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Social Network Analysis of Key Stakeholders in Brucellosis Prevention in Western Iran Publisher



Behzadifar M1 ; Yarahmadi M2 ; Bakhtiari A3 ; Kargar S4 ; Shahabi S5 ; Azari S6 ; Martini M7 ; Behzadifar M1
Authors
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Authors Affiliations
  1. 1. Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
  2. 2. Department of Medical Parasitology and Mycology, Lorestan University of Medical Sciences, Khorramabad, Iran
  3. 3. Health Equity Research Center (HERC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
  4. 4. Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
  5. 5. Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
  6. 6. Hospital Management Research Center, Health Management Research Institute, University of Medical Sciences, Tehran, Iran
  7. 7. Department of Health Sciences, University of Genoa, Genoa, Italy

Source: Tropical Medicine and Health Published:2025


Abstract

Background: Brucellosis remains a persistent public health challenge in Iran, particularly in rural regions such as Lorestan province, due to systemic, economic, and cultural barriers. Effective disease control requires multisectoral collaboration among stakeholders. This study aimed to map the stakeholder network involved in brucellosis prevention in Lorestan province, identify gaps in coordination, and provide actionable recommendations for improving control strategies. Methods: This cross-sectional study employed social network analysis (SNA) to explore the relationships among key stakeholders in brucellosis prevention. Data were collected through a structured questionnaire administered to 75 experts from various sectors, including health, veterinary, agriculture, and non-governmental organizations. The SNA evaluated network density, clustering coefficient, and centrality metrics to determine the levels of collaboration and influence among stakeholders. Results: The analysis revealed a moderately dense network (density: 0.2745; clustering coefficient: 0.2839) with central roles played by the Veterinary Organization of Lorestan Province, Lorestan University of Medical Sciences, and the Ministry of Agriculture. These organizations exhibited high levels of influence, support, and interest in brucellosis prevention. However, limited involvement of community-based organizations and environmental agencies was identified, highlighting a critical gap in grassroots engagement. Fragmented coordination was particularly evident in rural areas, where traditional livestock practices, inadequate veterinary services, and the consumption of unpasteurized dairy products perpetuate disease transmission. Economic constraints, such as the high cost of vaccines, along with limited public awareness, further hinder effective control efforts. Conclusions: Brucellosis prevention in Lorestan province requires a comprehensive, multisectoral approach. The adoption of a One Health framework can improve collaboration among stakeholders, enhance resource allocation, and address systemic barriers. Community engagement and intersectoral coordination are essential for improving public awareness and compliance with preventive measures. These findings provide a foundation for developing a National Brucellosis Control Program and inform strategies to mitigate zoonotic diseases in similar high-risk regions. © The Author(s) 2025.