One Health Evaluation: A Case Study at the University of Bologna

Abstract

The level of One Health (OH), or “One Health-ness,” of health interventions has been defined as the capacity to operate according to six dimensions concerning OH operations and OH infrastructures, respectively (thinking, planning, and working; and information sharing, reciprocal learning, and systemic organization). Although health initiatives and research increasingly claim their orientation toward OH, such a capacity is rarely assessed. The objective of this study is to evaluate the One Health-ness of the academic team of the University of Bologna (UNIBO Team) working in the “ELEPHANT” project (Empowering universities' Learning and rEsearch caPacities in the one Health Approach for the maNagement of animals at the wildlife, livestock and human interface in SouTh Africa). This project involves universities, six from South Africa and two from Europe, and aims at embedding OH in research and learning to enable the control of diseases at the human, animal, and environmental interface, and to emphasize the interests of local African communities with wildlife conservation. The methodology adopts the NEOH method, developed in 2018 by the EU-COST Action, “Network for the Evaluation of One Health.” The approach is based on questionnaires delivered to participants, which focus on the six OH dimensions, and then translate answers into quantitative metrics through the OH Index (OHI) and the OH Ratio (OHR). The following two evaluation levels are foreseen: the whole project and the single partner institutions. The evaluations are carried on in parallel, with preliminary, mid-term, and final assessments, to monitor the efficacy of the project actions. The preliminary evaluation of the UNIBO Team resulted in the OHI of 0.23 and the OHR of 1.69 which indicate a low degree of OH-ness and an imbalance between OH operation and OH infrastructure. The UNIBO case study will be the baseline for the evaluation of the other partner institutions involved in the ELEPHANT project. This type of evaluation can support the implementation of OH practices inside a project and underpin the strategies that allow to achieving more effective results. Any improvement in the OH-ness of each single academic team can be also considered as a result of the ELEPHANT project, thus showing its multiplier effect in the context.

One Health gains momentum in Africa but room exists for improvement

“…Finally, in terms of responses to the evaluation in countries, the assessment went smoothly, yet was challenged with some degree of disagreements in some countries where personnel from the NOHP and stakeholders disagreed on certain aspects of the assessment and the assigned scores, particularly in the areas of sharing thinking, working and systemic organization. Aragrande et al, [ 25 ] have similarly observed such disagreement in the selected projects evaluated at a University in Italy. The post evaluation validation meetings resolved many of these issues identified.…”

“…For instance, academic institution based One Health stakeholders seem to have strength in the areas under learning while the government-owned implementers/coordinating mechanisms (the NOHPs) have strength in systemic organization supporting One Health, it behoves these agencies to facilitate integration mechanisms that promotes cooperation and collaborations among themselves. Such suggestions for more integration and collaboration among various team members, disciplines and sectors have been advocated including allowing room for system thinking, and identification of clearly mapped out theory of change, which should ensure that despite differing goals and independent scientific domains, common aims in One Health can be pursued [ 6 , 7 , 18 , 22 , 25 ]. In our context, theory of change is “an outcomes-based approach which applies critical thinking to the design, implementation, and evaluation of One Health initiatives and programs intended to support change in their context” [ 26 ].…”

“…Previous evaluations have indicated the challenges associated with planning, thinking, sharing and learning, but also the working and systemic organization [ 7 , 18 , 22 , 25 ]. Such challenges include those related to sharing of data, information and communication, competition instead of complementarity, lack of adequate preparedness, lack of focused capacity development in One Health institutions, duplicity of roles, understaffing, over-dependence on external funding, lack of legal and monitoring/evaluation frameworks to support One Health, cross-border limitations preventing epizonal approach to addressing issues, lack of systemizing the One Health implementation, lack of subnational One Health platforms to transform policies into actions, insecurities and political instabilities, lack of co-creation, co-planning and co-implementation of projects and inadequate advocacy among others.…”

“…Furthermore, many studies have advocated that the inclusion of theory of change, monitoring, evaluation and learning frameworks, and tools for standardized evaluation of One Health policies into the overall national One Health engagement will sustain the future of One Health approach in Africa and elsewhere [ 18 , 22 , 25 ]. Future engagements should continue to respond to the need of the society and be outcomes-driven.…”

“…African One Health platforms must develop matching monitoring, evaluation and learning frameworks that is multi-layered (with consideration to socio-ecological model, multi-stakeholders and multiple perspectives) [ 30 ]. The idea of co-creation, co-designing of projects, co-planning as well as co-financing and co-implementation must be engendered within the NOHP and its stakeholders [ 22 , 25 , 29 ].…”