Exploring the capacity and challenges to strengthen the health system performance for future outbreaks of Aedes-borne diseases in Puducherry, India.

Vector-borne diseases (VBDs) pose a global health threat, particularly in tropical and sub-tropical regions like India. This study investigates the capacities and challenges of Puducherry's health system in combating Aedes-borne diseases. A multi-method qualitative approach including reviews of governmental documents and media reports, focus group discussions and in-depth interviews with stakeholders, and field observations was used. We performed a thematic stakeholder power-interest analysis using the World Health Organization's "Health System Building Blocks" framework. Key challenges included unsustainable interventions, poor interdepartmental collaboration, limited manpower, and urban-centric facilities causing long waiting times. Furthermore, growing migrant population, limited social media engagement, inefficient primary-level surveillance, and passivity in community responsibility sharing were noted. The findings emphasize the global value of investing in robust healthcare infrastructure, interdisciplinary collaboration, and community empowerment to mitigate VBD risks. The insights are valuable for policymakers and researchers to enhance the effectiveness of vector control programs in diverse settings.