Abstract
Background and Aim: The One Health approach promotes collaboration among human, animal, and environmental health sectors to address complex global health challenges. Despite increasing international and national commitment to One Health implementation, evidence describing how medical doctors enact this approach in routine professional practice remains limited. This study explored how One Health is enacted in the professional activities of medical doctors in Indonesia, with particular attention to professional roles, identity, and cross-sector collaboration.
Materials and Methods: This Exploratory-Descriptive Qualitative study employed semistructured online interviews with One Health practitioners from medical, veterinary, and public health backgrounds in Indonesia. Participants were purposively selected based on their involvement in cross-sector health activities related to zoonotic diseases, antimicrobial resistance, and emerging infectious diseases. Interviews were audio-recorded, transcribed verbatim, and analyzed thematically using an inductive approach. Concepts from Situated Learning Theory and boundary crossing were used as interpretive lenses during analysis.
Results: Thirteen participants were interviewed, comprising medical doctors, veterinarians, and public health professionals. Six interrelated themes were identified. One Health implementation was described as fragmented, reactive, and highly dependent on local commitment and informal networks. Doctors’ readiness to enact One Health was constrained by limited exposure during medical education, insufficient training on interprofessional collaboration, and systemic workplace limitations such as weak reporting systems and inadequate laboratory capacity. Clinician identity functioned both as a facilitator and barrier to cross-sector engagement. While clinical responsibilities positioned doctors as important initiators of collaboration, the immediacy of patient care and strong orientation toward independent clinical decision-making often limited sustained interaction with other sectors. Doctors’ roles extended beyond clinical care to include educator and collaborator functions, particularly in disease surveillance, advocacy, health promotion, and community engagement. Participants emphasized that apart from clinical competencies, effective One Health practice requires competencies in systems thinking, communication, collaboration, leadership, public health, and sociocultural understanding. Suggested educational strategies included systematic integration of One Health into existing curricula, interprofessional learning, and providing authentic collaborative learning experiences in diverse practice settings.
Conclusion: Medical doctors can enact One Health through clinical, educational, and collaborative roles. However, implementation remains limited and context-dependent due to systemic, educational, and professional identity-related constraints. Strengthening practice-oriented medical education and institutional support may facilitate more sustained and meaningful One Health engagement in professional practice.
Keywords: boundary crossing, cross-sector collaboration, Indonesia, medical education, medical doctors, One Health, professional identity, qualitative research.