Laing Gabrielle, Aragrande Maurizio, Canali Massimo, Savic Sara, De Meneghi Daniele
Department of Epidemiology and Population Health, University of Liverpool, Liverpool, United Kingdom.
Department of Agricultural and Food Sciences, University of Bologna, Bologna, Italy.
Front Public Health. 2018 Mar 27;6:45. doi: 10.3389/fpubh.2018.00045. eCollection 2018.
One health thinking for health interventions is increasingly being used to capture previously unseen stakeholders and impacts across people, animals, and the environment. The Network for One Health Evaluation (NEOH) proposes a systems-based framework to quantitatively assess integration and highlight the added value (theory of change) that this approach will bring to a project. This case study will retrospectively evaluate the pioneering use of a One Health (OH) approach during an international collaboration (satellite project to tackle production losses due to tick-borne disease in cattle in Southern Zambia in late 1980s). The objective of the evaluation is twofold: retrospective evaluation the OH-ness of the satellite project and identification of costs and benefits. Data for evaluation was recovered from publications, project documents, and witness interviews. A mixed qualitative and quantitative evaluation was undertaken. In this case study, a transdisciplinary approach allowed for the identification of a serious public health risk arising from the unexpected reuse of chemical containers by the local public against advice. Should this pioneering project not have been completed then it is assumed this behavior could have had a large impact on public wellbeing and ultimately reduced regional productivity and compromised welfare. From the economic evaluation, the costs of implementing this OH approach, helping to avoid harm, were small in comparison to overall project costs. The overall OH Index was 0.34. The satellite project demonstrated good OH operations by managing to incorporate the input across multiple dimensions but was slightly weaker on OH infrastructures (OH Ratio = 1.20). These quantitative results can be used in the initial validation and benchmarking of this novel framework. Limitations of the evaluation were mainly a lack of data due to the length of time since project completion and a lack of formal monitoring of program impact. In future health strategy development and execution, routine monitoring and evaluation from an OH perspective (by utilizing the framework proposed by NEOH), could prove valuable or used as a tool for retrospective evaluation of existing policies.
健康干预中的“同一健康”思维正越来越多地被用于涵盖以前未被关注的利益相关者以及对人类、动物和环境的影响。“同一健康”评估网络(NEOH)提出了一个基于系统的框架,以定量评估整合情况,并突出这种方法将为项目带来的附加值(变革理论)。本案例研究将回顾性评估在一次国际合作(20世纪80年代末在赞比亚南部开展的一个卫星项目,旨在应对蜱传疾病导致的牛生产损失)中“同一健康”(OH)方法的开创性应用。评估目标有两个:回顾性评估卫星项目的“同一健康”程度以及确定成本和效益。评估数据从出版物、项目文件和证人访谈中获取。进行了定性与定量相结合的评估。在本案例研究中,跨学科方法使得能够识别出当地公众违背建议意外重复使用化学容器所带来的严重公共卫生风险。如果这个开创性项目没有完成,那么可以推测这种行为可能会对公众福祉产生重大影响,并最终降低区域生产力和损害福利。从经济评估来看,与项目总成本相比,实施这种“同一健康”方法以避免危害的成本较小。总体“同一健康”指数为0.34。卫星项目通过成功整合多个维度的投入展示了良好的“同一健康”运作,但在“同一健康”基础设施方面稍显薄弱(“同一健康”比率 = 1.20)。这些定量结果可用于对这一新框架的初步验证和基准测试。评估的局限性主要在于项目完成时间较长导致数据缺乏,以及对项目影响缺乏正式监测。在未来的健康战略制定和实施中,从“同一健康”角度进行常规监测和评估(利用NEOH提出的框架)可能会被证明是有价值的,或者用作回顾性评估现有政策的工具。