School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
One Health Center, Shanghai Jiao Tong University-The University of Edinburgh, Shanghai, People's Republic of China.
Infect Dis Poverty. 2022 May 22;11(1):57. doi: 10.1186/s40249-022-00979-9.
A One Health approach has been increasingly mainstreamed by the international community, as it provides for holistic thinking in recognizing the close links and inter-dependence of the health of humans, animals and the environment. However, the dearth of real-world evidence has hampered application of a One Health approach in shaping policies and practice. This study proposes the development of a potential evaluation tool for One Health performance, in order to contribute to the scientific measurement of One Health approach and the identification of gaps where One Health capacity building is most urgently needed.
We describe five steps towards a global One Health index (GOHI), including (i) framework formulation; (ii) indicator selection; (iii) database building; (iv) weight determination; and (v) GOHI scores calculation. A cell-like framework for GOHI is proposed, which comprises an external drivers index (EDI), an intrinsic drivers index (IDI) and a core drivers index (CDI). We construct the indicator scheme for GOHI based on this framework after multiple rounds of panel discussions with our expert advisory committee. A fuzzy analytical hierarchy process is adopted to determine the weights for each of the indicators.
The weighted indicator scheme of GOHI comprises three first-level indicators, 13 second-level indicators, and 57 third-level indicators. According to the pilot analysis based on the data from more than 200 countries/territories the GOHI scores overall are far from ideal (the highest score of 65.0 out of a maximum score of 100), and we found considerable variations among different countries/territories (31.8-65.0). The results from the pilot analysis are consistent with the results from a literature review, which suggests that a GOHI as a potential tool for the assessment of One Health performance might be feasible.
GOHI-subject to rigorous validation-would represent the world's first evaluation tool that constructs the conceptual framework from a holistic perspective of One Health. Future application of GOHI might promote a common understanding of a strong One Health approach and provide reference for promoting effective measures to strengthen One Health capacity building. With further adaptations under various scenarios, GOHI, along with its technical protocols and databases, will be updated regularly to address current technical limitations, and capture new knowledge.
一种综合健康的方法已逐渐成为国际社会的主流，因为它为全面认识人类、动物和环境健康之间的紧密联系和相互依存关系提供了思路。然而，由于缺乏实际证据，综合健康方法在制定政策和实践方面的应用受到了阻碍。本研究提出了开发一种综合健康绩效评估工具的建议，以有助于综合健康方法的科学衡量，并确定最迫切需要综合健康能力建设的领域。
我们描述了制定全球综合健康指数（GOHI）的五个步骤，包括：（i）框架制定；（ii）指标选择；（iii）数据库构建；（iv）权重确定；以及（v）GOHI 得分计算。我们提出了一个细胞状的 GOHI 框架，包括外部驱动因素指数（EDI）、内在驱动因素指数（IDI）和核心驱动因素指数（CDI）。我们在与专家咨询委员会进行多轮小组讨论后，根据该框架构建了 GOHI 的指标方案。采用模糊层次分析法确定每个指标的权重。
GOHI 的加权指标方案包括三个一级指标、13 个二级指标和 57 个三级指标。根据基于 200 多个国家/地区数据的试点分析，GOHI 得分总体远不理想（最高得分为 100 分中的 65.0 分），并且我们发现不同国家/地区之间存在较大差异（31.8-65.0）。试点分析结果与文献综述结果一致，这表明 GOHI 作为评估综合健康绩效的潜在工具可能是可行的。
GOHI（在经过严格验证后）将代表世界上第一个从综合健康的整体视角构建概念框架的评估工具。GOHI 的未来应用可能会促进对强大综合健康方法的共同理解，并为加强综合健康能力建设提供参考。随着在各种情况下的进一步调整，GOHI 将与其技术协议和数据库一起定期更新，以解决当前的技术限制，并捕捉新的知识。
