A national One Health consultation workshop was convened in Tripoli, Libya, from September 3–5, 2024, to facilitate multisectoral collaboration. To ensure methodological validity, participants were selected through purposive sampling, prioritizing individuals with in-depth expertise, direct operational experience, and demonstrated engagement in human, animal, or environmental health domains. Additional criteria included availability, willingness to participate, and ability to articulate insights clearly consistent with established qualitative research standards. The workshop brought together 42 key stakeholders from governmental ministries, national technical agencies, and academic institutions. Participant distribution was as follows: National Center for Disease Control (NCDC, n = 9), National Center for Animal Health (NCAH, n = 7), Ministry of Health (MoH, n = 6), Ministry of Environment (MoE, n = 5), Food and Drug Control Center (FDCC, n = 5), Environmental Sanitation Affairs (ESA, n = 5), Ministry of Agriculture (MoA, n = 2), and academic institutions (n = 3). Participants represented diverse disciplines—including public health, epidemiology, veterinary medicine, laboratory sciences, food safety, environmental health, and climate change—ensuring multidisciplinary and multisectoral representation aligned with the One Health approach.

The overarching goal of the initiative was to establish a formal and sustainable One Health governance framework in Libya. To operationalize this, a multisectoral task force was formed with the mandate to develop a national MoU. Before the workshop, the task force agreed on three evidence-based analytical objectives:

Using the Net-Map tool—a participatory social network analysis method developed by the International Food Policy Research Institute (IFPRI) (18), workshop participants systematically identified 27 key actors across four categories (Figure 1):

These stakeholders were then plotted on an influence-interest matrix based on two dimensions:

This matrix enabled strategic stakeholder segmentation and guided tailored engagement strategies (e.g., “Manage Closely,” “Keep Satisfied”).

Building on the influence-interest analysis, participants defined functional relationships among stakeholders identified as key actors for the One Health institutionalization in Libya through a structured plenary session. The Prime Minister’s Office was not included in this analysis due to its unique, overarching convening role. Actors were first categorized by role:

Four key linkage types were operationally defined and prioritized for institutionalization:

Participants mapped existing communication channels, interaction frequency, directionality, and resource flows, identifying both leverage points and critical gaps in the current network.

Participants were divided into four thematic groups, each assigned to map one linkage type using color-coded directional ties. Arrows indicated direction of influence or support; bidirectional arrows denoted mutual engagement. “Influence towers” (constructed using Lego® bricks) visually represented each actor’s relative influence based on the number and strength of incoming ties. The resulting physical maps were digitized using network visualization software to produce dynamic diagrams for further analysis.

To complement the participatory mapping, a quantitative SNA was performed on a dataset of 11 core stakeholders (identified as having High Influence and High Interest) and 102 directed ties across the four linkage modalities. The analysis was executed using R software (version 4.3.1). The multi-edge weighted network was used, where edge weights represented the count of distinct interaction modalities (coordination, collaboration, capacity building, advocacy) between stakeholders.

Network construction, analysis, and metric computation were carried out using the igraph package. The following metrics were calculated to empirically validate the participatory findings and reveal nuanced stakeholder roles:

Network visualization was achieved using the ggraph package. The tidyverse suite was used for data wrangling, while scales, knitr, and kableExtra enhanced the clarity of data presentation and the generation of structured results tables.

A structured, multi-stage qualitative consensus process was employed to conduct the SWOT analysis. Participants were divided into four thematic working groups, each assigned to systematically identify factors for one of the four SWOT categories. The analysis was guided by a standardized framework of prompting questions aligned with the study’s objectives. For instance, groups considered questions such as: “What existing policies, skills, or infrastructure give Libya an advantage in One Health?” (Strengths); “What gaps in coordination, funding, or awareness hinder progress?” (Weaknesses); “What external support, partnerships, or global initiatives can be leveraged?” (Opportunities); and “What political, economic, or environmental pressures could threaten success?” (Threats). Following in-depth group discussions, the findings were presented in a plenary session where each factor was reviewed, debated, and validated through formal consensus voting to ensure only universally acknowledged items were retained. A pre-defined threshold of >70% participant agreement was required for a factor to be included in the final SWOT matrix. To strengthen internal validity and contextual relevance, the consolidated findings were cross-referenced with SNA results. This rigorous process ensured that the final SWOT matrix directly and reliably informed the strategic priorities embedded in the national One Health MoU.

