‘Multisectoral socialisation’ in national health governance: An ethnographic study of Singapore’s One Health approach

ABSTRACT Introduction The 2025 establishment of Singapore’s Communicable Diseases Agency (CDA) as the country’s national public health agency included creation of a One Health Office (OHO). OHO’s establishment supports the pre-existing One Health whole-of-government approach, consisting of multisectoral collaborations via five government agencies spanning human, animal, and environment-related health. Singapore’s One Health approach includes several unique features designed to stimulate preparedness, prevention, and mitigation measures during periods of non-emergency. We thus aimed to analyse how this approach developed and implemented multisectoral governance of national One Health priorities. Methods This ethnographic study, conducted over 9 months (2024-2025), included unstructured observations of 3 inter-agency One Health meetings and 8 partner agency engagements, 26 key informant interviews with public servants across the five One Health partner agencies, and review of 8 internal government documents (e.g. draft plans, reports, presentation slides). We analysed data thematically using abductive coding. Findings Foundational to Singapore’s One Health governance approach, we found a participant-driven socialisation process dependent on the development of ‘semi-informal’ inter-agency relations among public servants. A rotational governance structure and small size of the city-state fostered these relations, which in turn strengthened/were strengthened by regular bilateral and multilateral communication and engagement by OHO to achieve workable arrangements while continuously building multisectoral governance of One Health nationally. Conclusions Singapore’s One Health approach and emergent multisectoral governance is predicated on cultivating interpersonal socialisation among stakeholders. Agencies such as CDA exemplify how formal structures can be strengthened through “semi-informal” social networks that foster shared ownership, trust, and consensus across government entities. For national public health agencies elsewhere, embedding such socialisation processes within governance may enhance collaboration and ownership building, even across multiple sectors.