The Network for Evaluation of One Health (NEOH) was an international EU-COST (European Cooperation in Science and Technology) funded network (2014-2018) that aimed to enable evaluation of One Health activities and comparison of initiatives, as well as informed decision-making and resource allocation. It was then converted into the Network for Ecohealth and One Health as the European Chapter of Ecohealth International that has several active working groups.

Challenge       

Human health and well-being are increasingly affected by global challenges such as malnutrition, emerging and endemic zoonotic diseases, antimicrobial resistance and climate change. One Health addresses health challenges arising from the intertwined spheres of humans, animals, and ecosystems. A One Health approach has been proposed to tackle the challenges through accepting that their complexity requires interdisciplinarity. Several One Health initiatives have been implemented, such as the establishment of cross-sectoral coordination, communication and data sharing mechanisms, however a standardised methodology for quantitative evaluation of One Health activities was lacking.

Therefore, NEOH aimed to enable future quantitative evaluations of One Health activities, and to further the evidence base by developing and applying a science-based evaluation protocol in a community of experts.

NEOH planned to deliver:

  1. A science-based, standardised framework for the evaluation of One Health
  2. A suite of example evaluations of One Health initiatives
  3. A networked community of experts collaborating to assess the value of One Health;
  4. A pool of early-stage researchers trained in performing evaluations of One Health activities.

Solution      

NEOH focused on an integrated, interdisciplinary evaluation of One Health activities to enhance the evidence base on the added value of One Health. Our activities included the development of an evaluation protocol and guidelines, case studies, comparative analysis, and dissemination. NEOH was an open international network with more than 250 participants from around the world who were working on One Health and were interested in collaboration, cooperation, and networking to promote a common cause.

The project published multiple peer reviewed publications (see list below), including a special research topic in Frontiers Journal, and an open access handbook Integrated approaches to health: A handbook for the evaluation of One Health. The latter provides science-based guidance for the evaluation of One Health and other integrated approaches to health. It guides the reader through a systems approach and framework to evaluate such approaches in a standardised way. It provides an overview of concepts and metrics from health and life sciences, social sciences, economics, and ecology that are relevant for the evaluation of the processes involved, as well as the characterisation of expected and unexpected outcomes of One Health initiatives. It also provides guidance and practical protocols to help plan and implement evaluations in order to generate new insights and provide meaningful information about the value of One Health. The handbook is intended for practitioners, researchers, evaluators as well as funders of integrated approaches to health and beyond.

This was achieved in four working groups:

WG1 worked on a standardised and widely accepted framework, index, and protocol for systematic evaluation of One Health, taking into account various disciplinary perspectives and resulting complexity. This included identification and description of the health, economic, environmental, social and cultural impacts of One Health, compilation and comparison of metrics and methods available to measure these impacts based on a literature review (including technical and data requirements, and presentation of examples), mapping of pathways to impact and categorisation and prioritisation of One Health challenges.

WG2 applied the framework, protocol, and index from WG1. Members used and facilitated access to available primary and secondary datasets stemming from ongoing One Health projects they were involved in (e.g. data on use of growth promoters in poultry production, mass drug administration for helminth control, land-use change and pathogen emergence etc.). They applied the protocol in One Health projects in their institutions and local networks and actively created opportunities for the testing of the framework, index and protocol.

WG3 conducted a meta-analysis of the available case study results to facilitate international comparison and the elaboration of policy recommendations. The case studies and meta-analysis were published in joint publications. In addition, WG3 developed recommendations for policy makers with regards to new policies and resource allocation.

WG4 sought to establish a dialogue with relevant stakeholders to get their input and feedback. The participants were responsible for the website, the establishment of an internal and external communication and influencing strategy covering the dissemination of contracted products (journal articles, popular articles, conference presentations, etc.) during the life of the project and invitation of key decision makers to relevant NEOH meetings. National and international dissemination of the handbook and active promotion in the scientific community facilitated implementation of further case studies and generation of evidence in different settings and contexts.

Impact      

Between 2015-17, three annual training schools were held, i) Evaluation: Best practice, approaches and applications in multiple disciplines; ii) How to apply the evaluation framework, protocol and index; and iii) Evaluation of One Health.