Actors were plotted on a stakeholder influence/interest matrix (Figure 1), which serves as a strategic visual tool for understanding their relative potential impact on and commitment to the One Health initiative. The matrix revealed distinct stakeholder segments, guiding targeted engagement strategies:

The resulting matrix served as a strategic framework to prioritize engagement, highlighting influential stakeholders whose buy-in was critical for driving the initiative forward and identifying entities requiring targeted communication. This approach enabled the systematic development of tailored strategies to secure broad-based, multi-sectoral commitment.

Figure 2 presents the network map generated from the participatory Net-Map exercise, illustrating the structure and nature of relationships among key actors in Libya’s One Health network. The map identifies the NCDC and the National Center for Animal Health (NCAH) as the most connected nodes. The MoA was observed to be the primary connection point between international organizations (FAO, WOAH) and national agencies.

Application of the Louvain algorithm to the stakeholder network identified three distinct communities with a modularity score of 0.195, indicating a statistically significant, non-random community structure Figure 3 (Supplementary Table 1)

The most significant strengths identified were the strong technical expertise of national institutions, the existence of centralized infrastructure, and a notable willingness among stakeholders to collaborate. Conversely, the most critical weaknesses included deeply fragmented intersectoral coordination, the absence of joint strategic plans, and limited financial resources dedicated to One Health activities. Key opportunities centered on the potential for alignment with the Quadripartite’s Joint Plan of Action and access to sustained international technical support. The most pressing threats were identified as the overarching political and economic instability, the impacts of climate change, and cross-border disease risks associated with migration Figure 4.

The MoU was developed as a direct outcome of this stakeholder engagement process and established the formal governance framework for One Health in Libya. Its key provisions include:

The SNA findings indicate that the NCDC and the NCAH are fundamental to Libya’s One Health framework. Although both entities are central, their functions differ significantly: NCAH exhibits a balanced combination of influence and intermediacy (with high in-degree and betweenness), making it a key connector between human and animal health sectors. Conversely, NCDC stands out as the most active entity operationally (with the highest weighted out-degree), driving collaboration, capacity enhancement, and advocacy efforts. This contrast between strategic impact and operational engagement highlights the necessity for complementary leadership strategies in One Health governance. Among the international entities, the SNA results indicate that the WHO has the most operational entity (with the highest degree of centrality and weighted degree) in Libya.

The network displays a disassortative mixing pattern, with an assortativity of −0.13, leading to a ‘hub-and-spoke’ arrangement where central hubs primarily link to less-connected peripheral nodes. This structure provides efficiency and cohesion, which allow for effective coordination and rapid dissemination of information and resources from central nodes (such as NCDC and NCAH) to outer regions, enhancing leadership during routine operations. However, it introduces structural vulnerability; this efficiency renders the network at risk, especially if a central hub like the NCDC were to be removed. Such a loss could fragment the connections among peripheral nodes, causing disruption. This vulnerability is particularly alarming in Libya’s volatile context, where institutional stability is unpredictable.

Though the MoH does not get deeply involved in operations, it maintains a significant structural position due to its critical policy-making function. This observation is consistent with global patterns, where technical bodies typically lead execution and ministries offer strategic guidance (24).

Human-driven environmental changes—particularly agricultural intensification, deforestation, and ecosystem disruption—have led to increased encroachment into wildlife habitats, disrupting ecological balances and bringing humans and livestock into closer contact with wildlife reservoirs and disease vectors, thereby heightening the risk of infectious disease emergence and spread (25, 26). This highlights the essential role of MoA. In this research, MoA serves a crucial intermediary function, linking the domestic operational center (Community 1) with international standard-setting organizations (FAO, WOAH) in Community 2. Its significant betweenness centrality (0.334) and closeness (0.667) underscore its role as a channel for adapting global standards to national actions, a pattern also recognized in other LMICs where agriculture ministries lead zoonotic disease management (7).

The identification of distinct clusters and key brokers provides a solid foundation for creating strategies to bridge sector gaps. To operationalize the strategic roles of these brokers, several mechanisms are recommended. First, the MoA should be utilized for policy bridging. With high betweenness centrality (0.334) but a low weighted degree (31), the MoA’s strength lies in connecting disparate parts of the network rather than in frequent interactions. Its role should be formalized as a policy facilitator, concentrating on developing integrated policies that align agricultural, public health, and environmental goals. Additionally, it should leverage its international ties (e.g., FAO, WOAH) to secure funding for cross-sector initiatives. Second, the NCAH needs to be empowered as an operational integrator. Given its high activity level (weighted degree = 96) and significant brokerage (betweenness = 0.152), the NCAH serves as an effective “hub-broker.” Its focus should be on creating standardized protocols for surveillance, laboratory testing, and data sharing, which will enhance collaboration between human and animal health sectors. Lastly, to mitigate structural risk, it is crucial to create redundancy within the network. The current disassortative structure (−0.13) and centralization around the NCDC and NCAH pose systemic risks. Therefore, the governance framework should promote direct connections by establishing multisectoral joint technical working groups (e.g., a “Zoonotic Disease Task Force”) and implementing a unified digital platform for disease surveillance. This strategy would aid in breaking down information silos and enhancing collaboration without the constant need for central intermediaries.

