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With disease outbreaks rising, responsive and resilient systems are needed. Understanding how disease outbreaks are managed, and how governments, non-governmental organisations (NGOs), and international governmental organisations (IGOs) work together to respond is essential. Fifteen key informant interviews and one group interview were conducted with individuals in water and health sectors from the Fijian government, NGOs, and IGOs at the water catchment, divisional, and national levels about decision-making during outbreaks. Thematic analysis found changes in communication, collaboration, and coordination during an outbreak. Communication becomes open, transparent, frequent, and utilises informal pathways including social media. Collaboration increases and becomes more flexible, leading to changes in roles, responsibilities and decision-making. The flexibility helps resource and fund redistribution. Coordination guided by government priorities, funding, laws, adaptability, and flexibility, enables targeted actions including resource prioritisation. Maximising the communication, collaboration, and coordination amongst sectors during disease outbreaks and non-outbreak periods can strengthen system resilience and responsiveness.

Information sharing, collaboration, and decision-making during disease outbreaks: the experience of Fiji