A total of 9 workshops were held between 2016-18 to bring together NEOH members, interested researchers, and policymakers, and to report on network activities, disseminate products and foster knowledge exchange and collaboration.

A total of 34 Short Term Scientific Missions (STSM) were conducted by NEOH members. The STSM aimed to support individual mobility and to strengthen the existing networks and foster collaborations. They allowed researchers to visit an institution in another participating COST country or an approved Near Neighbouring Country, International Partner Country institution, or one of eight European scientific research (RTD) Organisations.

The network provided a platform for continued dialogue, engagement, and networking from which spinoff activities such as new research collaborations emerged. These activities continue in the   NEOH as part of the European Chapter of Ecohealth International, a member-based grouping of One Health practitioners. One of the key activities going on in NEOH is the development of an entry-level textbook for One Health, spanning nine core competences.

Partners      

We thank the EU-COST (European Cooperation in Science and Technology) for funding this project.

Publications     

Title

Publication

Year

Process evaluation of integrated West Nile virus surveillance in northern Italy: an example of a One Health approach in public health policy

Evaluation and Program Planning

2021

System thinking and citizen participation is still missing in One Health initiatives- Lessons from fifteen evaluations

Frontiers in Public Health

2021

A survey on One Health Perception and Experiences in Europe and Neighbouring Areas

Frontiers in Public Health; Public Health Policy

2021

One Health continues to evolve for better health of people, animals and ecosystems

Conexus 3

2020

Helping to heal nature and ourselves through human-rights-based and gender-responsive One Health

One Health Outlook

2020

Editorial: Concepts and Experiences in Framing, Integration and Evaluation of One Health and EcoHealth

Frontiers in Veterinary Science

2019

Planning a One Health Case Study to Evaluate Methicillin Resistant Staphylococcus aureus and Its Economic Burden in Portugal

Frontiers in Microbiology

2018

European dog owner perceptions of obesity and factors associated with human and canine obesity

Scientific Reports

2018

A One Health Evaluation of the University of Copenhagen Research Centre for Control of Antibiotic Resistance

Frontiers in Veterinary Science

2018

Application of the NEOH Framework for Self-Evaluation of One Health Elements of a Case-Study on Obesity in European Dogs and Dog-Owners

Frontiers in Veterinary Science

2018

Brucellosis Control in Malta and Serbia: A One Health Evaluation

Frontiers in Veterinary Science

2018

Quantitative Outcomes of a One Health approach to study Global Health Challenges

EcoHealth

2018

One Health-ness Evaluation of Cysticercosis Surveillance Design in Portugal

Frontiers in Public Health

2018

Control of Cattle Ticks and Tick-Borne Diseases by Acaricide in Southern Province of Zambia: A Retrospective Evaluation of Animal Health Measures According to Current One Health Concepts

Frontiers in Public Health

2018

A One Health evaluation of the Southern African Centre for Infectious Disease Surveillance

Frontiers in Veterinary Science

2018

A Systems Approach to Evaluate One Health Initiatives

Frontiers in Veterinary Science

2018

Knowledge integration in One Health policy formulation, implementation and evaluation

WHO Bulletin

2018

Positioning Animal Welfare in the One Health Concept through Evaluation of an Animal Welfare Center in Skopje, Macedonia

Frontiers in Veterinary Science

2018

The need for European OneHealth/EcoHealth networks

Archives of Public Health

2017

The Degree of One Health Implementation in the West Nile Virus Integrated Surveillance in Northern Italy, 2016

Frontiers in Public Health

2017

A blueprint to evaluate One Health

Frontiers in Public Health

2017

Roadmap to a One Health agenda 2030

CAB Reviews

2017

Expectations for a new WHO Director General: health in a rapidly changing environment 

The Lancet Planetary Health

2017

Experiences of international networks for collaborative education and research using the One Health approach

Italian Journal of Tropical Medicine and Global Health

2016

Occurrence of Borrelia burgdorferi Sensu Lato in Ixodes ricinus Ticks with First Identification of Borrelia miyamotoi in Vojvodina, Serbia

Vector-borne and zoonotic diseases

2016

Policy evaluation: a One Health approach

The European Journal of Public Health

2015

The Network for Evaluation of One Health: evidence-based added value of One Health. Letter to the Editor

Infection Ecology and Epidemiology

2015

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