The SWOT analysis contextualizes network findings within Libya’s operational reality. Key strengths—technical expertise, centralized infrastructure, and political will—provide a solid foundation. A global health risk framework is only as strong as the national public health infrastructure that forms its base, as these national systems are the first to confront pandemic threats and are therefore the essential foundation of our collective defense (28). However, key weaknesses, including fragmented coordination, the absence of joint intersectoral strategies, and limited capacity at decentralized levels, pose significant barriers to scaling up One Health implementation. Compounding these internal challenges are critical external threats such as political instability, climate change, and cross-border disease risks, all of which necessitate a resilient and adaptive governance framework. To effectively mitigate heightened risks and associated costs, policymakers must proactively address these vulnerabilities (29, 30). A successful adaptation strategy must be grounded in a robust conceptual understanding of the complex, multi-scale dynamics that shape health security in fragile contexts (31). The MoU’s focus on zoonotic surveillance, AMR containment, and climate-health interfaces directly responds to these systemic vulnerabilities.

This study represents the first comprehensive, mixed-methods stakeholder network analysis to inform One Health institutionalization in Libya. Its primary strength lies in the integration of participatory Net-Map exercises, quantitative SNA, and SWOT assessment—providing both qualitative depth and empirical rigor. The process directly engaged 42 participants from key national stakeholders across human, animal, and environmental health sectors, ensuring high contextual relevance and ownership. Critically, the findings were not merely diagnostic but were immediately operationalized into Libya’s national One Health MoU, demonstrating tangible policy impact. The use of multiple SNA metrics (degree, betweenness, eigenvector centrality, modularity, etc.) allowed for nuanced insights into both structural influence and operational engagement, revealing key brokers and functional clusters that would be invisible through simple stakeholder lists.

However, several limitations should be considered when interpreting these results, primarily stemming from the study’s scope and participant-defined boundaries. First, the purposive selection of national-level decision-makers and technical experts, while appropriate for mapping the core governance structure, led to the underrepresentation of subnational, private sector, and civil society actors. Consequently, the findings may not fully capture critical perspectives from frontline implementation, community engagement, and market-driven influences, potentially overrepresenting formal, government-led collaboration pathways. Second, the stakeholder network’s boundaries were defined by the workshop participants, resulting in the omission of influential international actors. Notably, entities with established environmental mandates, such as the United Nations Environment Program (UNEP) and the United Nations Development Program (UNDP), as well as key donors like the European Union and the Italian Agency for Development Cooperation, were not identified as central nodes. Their absence may obscure important sources of indirect influence, funding, and technical assistance that shape the network’s dynamics. As a result, the identified network structure represents a specific, top-down institutional perspective captured at a single point in time. This snapshot likely underestimates the complexity of the broader One Health landscape. For instance, including subnational actors might have revealed a more fragmented network, highlighting a policy-implementation disconnect. Similarly, the inclusion of UNEP and UNDP could have consolidated a stronger environmental cluster or identified a new broker for the climate-health nexus. Future research should deliberately incorporate these underrepresented groups to provide a more holistic, multi-level understanding of the One Health ecosystem in Libya and its capacity for decentralized execution and sustainable impact.

To translate stakeholder network analysis into effective One Health governance in Libya, three key priorities are essential: First, institutionalizing national leadership by embedding the One Health within the governmental framework through a formal decree or mandate. This should include a dedicated budget and a transition plan to shift leadership from the WHO to a national agency, ensuring sustainability through domestic coordination. Second, bridging sectoral clusters by empowering the MoA and NCAH to connect under-engaged sectors, such as the MoE, particularly given the MoE’s role as the national lead for climate adaptation and resilience, as well as in the education and defense sectors. Developing formal inter-cluster protocols—like joint risk assessments and simulation exercises—is crucial to operationalize cross-sector collaboration. Third, establishing a results-oriented monitoring and evaluation (M&E) framework that tracks process and outcome indicators, such as joint planning meetings and budget allocations for One Health activities. This M&E system should be integrated into the national health information architecture and reported annually to enhance transparency and learning. These actions will strengthen Libya’s One Health system, making it resilient to political changes and health challenges.