A Systems Approach to Evaluate One Health Initiatives

Research output: Contribution to journalJournal article – Annual report year: 2018Researchpeer-review



  • Author: R. Rüegg, Simon

    University of Zurich, Switzerland

  • Author: Nielsen, Liza Rosenbaum

    University of Copenhagen, Denmark

  • Author: Buttigieg, Sandra C

    University of Malta, Malta

  • Author: Santa, Mijalche

    SS Cyril and Methodius University in Skopje, Macedonia, The Former Yugoslav Republic of

  • Author: Aragrande, Maurizio

    University of Bologna, Italy

  • Author: Canali, Massimo

    University of Bologna, Italy

  • Author: Ehlinger, Timothy

    University of Wisconsin-Milwaukee, United States

  • Author: Chantziaras, Ilias

    Ghent University, Belgium

  • Author: Boriani, Elena

    Research group for Genomic Epidemiology, National Food Institute, Technical University of Denmark, Kemitorvet, 2800, Kgs. Lyngby, Denmark

  • Author: Radeski, Miroslav

    SS Cyril and Methodius University in Skopje, Macedonia, The Former Yugoslav Republic of

  • Author: Bruce, Mieghan

    Murdoch University, Australia

  • Author: Queenan, Kevin

    Royal Veterinary College, United Kingdom

  • Author: Häsler, Barbara

    Royal Veterinary College, United Kingdom

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Challenges calling for integrated approaches to health, such as the One Health (OH) approach, typically arise from the intertwined spheres of humans, animals, and ecosystems constituting their environment. Initiatives addressing such wicked problems commonly consist of complex structures and dynamics. As a result of the EU COST Action (TD 1404) "Network for Evaluation of One Health" (NEOH), we propose an evaluation framework anchored in systems theory to address the intrinsic complexity of OH initiatives and regard them as subsystems of the context within which they operate. Typically, they intend to influence a system with a view to improve human, animal, and environmental health. The NEOH evaluation framework consists of four overarching elements, namely: (1) the definition of the initiative and its context, (2) the description of the theory of change with an assessment of expected and unexpected outcomes, (3) the process evaluation of operational and supporting infrastructures (the "OH-ness"), and (4) an assessment of the association(s) between the process evaluation and the outcomes produced. It relies on a mixed methods approach by combining a descriptive and qualitative assessment with a semi-quantitative scoring for the evaluation of the degree and structural balance of "OH-ness" (summarised in an OH-index and OH-ratio, respectively) and conventional metrics for different outcomes in a multi-criteria-decision-analysis. Here, we focus on the methodology for Elements (1) and (3) including ready-to-use Microsoft Excel spreadsheets for the assessment of the "OH-ness". We also provide an overview of Element (2), and refer to the NEOH handbook for further details, also regarding Element (4) (http://neoh.onehealthglobal.net). The presented approach helps researchers, practitioners, and evaluators to conceptualise and conduct evaluations of integrated approaches to health and facilitates comparison and learning across different OH activities thereby facilitating decisions on resource allocation. The application of the framework has been described in eight case studies in the same Frontiers research topic and provides first data on OH-index and OH-ratio, which is an important step towards their validation and the creation of a dataset for future benchmarking, and to demonstrate under which circumstances OH initiatives provide added value compared to disciplinary or conventional health initiatives.

Original languageEnglish
Article number23
JournalFrontiers in Veterinary Science
Number of pages19
Publication statusPublished - 2018
CitationsWeb of Science® Times Cited: No match on DOI

    Research areas

  • Transdisciplinary, Integrated approaches to health, Evaluation framework, One health, One health index, One health ratio

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