Elevating Community Voices in One Health: Application of the Community Zoonoses Prioritization tool in Somalia

Background: Pastoral and agro-pastoral communities in Somalia face zoonotic risks due to close human–livestock contact but they are rarely represented in national health planning. We applied the Community Zoonoses Prioritization (CZP) tool to identify and rank community-prioritised zoonoses and assess alignment with national priorities.<br><br>Methods: We conducted 40 gender-segregated CZP exercises across four regions of Somalia (Bari, Sool, Middle Shabelle, and Gedo), engaging 480 pastoral and agro-pastoral participants (240 men, 240 women). Communities were guided through a six-step procedure involving general health problems mapping; zoonoses listing; criteria selection and weighting; disease scoring; identification of actions and responsible actors; and contextualisation within broader health concerns. Kendall's W was used to assessed within-group agreement while Kendall's τ was used to examine correlations between genders and regions.<br><br>Findings: Communities identified 26 zoonoses. Top priorities where anthrax, bovine tuberculosis, brucellosis, child diarrhea from raw milk, toxoplasmosis and sarcoptic mange. Agreement was strong within male (W=0·659, p&lt;0.001) and female groups (W=0.614, p&lt;0.001), and within regions (W=0.599–0.763, p&lt;0.001). Correlation was high between male and female groups (τ=0.882, p&lt;0.001) and moderate-to-high between regions (τ=0.600–0.854, p&lt;0.001). Gender differences emerged in criteria weighting, actions, and responsibility attribution. Zoonoses received lower priority scores than human and animal health problems when contextualised.<br><br>Interpretation: Structured community discussions can generate reproducible, policy-relevant evidence on priority zoonoses. Community priorities diverged from national frameworks, reflecting livelihood-based and local concerns. Integrating community-level prioritization into One Health planning would enhance intervention relevance, legitimacy, and sustainability in Somalia and similar settings.