Omuse Evanson R, Machekano Honest, Sokame Bonoukpoè M, Mutyambai Daniel M, Dubois Thomas, Subramanian Sevgan, Chidawanyika Frank
International Centre of Insect Physiology and Ecology (ICIPE), P.O. Box 30772-00100, Nairobi, Kenya.
Department of Zoology and Entomology, University of Pretoria, Private Bag X20, Hatfield 0028, South Africa.
One Health. 2025 Jan 2;20:100959. doi: 10.1016/j.onehlt.2024.100959. eCollection 2025 Jun.
The global human population is rapidly increasing, escalating interactions of people, animals and the environment. This has led to more convoluted health challenges, for which African smallholder farmers bear the brunt. The One Health (OH) approach recognises the interconnectedness of these health challenges and thus follows a transdisciplinary approach involving diverse stakeholders to address them. Although there have recently been global concerted efforts and studies on OH, an information gap exists in Africa, particularly regarding smallholder farmers and their needs. Additionally, evaluation frameworks and outcome metrics for OH initiatives are still unclear. Thus, this study was conducted to critically map the available evidence of OH initiatives in the lens of African smallholder settings and identify gaps and opportunities for optimally targeted interventions. An extensive article searches yielded 1479 references, with only 21 studies from 11 countries qualifying for this review. Implementation of OH initiatives involved the collaboration of diverse stakeholders at local, national, regional and global levels. Most of the reported stakeholders of the OH initiatives were largely UN agencies, CGIAR centres, non-governmental organizations and universities. More than half of the studies focused on zoonotic and human-animal shared diseases. Conversely, few studies focused on human or animal food and nutrition security; land degradations; livelihoods and well-being; antimicrobial resistance, water sanitation and hygiene; food safety; soil health; crop health; biodiversity loss; climate change and gender equity. Effective capacity building, risk mitigation, social benefits, economic benefits, improved animal health and welfare, improved human health and well-being and improved ecosystem health and resilience were identified as OH outcomes. Based on the many evidence gaps, the OH initiatives must address health challenges mostly encountered by smallholder farmers with an increased focus on food security and safety, especially under the ongoing climate change. However, the successful implementation of OH initiatives was constrained by weak governance and coordination structures, poor communication and information sharing, lack of integrated surveillance system, limited community engagement, lack of political will, inadequate resources and logistical support, limited multi-disciplinarity and divergent priorities. Additionally, the lack of consensus on evaluation framework and outcomes highlights the need for an integrated standard framework for developing and implementing OH initiatives and harmonised outcome evaluation metrics to avoid under- or over-estimation of OH benefits.
全球人口正在迅速增长，人与动物及环境之间的互动也日益频繁。这导致了更为复杂的健康挑战，非洲小农户首当其冲。“同一健康”（OH）方法认识到这些健康挑战的相互关联性，因此采用跨学科方法，让不同利益相关者共同应对这些挑战。尽管最近全球在“同一健康”方面开展了协同努力和研究，但非洲存在信息差距，特别是在小农户及其需求方面。此外，“同一健康”倡议的评估框架和成果指标仍不明确。因此，本研究旨在从非洲小农户的角度批判性地梳理“同一健康”倡议的现有证据，并确定针对性强的最佳干预措施的差距和机会。广泛的文献检索共得到1479篇参考文献，只有来自11个国家的21项研究符合本综述的要求。“同一健康”倡议的实施涉及地方、国家、区域和全球各级不同利益相关者的合作。报告的“同一健康”倡议的利益相关者大多是联合国机构、国际农业研究磋商组织（CGIAR）各中心、非政府组织和大学。超过一半的研究集中在人畜共患病和人畜共患疾病上。相反，很少有研究关注人类或动物的粮食和营养安全、土地退化、生计与福祉、抗微生物药物耐药性、水环境卫生与个人卫生、食品安全、土壤健康、作物健康、生物多样性丧失、气候变化和性别平等。有效的能力建设、风险缓解、社会效益、经济效益、改善动物健康与福利、改善人类健康与福祉以及改善生态系统健康与恢复力被确定为“同一健康”的成果。基于众多的证据差距，“同一健康”倡议必须应对小农户最常遇到的健康挑战，尤其要更加关注粮食安全和食品安全，特别是在当前气候变化的背景下。然而，“同一健康”倡议的成功实施受到治理和协调结构薄弱、沟通与信息共享不畅、缺乏综合监测系统、社区参与有限、缺乏政治意愿、资源和后勤支持不足、多学科性有限以及优先事项分歧等因素的制约。此外，在评估框架和成果方面缺乏共识，凸显了制定和实施“同一健康”倡议需要一个综合标准框架以及统一的成果评估指标以避免对“同一健康”效益的低估或高估。
