目的 探索全健康（One Health）理念在我国基层的落地困境与优化路径，为基层健康治理提供决策依据。 方法 于2023年6月至8月选择北京、浙江、海南、青海等4个地区与One Health相关的政府基层部门（包括省、市、县级卫生健康委员会、疾病预防控制、生态环境、农业、交通运输和市场监督管理等部门）的30名工作人员作为访谈对象，采用方便抽样法进行半结构化访谈，收集One Health理念多部门健康协同相关的实践经验、现状和存在问题。使用NVivo12对访谈资料进行开放式编码、主轴式编码、选择性编码并分析。 结果 收集的访谈资料经开放式编码得到51个初始概念，同时得到25个子范畴，分别为准备和响应、安全风险、信息交流、理念认可、管理和协调、沟通方式、社会效益、协作机制、协同治理、跨区协作、政策与规划、激励机制、国际合作、审计计划、部门职责、联合规划、跨部门协作、信息共享、经济情况、健康情况、宣传、资源、评价机制、反馈机制、监督实施等；25个子范畴经主轴式编码重新聚类后，归纳为10个主范畴，分别为信息交流、政策与规划、激励机制、社会效益、传播、协作机制、沟通、资源、准备和反应、国际合作等；主轴式编码和选择性编码的分析表明，在实践One Health理念时，多部门之间的协作尤为关键。这种协作体现在跨部门合作、应急响应、数据共享、社会责任和全球协同等多个方面。 结论 One Health落地关键在于制度创新，需通过基层机制建设实现“人-动物-环境”健康协同治理。落实“人病兽防、关口前移”策略，强化源头防控。未来应深化试点，推广评估工具，推动政策向社区延伸。

Objective To investigate the dilemma and optimization path for implementation of the One Health concept at the grassroots level in China, so as to provide the decision-making evidence for grassroots health governance in China. Methods A total of 30 workers were sampled from grassroots government departments related to One Health in Beijing, Zhejiang, Hainan, and Qinghai from June to August in 2023, including provincial-, municipal-, and county-level health commissions, centers for disease control and prevention, departments of ecology and environment, agriculture departments, transportation departments, and administrations for market regulation) as interviewees. Semi-structured interviews were conducted using the convenience sampling method to collect practical experiences, current situations, and problems related to the multi-sectoral health collaboration of the One Health concept. The interview data were subjected to open coding, axial coding, selective coding and analysis using the software NVivo 12. Results Following open coding of interview data， a total of 51 initial concepts, along with 25 sub-categories were yielded, including preparation and response, safety risk, information exchange, concept acceptance, management and coordination, communication methods, social benefits, collaboration mechanisms, collaborative governance, cross-regional collaboration, policy and planning, incentive mechanisms, international cooperation, audit plans, departmental responsibilities, joint planning, cross-sectoral collaboration, information sharing, economic conditions, health conditions, publicity, resources, evaluation mechanisms, feedback mechanisms, and supervision and implementation. Following axial coding and re-clustering, these 25 sub-categories were condensed into 10 main categories, namely information exchange, policy and planning, incentive mechanisms, social benefits, dissemination, collaboration mechanisms, communication, resources, preparation and response, and international cooperation. Axial coding and selective coding revealed that multisectoral collaboration was notably crucial in implementation of the One Health concept, and this collaboration was embodied in cross-sectoral cooperation, emergency response, data sharing, social responsibility, and global collaboration. Conclusion Institutional innovation is critical to implementation of One Health, which requires the establishment of grassroots mechanisms to achieve health coordinated governance of “human-animal-environment”. It is necessary to implement the strategy of “preventing human diseases by controlling animal diseases, and implementation of interventions moving forward from the source”, and strengthen the prevention at the source. Future efforts should focus on expansion of pilot programs, popularization of assessment tools, and extension of policies to communities.