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Abstract Background: The cross-border areas of Ethiopia and Kenya are home to pastoralist communities that rely on livestock as a primary source of food and income, leading to frequent interaction between humans and animals and increasing the potential for exposure to health risks, including zoonotic diseases. Given limited access to healthcare in these areas, primary prevention efforts that raise individual and community awareness and promote sustained health behaviour change are paramount. Community conversations (CCs) are facilitated dialogues that engage community members in examining their perceptions and practices around a specific issue, while collaboratively identifying and developing solutions. Methods: CCs were piloted in three sites (one in Ethiopia and two in Kenya) to explore pastoralist communities’ awareness of zoonotic risks arising from daily human-animal interaction. Participants were women and men community members (n=69; 38% female) engaged with community platforms associated with the One Health for Humans, Environment, Animals and Livelihood (HEAL) project. Facilitators were trained on the CC methodology, documentation process and ethical community engagement practices. Guided after-event reflections with facilitators supported real-time analysis and validation of conversation outcomes, capturing valuable contextual insights in field reports and enabling thematic analysis. Results: Findings revealed that gender roles and cultural practices influence the health behaviours of pastoralist communities. Across sites, community awareness of health risks from daily human-animal interaction and associated preventive measures was limited and inconsistent. Hygiene and prevention practices were minimal, and communities often failed to connect animal and human health. Hand hygiene was primarily practiced to prevent animal infection rather than to protect human health. Despite some awareness of zoonotic diseases, such as anthrax and brucellosis, the consumption of raw meat and milk remained common in these communities. Conclusions: CCs have shown potential to effectively foster meaningful engagement among pastoralist communities, enabling collaborative analysis, shared learning, and coordinated action between communities and service providers. This study highlights that targeted social and behavioural change communication, combined with culturally appropriate community engagement approaches, is vital for improving health practices and mitigating zoonotic risks in pastoralist settings. Given the centrality of livestock to these communities, integrating hygiene promotion into animal health programs presents a strategic entry point for encouraging improved human hygiene practices, thereby reducing the risk of zoonotic disease transmission. One Health impact statement The paper highlights the interconnected health risks faced by pastoralist communities due to close human-animal interaction. By raising community awareness of zoonotic diseases through CCs in cross-border areas of Ethiopia and Kenya, this work benefits both human and animal health by promoting safer practices, reducing disease transmission and improving community resilience. The One Health approach has been instrumental in amplifying impact by fostering collaboration across human, animal, environmental and social science sectors. This cooperation has enabled a holistic understanding of zoonotic risks, leading to integrated prevention strategies that would not have been as effective in isolation. Engaging women and men pastoralists as active participants is essential to exploring diverse perspectives, facilitating knowledge sharing within communities and co-developing culturally appropriate solutions.