Awareness Regarding the One Health Approach Among Postgraduate Residents of a Tertiary Care Hospital in Northern India: A Cross-Sectional Study

Abstract

Background: The One Health model recognizes the complex interrelationships among human, animal, and environmental health, and has emerged as a pivotal framework for tackling zoonotic diseases, antimicrobial resistance (AMR), food safety concerns, and emerging infectious threats. Notwithstanding its global significance, the level of awareness regarding the One Health approach among medical practitioners in low- and middle-income countries (LMICs) such as India has not been thoroughly evaluated. The objective of this study was to assess the level of awareness of the One Health paradigm and its three fundamental pillars — human, animal, and environmental health — among postgraduate (PG) medical residents at a tertiary care teaching hospital. Methods: A cross-sectional, institution-based investigation was undertaken involving 295 postgraduate medical residents at a tertiary care facility in Uttar Pradesh, India, during the period spanning November 2022 to January 2023. The methodology employed was convenience sampling. A self-administered, semi-structured, pre-validated questionnaire was utilized to evaluate the levels of awareness across three domains of One Health (human health, animal health, and environmental health) and to gather sociodemographic data. The data were subjected to analysis utilizing SPSS version 25. Descriptive statistics and chi-square tests were implemented, with statistical significance established at p<0.05. Results: A total of 295 individuals participated in the study, comprising 53.9% males and 46.1% females, with 45.1% originating from para-clinical departments, 34.9% from clinical departments, and 20.0% from pre-clinical departments. A commendable level of awareness regarding the One Health framework was observed in 90.8% of participants, pertaining to the interconnectedness of human, animal, and environmental health. Domain-specific knowledge was found to be proficient in 53.9% for human health, 86.4% for animal health, and 40.3% for environmental health. A statistically significant relationship was identified between gender and awareness of human health (χ²=6.284, p=0.012) as well as environmental health (χ²=4.451, p=0.035). Furthermore, departmental affiliation exhibited a significant correlation with awareness of environmental health (χ²=7.361, p=0.025) and animal health (χ²=21.83, p<0.001). Conclusion: While there exists a considerable overarching conceptual understanding of the One Health paradigm among postgraduate residents, notable deficiencies are evident in their comprehension of environmental health concepts. The awareness of One Health is substantially affected by both gender and departmental affiliation. It is imperative to incorporate One Health principles into medical curricula and ongoing professional development initiatives to adequately prepare future health practitioners with the requisite interdisciplinary skills.