then, many natural scientists have emphasized the importance of human behaviour and cultural practices, for example for understanding risk exposure, transmission routes and the development of behaviour change interventions. Robertson and Thompson (2002) pointed to the need of educating dog and cat owners for managing enteric parasitic zoonoses in humans and their animals. The parasitologist Macpherson (2005) drew attention to the pivotal role human behaviour plays in the macro and microepidemiology of emerging or re-emerging parasitic diseases. The entomologist Gillett (1985) discussed the forgotten factor – human behaviour – and the complex relationships that exist between human behaviours and public works, urbanization, packaging, agricultural practices – and the transmission of vector-borne diseases. Dung et al. (2007) investigated the epidemiology of fish-borne zoonotic trematodes in Vietnam and suggested that behavioural factors warrant greater collaboration between epidemiologists and anthropologists in designing approaches for mitigating risk in a population with great resistance to change in eating habits. In discussing integrated rabies control, Lechenne et al. (2015) highlighted the importance of understanding the ecology of rabies, animal behaviour and human beliefs and behaviours in order to have effective programmes. Wildlife scientists Alexander and McNutt (2010) used data from a comparative study conducted in Kenya and Botswana to investigate the relationship between divergent cultural practices of pastoralists and contact between domestic dogs and African wild dogs. Based on this study and other examples, they developed a conceptual model of the potential influence of human behaviour on pathogen emergence at the human–domestic animal–wildlife interface and call for greater inclusion of the social sciences in emerging infectious disease research.
The outbreaks of SARS (severe acute respiratory syndrome), MERS-CoV (Middle East respiratory syndrome-related coronavirus), Ebola and Zika have further highlighted the need for social science approaches and actions. However, in 2017, the World Health Organization’s (WHO) Health Emergency Programme and the Wellcome Trust noted that:
Medical anthropologists and social scientists have been used to investigate and manage disease outbreaks, but social science interventions are not yet systematically used in all health emergencies, nor are social scientists trained to work with response teams effectively.
To address this concern a consultative meeting was organized, bringing together 72 experts and partners from more than 40 agencies (WHO, 2018).
Since the first edition of this book (Whittaker, 2015; Zinsstag, et al. 2015), there has been an increase in publications on social science research in the field of One Health. This includes special issues in the journals in Social Science and Medicine (2015) and Medical Anthropology Theory (2018). A particular focus has been the role that social science inputs and insights can play in supporting health security issues like major infectious disease outbreaks.
This chapter discusses several approaches that expanded the One Health research and interventions to include social and cultural dimensions. The first set of approaches frame the research interest and concerns theoretically and practically in the disciplinary context of parasitology, epidemiology and other natural and public health sciences, even if they address social and cultural dimensions of the phenomena under study. This mirrors the fact that, in spite of its programmatic emphasis on interdisciplinarity, the biological paradigm clearly dominates the ways in which pathways to improve human, animal and environmental health are framed. The second set of approaches offer more opportunities for contributions and engagement that move theoretical and empirical concerns of the social sciences into the foreground of One Health research and interventions.
Social science can also inform and stimulate reflectivity of practitioners and researchers, to ensure a ‘more holistic approach to joint problem solving and collective knowledge development’ (Cole, 2017, p. 127). Transdisciplinarity, one of the pillars of One Health, behoves us to embrace local and indigenous knowledge, and not privilege Western science knowledge over the vast cultural continuum of knowledge (Schelling and Zinsstag, 2015).
Examining Social and Cultural Aspects of Human–Animal Interactions
The well-known public health tool of the knowledge, attitude and practice (KAP) survey, also called the knowledge, attitude, behaviour and practice (KABP) survey, is widely used in One Health research. Most KAP surveys use predefined questions and the format of a standardized questionnaire to discover characteristic traits in knowledge, attitude and behaviour about health risks, disease and ill health related to religious, social and traditional factors (Médecins du Monde, 2012). The underlying assumption is that these factors may be the source of misconceptions or misunderstandings that often represent obstacles to behaviour change. Numerous KAP surveys have been conducted in response to the Ebola outbreak in West Africa, for instance in Guinea (Buli et al., 2015), Nigeria (Iliyasu et al., 2015) and Sierra Leone (Jalloh et al., 2017). For example 3 months into the 2014 Ebola outbreak in Sierra Leone, Jalloh and colleagues (2017) conducted a national KAP survey. They found a high awareness of Ebola among all respondents. Without being prompted, 60% of respondents correctly cited fever, diarrhoea and vomiting as signs/symptoms of Ebola. Most respondents knew that avoiding infected blood and bodily fluids (87%) and contact with an infected corpse (85%) could prevent Ebola. But they also found widespread misconceptions, for instance the belief that Ebola can be prevented by washing with salt and hot water (41%). Nearly all respondents (95%) expressed at least one discriminatory attitude towards Ebola survivors. Unprompted, self-reported actions to avoid Ebola infection included handwashing with soap (66%) and avoiding physical contact with patients with suspected Ebola (40%). The findings of Jalloh and colleagues directly informed the development of a national social mobilization strategy in the early stages of the epidemic.
Although KAP surveys address topics that are of key interest to social scientists, they have not been developed for research in the social sciences but to conduct operational or implementation research in the field of family planning and populations studies (Launiala, 2009). Since then they have become increasingly popular, mainly for practical reasons; they can be used for low-cost rapid assessments by researchers with little or no social science background (Manderson and Aaby, 1992). At the same time, they have been criticized by social scientists and public health specialists mainly because the underlying assumptions are based on common sense and highly simplified psychological theories about the relationship between knowledge, attitude and behaviour and completely disregard the importance of contextual influences (Manderson and Aaby, 1992; Launiala, 2009; Muleme et al., 2017).
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