Animal and Human Health Program, International Livestock Research Institute, Nairobi, Kenya.
Center for Public Health and Ecosystem Research, Hanoi University of Public Health and Vietnam Public Health Association, Hanoi, Vietnam.
Front Public Health. 2021 Feb 5;9:592311. doi: 10.3389/fpubh.2021.592311. eCollection 2021.
Sustainably intensifying agriculture to secure food for people, while minimizing the human, animal, and environmental health impacts is an unprecedented global food security challenge. Action research is needed to understand and mitigate impacts, with Ecosystem approaches to health (Ecohealth) emerging as a promising framework to support such efforts. Yet, few have critically examined the application of Ecohealth principles in an agricultural context, particularly in Southeast Asia where agricultural intensification is rapidly expanding. In this paper, we evaluate the strengths, challenges, and opportunities of agriculture-related Ecohealth projects in low-resource settings of Vietnam, Thailand, Indonesia, and China, drawing on a case study of the Field Building Leadership Initiative (FBLI). To do this, we used a developmental evaluation framework involving several iterative cycles of document reviews, interviews, focus groups, and outcome harvesting with researchers, partners, and community members involved in FBLI. Results highlight the importance of transdisciplinarity, participation, and knowledge-to-action principles in co-generating knowledge and co-developing practical solutions. Implementing such principles presents challenges in terms of coordinating regional collaborations, managing high workloads, meaningfully engaging communities, and ensuring ongoing monitoring and evaluation. To address these challenges, there is a need to strengthen capacity in integrated approaches to health, improve institutionalization of Ecohealth, foster community engagement, and systematically monitor and evaluate efforts. Ecohealth holds significant promise in improving food security, but only when considerable time is spent developing and implementing projects with communities.
可持续地加强农业生产以保障人类粮食安全，同时将对人类、动物和环境健康的影响降至最低，这是一项前所未有的全球粮食安全挑战。需要开展行动研究来了解和减轻这些影响，健康的生态系统方法（Ecohealth）作为支持此类努力的一个有前途的框架正在出现。然而，很少有人批判性地审视生态健康原则在农业背景下的应用，特别是在农业集约化迅速扩张的东南亚。在本文中，我们评估了越南、泰国、印度尼西亚和中国资源有限环境下与农业相关的生态健康项目的优势、挑战和机遇，借鉴了实地建设领导力倡议（FBLI）的案例研究。为此，我们使用了发展评估框架，涉及对参与 FBLI 的研究人员、合作伙伴和社区成员的文件审查、访谈、焦点小组和成果收集的几个迭代周期。结果强调了跨学科性、参与性和知识行动原则在共同产生知识和共同制定实际解决方案方面的重要性。实施这些原则在协调区域合作、管理高工作量、有意义地让社区参与以及确保持续监测和评估方面存在挑战。为了解决这些挑战，需要加强健康综合方法方面的能力，促进生态健康的制度化，促进社区参与，并系统地监测和评估各项努力。生态健康在改善粮食安全方面具有重要意义，但只有在与社区一起花费相当多的时间来开发和实施项目时才会如此。
