Abstract:
Background: In 2023, Sierra Leone’s National Public Health Agency (NPHA) conducted a national gender audit, identifying significant gaps regarding the integration of gender in epidemic preparedness, response systems, and cross-sector collaboration. To further investigate these gaps, the NPHA, in collaboration with GIZ, conducted a Gender in One Health assessment in 2025 across three districts. The assessment examined capacities and challenges for mainstreaming gender within district-level One Health (OH) systems and informed the design of a campaign aimed at strengthening cross-sectoral coordination, the capacity of Chiefdom OH Committees, community ownership of OH practices, and the public awareness of Gender in OH.
Methods: We adopted a mixed-methods design at district-level consisting of a qualitative assessment followed by an awareness raising campaign. The assessment triangulated focal group discussions with members of One Health Chiefdom Committees (separate male and female groups), key informant interviews with institutional actors, and expert roundtable discussions. Data was coded systematically to identify gender-related barriers, capacities, and opportunities for strengthening gender-responsive OH implementation.
Assessment findings informed the design of an awareness raising campaign implemented through roundtable discussions with community members and technical experts, radio panel discussions, training-of-trainers for Chiefdom One Health Committees, community outreach activities, and engagement with school health clubs. The campaign was evaluated through standardized 10-item pre- and post-tests.
Results: The assessment identified significant gender disparities in OH governance at district and chiefdom levels. While communities recognized links between human, animal, and environmental health, awareness of the formal OH approach remained limited. Women played key roles in caregiving, environmental management, and small livestock production but were often excluded from decision-making, outbreak preparedness planning, and formal risk communication channels. Institutionally, stakeholders reported limited capacity for gender mainstreaming in surveillance systems, emergency preparedness and response, risk communication, community engagement, and gender-based violence mitigation.
The awareness campaign strengthened multi-sectoral coordination through roundtables, increased community awareness through radio and outreach activities, trained 130 Chiefdom One Health Committee members as community champions, and enhanced youth engagement through school health clubs. Understanding of Gender in One Health among community members and stakeholders also improved, as shown in pre- and post-tests analysis with significantly higher knowledge scores following the campaign, with mean scores increasing from 4.53 to 7.01 (t(309) = 14.27, p < .001; Cohen’s d = 1.37).
Conclusions: Gender integration within OH systems remains limited despite growing recognition of the interconnectedness between human, animal, and environmental health. Addressing these gaps requires gender-responsive communication, sustained capacity building, and the deliberate inclusion of women and community voices in OH governance. The campaign demonstrates that participatory, multi-sectoral engagement can strengthen awareness of gender in OH. However, further research is needed to assess whether knowledge gains translate into sustained behavioral change during future outbreaks.
Biography:
Dr. Lisa Seidelmann is a medical doctor with a background in surgery and a focus on global and public health. She has worked at WHO on advancing universal health coverage and at the NGO Wemos on promoting health as a human right. Since 2020, she has been with GIZ supporting health system strengthening, and since 2024, she has been advising the Government of Sierra Leone on epidemic prevention, preparedness, and response through a One Health approach, with a focus on governance and gender.
