criteria selection and weighting; disease scoring; identification of actions and responsible actors; and contextualisation within broader health concerns.
Communities identified 26 zoonoses and related conditions. Top priorities were anthrax, bovine tuberculosis, brucellosis, child diarrhoea from raw milk, toxoplasmosis and sarcoptic mange. Agreement was strong within male (W = 0.659, p < 0.001) and female groups (W = 0.614, p < 0.001), and within regions (W = 0.599–0.763, p < 0.001). Correlation was high between male and female groups (τ = 0.882, p < 0.001) and moderate-to-high between regions (τ = 0.600–0.854, p < 0.001). Gender differences emerged in criteria weighting, actions, and responsibility attribution. Zoonoses received lower priority scores than human and animal health problems when contextualised.
Structured community discussions can generate reproducible, policy-relevant evidence on priority zoonoses. Community priorities diverged from national assessments, reflecting livelihood-based and local concerns. Integrating community-level prioritisation into One Health planning would enhance intervention relevance, legitimacy, and sustainability in Somalia and similar settings.
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