Examining bhutan's zoonotic disease policies through a One Health lens: a qualitative policy analysis using the policy triangle framework.

Abstract

Background: The recurrent threat of zoonotic diseases necessitates integrated, multisectoral strategies, such as the One Health, which recognises the interconnectedness of human, animal and environmental health. Institutionalising such approaches requires comprehensive national policy frameworks that ensure cross-sectoral coordination, sustainable resource allocation, and robust governance mechanisms. Bhutan adopted One Health in 2013, however, its integration into national policies remains unexplored. This study aimed to examine Bhutan's policy landscape for zoonotic disease prevention and control through a One Health lens.

Methods: Eleven documents related to zoonotic disease prevention and control in Bhutan, published between 2013 and 2024, were retrieved from official government websites and obtained from relevant authorities. A qualitative document analysis was conducted, guided by the Policy Triangle Framework, which evaluates policy across four dimensions: Actors, Context, Content, and Process. Key One Health components were mapped to each dimension using internationally recognised One Health frameworks to systematically evaluate the extent to which Bhutan's zoonotic disease policies align with the principles of One Health approach.

Results: The findings revealed clearly defined roles and responsibilities among key stakeholders, but limited inclusion of the environmental sector. While the policies reflected contextual relevance and alignment to international disease prevention and control frameworks, their integration with holistic One Health strategies remained limited due to persistent sectoral silos. Policy contents revealed a strong commitment to disease prevention and control, but major gaps were identified in financial planning, human resource development, and investment in technical infrastructure. Policy processes were largely undocumented, with weak stakeholder engagement, limited cross-sectoral coordination, and absence of robust monitoring and evaluation mechanisms.

Conclusions: Strengthening policy design, enhancing governance structures and institutional frameworks are essential to improve intersectoral coordination, resource allocation, and stakeholder engagement for effective operationalisation of zoonotic disease prevention and control within the One Health framework in Bhutan. The insights from this study may offer practical implications for low- and middle-income countries working to embed One Health into national policy. Furthermore, it demonstrates how the Policy Triangle Framework can be adapted to systematically evaluate policy alignment in the context of One Health.