“We love our livestock”: relational care-based One Health in pastoral drylands

Pastoralist communities in the Horn of Africa face intensifying health and livelihood challenges driven by climate change, infectious disease outbreaks, and conflict. One Health (OH) has gained prominence as a holistic approach capable of addressing these interconnected socioecological risks. Yet gendered OH research in pastoral settings has narrowly focused on zoonotic disease. As a result, little is known about how pastoralist men and women themselves conceptualize OH–what aspects are most important and how they understand the relationships between them. To address this gap, we aimed to generated locally grounded, gendered understandings of OH to inform more equitable and effective OH policy and practice. We employed a mixed methods approach that combined fuzzy cognitive mapping (FCM) with grounded theory qualitative analysis. We conducted 15 small-group mapping sessions with pastoralist men and women across one village and five kraals in Turkana County, Kenya. Maps were aggregated by gender and analyzed using network metrics, while mapping transcripts were analyzed using the One Health Coding Paradigm–applied for the first time to gender analysis. Women’s maps had more components and connections, while men and women shared the same top ten most central components in their maps. These included human and livestock health, nutrition, access to services and natural resources. Within shared components, women emphasized drought, workload, nutrition, and education, while men emphasized veterinary service delivery tradeoffs, income, and conflict. We found gendered roles, institutional access, and power relations shaped how men and women conceptualized OH in distinct ways. Women understood OH through embodied labor and care, while men had a governance and risk perspective. Women also demonstrated less knowledge of zoonotic diseases due to their exclusion from formal and customary decision-making and governance spaces. We argue that care-based OH represents a paradigm shift capable of expanding OH beyond its biomedical focus, and that gender is not only an equity concern but a fundamental analytical entry point for more effective and equitable OH policy and practice in pastoral drylands.