Analyzing countries’ needs to improve multisectoral collaboration against health threats at the human-animal-environment interface: a study of 51 National Bridging Workshop Roadmaps

The devastating effects of global health threats at the human-animal-environment interface have highlighted the continued need to improve collaboration between the human, animal, and environment health sectors. The National Bridging Workshop (NBW) Program contributes to this effort, gathering representatives from relevant sectors to assess their collaborative capacities and to develop a joint Roadmap to strengthen them. We conducted NBWs in 58 countries and 51 Roadmaps are publicly available. A document analysis of these Roadmaps was conducted using a hybrid inductive-deductive coding approach. Roadmap activities were coded, categorized, and quantified for descriptive analysis. Hierarchical clustering (HCA) and principal component analysis (PCA) were applied to examine co-occurrence and variability across countries and activities. Jaccard index was used to assess inter-country alignment and regional trends were evaluated. The analysis identified 60 distinct activity types (codes), grouped into six key themes, describing 2028 activities, providing unique and meaningful insight into how countries plan to improve their One Health capacity. Of these 60 activity types, 37 were present in a third of Roadmaps or more. The HCAs revealed an absence of clustering between activities or countries and the PCA confirmed a high degree of variability. The highest Jaccard similarity score between two countries was 0.64, and intra-regional (0.34) and inter-regional (0.32) average similarity scores were almost identical. The activity needs, and their frequency, can help streamline international efforts to support countries in building their multisectoral collaborative capacities. With no dominant patterns of activity inclusion identified across countries or regions, our results offer concrete evidence for the need to tailor the One Health approach to countries' national contexts. The findings support the growing body of literature that emphasizes the absence of a "one-size-fits-all" approach. They also demonstrate that the NBW method supports this needed flexibility. This study is the first to investigate One Health needs from such a broad range of countries, based on a common, standardized tool. Our findings offer critical insights into national and, by extension, global priorities for One Health collaboration, that can guide the development of tools and strategies that align with the specific needs articulated by countries.