An operational One Health framework for enhanced multi-sectoral coordination and collaboration in Tanzania

The One Health (OH) approach promotes integrated, multi-sectoral collaboration to address complex health threats at the human-animal-environment interface. This study examined operational gaps and opportunities to strengthen multi-sectoral OH coordination in Tanzania, drawing on empirical data and lessons from recent Marburg virus disease outbreaks. Given the growing number of emerging and re-emerging threats, the research aimed to develop a context-specific framework to enhance OH governance, communication, collaboration, and capacity building. A descriptive cross-sectional design included 101 participants from the health, livestock, agriculture, environment, and wildlife sectors across three regions (Arusha, Iringa, and Dodoma). Data were collected via semi-structured questionnaires and analyzed using quantitative and qualitative methods to assess knowledge, awareness, communication, and institutional structures. General findings revealed weak inter-sectoral coordination, limited awareness of OH guidelines, siloed operations, ad hoc communication, inadequate training, and insufficient financial resources, particularly at the subnational level. At the subnational level, only 33.7% (n=34) reported awareness of OH, and 27.7% (n=28) could identify core elements of OH. Coordination was largely reactive: 76.2% (n=77) were engaged only during crises, while routine operations remained fragmented. Communication was similarly ad hoc: 58.4% (n=59) reported it, and only 28.7% (n=29) reported regular interaction during outbreaks. Resource mobilization was donor-dependent and unpredictable, constraining preparedness and response. A striking 78.2% (n=79) of subnational participants reported a lack of policy integration and limited awareness of OH guidelines, while 56.4% (n=57) indicated unclear roles and responsibilities. The proposed framework offers a practical roadmap for institutionalizing OH in Tanzania. Its implementation is expected to enhance preparedness, early detection, and response to health threats, while fostering resilience and whole of government collaboration. It provides a scalable model for strengthening health security and operationalizing OH in similar contexts. Therefore, it is recommended that the proposed operational framework be tested and its performance systematically evaluated during future outbreak responses in Tanzania and extended to broader contexts beyond.