Abstract Background : Pastoralist communities in Northern Kenya face intensifying health and livelihood challenges driven by climate change, infectious disease outbreaks, and conflict. One Health (OH) has increasingly been promoted as a holistic approach capable of addressing these interconnected socioecological risks. However, in practice, OH policy and most initiatives in Kenya remain largely driven by the human health and veterinary sectors and are biomedical in focus. Systems thinking approaches, including participatory modeling, can help to elucidate socioecological system (SES) dynamics and inform more integrated OH policy and practice. This study aims to characterize the OH system in Turkana County, Kenya and to identify the drivers, mediators, and outcomes that shape health and well-being. Methods : We applied a participatory fuzzy cognitive mapping (FCM) approach. Participants were purposively sampled and included community members and leaders, as well as representatives from health, veterinary, environment, and non-governmental organization. A total of 35 cognitive maps were co-developed and aggregated into a final consensus OH system map. The aggregated map was analyzed using centrality metrics, including indegree and outdegree, to classify system components as drivers, mediators, or outcomes. Results : The most central components of the OH system were classified as outcomes, and included human and livestock health, nutrition, and access to health and veterinary services. Mediators, broadly the second most central group of components, included natural resource access, insecurity, income, mobility, human resources, education, environmental degradation, and gender inequity. Key drivers of the system included drought, water infrastructure, seasonality, the Kimormor Initiative, and community animal disease reporters. Conclusion : In contrast to most OH policies and initiatives in Kenya that focus predominantly on zoonotic and infectious disease threats, our study highlights how health and well-being emerge from interactions among social, institutional, and ecological processes, rather than discrete sectoral pathways. By empirically grounding a socioecological framing of OH in a participatory systems model, this study helps to operationalize recent OH theoretical frameworks at the local level. In Turkana, this perspective highlights priority areas for OH action, including public-private partnerships to support frontline service delivery, conflict-sensitive approaches, and more integrated surveillance that reflects livelihood and environmental dynamics. One Health impact statement This study provides an empirically grounded systems representation of One Health (OH) in Turkana County, Kenya. By integrating the knowledge and perspectives of community members, government, and non-governmental actors through participatory fuzzy cognitive mapping, the study produces a shared understanding of the OH system that no single sector could have generated alone. Critically, community members contributed place-based and Indigenous knowledge of human, animal, and environmental relationships that is rarely captured in conventional OH research. This transdisciplinary approach revealed that nutrition, natural resource governance, and insecurity as central drivers of human and livestock health outcomes that fall outside conventional OH policy frameworks, yet profoundly shape disease burden, food security, and livelihood resilience. By making these interactions explicit, the study supports more coordinated, resource-efficient OH action – including strengthening frontline service delivery through public-private partnerships, conflict-sensitive programming, and integrated surveillance that reflects the livelihood and environmental dynamics shaping health in pastoral communities.
Griffith et al. (2026) studied this question.