ABSTRACT:
Neglected tropical diseases (NTDs) continue to pose a significant health and socioeconomic burden in Nepal, disproportionately affecting rural and marginalized populations. Diseases such as rabies, soil-transmitted helminthiases, leptospirosis, and foodborne trematodiases contribute to chronic illness, disability, and social stigma, while undermining livelihoods, education, and community well-being. In Nepal, Community Animal Health Workers (CAHWs) and Female Community Health Volunteers (FCHVs) represent trusted community actors embedded in local social networks. Unlike external health agents, they possess intimate knowledge of households, cultural practices, and community dynamics, enabling them to deliver effective health education, monitor disease trends, and implement preventive interventions. CAHWs provide critical veterinary services, including livestock vaccination and zoonotic disease surveillance, while FCHVs focus on human health, including deworming campaigns, rabies awareness, and maternal child health initiatives. This study evaluates the operational integration of CAHWs and FCHVs under a One Health framework to strengthen NTD prevention and control in low-resource settings. Using a mixed- methods approach, we conducted field assessments, participatory workshops, and key informant interviews in selected rural districts. Data were collected on intervention coverage, community engagement, early detection of NTD cases, and implementation challenges. Coordinated activities included synchronized rabies vaccination drives, mass deworming programs, community sensitization campaigns, and joint surveillance protocols. Findings indicate that integrated One Health interventions significantly improve preventive coverage and early detection of NTDs. Communities demonstrated higher participation and compliance when interventions were delivered by trusted, embedded actors. Joint planning and monitoring facilitated rapid response to disease outbreaks, while combining human and animal health services reduced operational costs and maximized reach. Importantly, these interventions strengthened local capacity for sustained NTD management and empowered communities to take active roles in health promotion. By operationalizing One Health from the ground up, this approach translates systems thinking into practical, community-driven solutions, bridging gaps between research, policy, and field implementation.