One Health disease surveillance and community engagement in Sierra Leone

INTERVENTION: We collaborate with the Ministry of Agriculture, Forestry, and Food Security (MAFFS), the Ministry of Health and Sanitation (MoHS), and the FAO in Sierra Leone to implement a pilot One Health disease surveillance programme in 375 rural communities. Included communities have been identified by MAFFS as eligible communities. First seven Chiefdoms were identified where households are to a large extend dependent on livestock rearing. Second, within each Chiefdom a list of communities was made (by MAFFS) that had a Community Health Worker (CHW). CHWs are required to report on human disease events and symptoms in weekly surveillance reports submitted to the District One Health Technical Working Group. The treatment comprises a One Health Programme. Of the 375 communities, 300 communities are randomly selected to participate in the One Health Programme. The programme consists of: a) recruiting a Community Animal Health Worker (CAHW) for each community (eligibility criteria of candidates include literacy, numeracy, and residing in said community), b) a 21 day animal health training, c) instalment of CAHW at community meeting, d) a 2‐day One Health training for both CHW and CAHW on One Health topics (spillover diseases, good animal husbandry practices, surveillance), e) facilitating the creation of a community One Health Platform and One Health Action Plan, and f) in parallel to CHW, CAHWs are required to complete weekly animal health disease and symptom surveillance reports submitted to the District One Health Technical Working Group. CONDITION: Health, Disease surveillance, Health level, Health behaviour ; ; PRIMARY OUTCOME: Effectiveness of Community Health Worker Disease Surveillance Behavior; ; Human Health Knowledge Index; ; Human Health Behavior Index; ; Human Health Index; ; Animal Health Index; SECONDARY OUTCOME: Animal spillover disease levels ; ; Disease knowledge ; ; Hygienic practices ; ; Access to local government services ; ; Food security ; ; Wealth INCLUSION CRITERIA: Intervention participants: ‐ at least 18 years of age ‐ adequate levels of numeracy and literacy ‐ villages should have a Community Health Worker Survey respondents: ‐ at least 18 years of age