Background and Objective:
Snakebite kills 64,100 people in India annually. Odisha, a state in eastern India, is one of the high burden states for snakebite. In 2015, the Government of Odisha declared snakebite a ‘state-specific disaster’. We aimed to explore stakeholder perceptions on the burden and systems preparedness for addressing the issue and suggest areas for future research and funding to reduce snakebite burden in Odisha.

Methods:
We conducted 21 in-depth interviews with key stakeholders, including clinicians, academicians, community health workers, wildlife workers and snake rescuers. We anonymised interview data, developed coding framework and conducted thematic analysis using NVivo 12 software.

Results:
The following four themes emerged based on interim results of 17 interviews– 1) There is discordance on the status of availability of snake anti-venom between clinicians, healthcare workers and the wildlife workers and snake rescuers. 2) There is a strong felt need, across all stakeholders, for community-based interventions for promoting use of formal healthcare system, increasing awareness about decreasing snake-human conflict and awareness on government scheme for snakebite death compensation. 3) Clinicians and health workers identified the need for training and support to address hesitancy to treat snakebite patients at the primary health centers. 4) Lack of funding, partnerships, and coordination between government, community-based organisations, and advocacy groups was identified as a key challenge in Odisha.

Conclusion:
There are multiple challenges at different levels for addressing snakebite burden in Odisha. There is a need for conducting more policy and systems research in the domain along with active involvement of policy makers and government stakeholders to develop and implement a dedicated state-specific strategy for snakebite. Such a strategy should focus on awareness and education of communities, training of healthcare workers, and strengthening of formal primary healthcare system of the state, which is first point of seeking care for snakebite.