Towards an One Health Surveillance System in Cuba: co-productive stakeholder engagement

We advocate for a holistic approach to building resilience against health hazards in Cuba by improving cross-sectoral and transdisciplinary collaboration. As a step in this direction, we conducted participatory workshops to design two One Health Surveillance Systems (OHSS): (i) for Influenza viruses with zoonotic/pandemic potential and (ii) for Antimicrobial Resistance (AMR). We engaged multiple stakeholders and used a Constellation Analysis (CA) tool to identify and visualize the elements of the ongoing veterinary and public health surveillance systems that are currently in place for AMR and Influenza. The stakeholders also delivered innovative insights regarding their views on the future OHSS. The participatory workshops consisted of four stages: (1) description of the case studies and their impact in Cuba; (2) validation of pre-designed CAs; (3) focus group discussions about the future OHSS; and (4) listing and discussing essential action points to develop and implement an OHSS. The workshops encompassed several group discussions and plenary sessions. The discussions were guided by a set of questions and supported by the CA tool. In both studies, we found that the transdisciplinary approach of the CA was suitable for encouraging group and plenary discussions. Stakeholder engagement is essential for the co-production of viable solutions to address complex health problems. Overall, this case illustrates how transdisciplinary research enables rapid co-production of knowledge among stakeholders that can inform both policy and practice.