Table 3.

Different barriers found.

Barriers summary
Governance and leadership National (27–31) Regional (32) District (33) Community (34)	_Lack of political will, unsupportive policies _Lack of organized institutions and a proper and legal framework. _Lack of policies in different sectors _Duplication of other institutional arrangements _Bureaucracy and coordination challenges _Problem of ownership by ministries _Underbudget for the support of the function of the approach _Unproper decisions taken at the central level, not adapted to the realities in the field _The platform is not fully operational to meet the objectives _Lack of interest of health experts in the “one health” concept _Low level of adoption of One Health approaches was low (in the community), _No sops for preparedness and response available at the local level
Planning process District (34)	_No guidelines for preparedness and response _No up-to-date information on preparedness and response protocols and availability of emergency resources such as PPE vaccines, syringes etc. was often poor
Collaborative networks National (28, 29) District (33, 34) Community (27, 34, 35)	_Competing departmental priorities and institutional interests _Shortcomings in collaboration for intersectoral surveillance _No evidence of formal multisectoral collaboration and communication _Lack of teamwork between health experts _Egoism of health experts who do not consider public benefits when collaborating _Lack of data sharing with other sectors _Lack of trust in drugs and the intervention by the community _Lack of communication with the community _Weak implication of animal health sector response in the community
Community engagement At the local level (35)	_Hesitancy due to hygienic problems (mode of delivery)
Surveillance and monitoring National (28, 31) Regional (28) District (29, 34) Community (34)	_Disparate human and animal disease reporting systems, _Weak health system in the animal and human sector _Absence of an effective data-sharing system at all the level _Weak mainstreaming in the disease surveillance system _Lack of adequate resources, particularly for the detection of cases in event-based surveillance systems _Not enough staff to cover the whole territory effectively _High turnover of officers at the local level exacerbates the lack of skilled maintenance _Weakness of laboratory network _The paper-based alert system is considered too archaic to allow for rapid and quality notification and response
Practice and experience National (28, 29) District (29) Community (29, 35)	_Limited knowledge of zoonoses by relevant cross-sector actors _Lack of training and technical capacities and lack of appropriation of the concept by some sectors like environment and animal _Low level of implication in the environment and animal sector in surveillance and interventions _Lack of support of another sector, like the environment, by TFPs _Lack of dissemination of the approach within the various institutions in the central and decentralized services _Lack or low level of knowledge about how joint interventions at the local level _Communities are less well aware than the central level in One Health activities
Resources National (27–30, 34) Regional (29, 32) District (33, 34) Community (34)	_Insufficient financial resources from the government _Mismanagement or lack of funds and supplies for emergency and disease investigation _Poor infrastructure and resourcing, particularly in human and animal health service _Lack of human resources _Lack of cold chain maintenance of the vaccine _Lack of adequate resources for the function of One Health Platform activities _The TFPs more frequently tend to finance vertical programs for specific diseases, particularly in the human sector _Weakness of the national capacity to mobilize resources
Workforce capacity National (27, 29)	_Lack of trust toward local health systems _Mistrust between actors _Egos and different mindsets among actors _Different administrative cultures or working practices
Communication National (27–29) Regional (32) District (27) Community (27, 35)	_Lack of information and communication for the activities to put in place in the community or asymmetries of information _Lack of telephone coverage in certain areas, which hinders the proper circulation of information _Problem of leadership during investigation missions and the ability to work as a team remains difficult in the field __Absence of formal channels of communication __Low-risk awareness of zoonotic activities at all the level __Not enough communication awareness about drugs and One Health intervention with the community