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System Thinking and Citizen Participation Is Still Missing in One Health Initiatives – Lessons From Fifteen Evaluations

Tackling complex public health challenges requires integrated approaches to health, such as One Health (OH). A key element of these approaches is the integration of knowledge across sectors, disciplines and stakeholders. It is not yet clear which elements of knowledge integration need endorsement to...

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Autores principales: Hitziger, Martin, Berezowski, John, Dürr, Salome, Falzon, Laura C., Léchenne, Monique, Lushasi, Kennedy, Markosyan, Tigran, Mbilo, Céline, Momanyi, Kelvin N., Özçelik, Ranya, Prejit, Nambiar, Zinsstag, Jakob, Rüegg, Simon R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8211880/
https://www.ncbi.nlm.nih.gov/pubmed/34150701
http://dx.doi.org/10.3389/fpubh.2021.653398
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author Hitziger, Martin
Berezowski, John
Dürr, Salome
Falzon, Laura C.
Léchenne, Monique
Lushasi, Kennedy
Markosyan, Tigran
Mbilo, Céline
Momanyi, Kelvin N.
Özçelik, Ranya
Prejit, Nambiar
Zinsstag, Jakob
Rüegg, Simon R.
author_facet Hitziger, Martin
Berezowski, John
Dürr, Salome
Falzon, Laura C.
Léchenne, Monique
Lushasi, Kennedy
Markosyan, Tigran
Mbilo, Céline
Momanyi, Kelvin N.
Özçelik, Ranya
Prejit, Nambiar
Zinsstag, Jakob
Rüegg, Simon R.
author_sort Hitziger, Martin
collection PubMed
description Tackling complex public health challenges requires integrated approaches to health, such as One Health (OH). A key element of these approaches is the integration of knowledge across sectors, disciplines and stakeholders. It is not yet clear which elements of knowledge integration need endorsement to achieve best outcomes. This paper assesses 15 OH initiatives in 16 African, Asian and European countries to identify opportunities to improve knowledge integration and to investigate geographic influences on knowledge integration capacities. Two related evaluation tools, both relying on semi-quantitative questionnaires, were applied to two sets of case studies. In one tool, the questions relate to operations and infrastructure, while the other assigns questions to the three phases of “design,” “implementation,” and “evaluation” of the project life cycle. In both, the question scores are aggregated using medians. For analysis, extreme values were identified to highlight strengths and weaknesses. Seven initiatives were assessed by a single evaluator external to the initiative, and the other eight initiatives were jointly assessed by several internal and external evaluators. The knowledge integration capacity was greatest during the project implementation stage, and lowest during the evaluation stage. The main weaknesses pointing towards concrete potential for improvement were identified to be a lack of consideration of systemic characteristics, missing engagement of external stakeholders and poor bridging of knowledge, amplified by the absence of opportunities to learn and evolve in a collective process. Most users were unfamiliar with the systems approach to evaluation and found the use of the tools challenging, but they appreciated the new perspective and saw benefits in the ensuing reflections. We conclude that systems thinking and associated practises for OH require not only specific education in OH core competencies, but also methodological and institutional measures to endorse broad participation. To facilitate meta-analyses and generic improvement of integrated approaches to health we suggest including knowledge integration processes as elements to report according to the COHERE guidelines.
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spelling pubmed-82118802021-06-19 System Thinking and Citizen Participation Is Still Missing in One Health Initiatives – Lessons From Fifteen Evaluations Hitziger, Martin Berezowski, John Dürr, Salome Falzon, Laura C. Léchenne, Monique Lushasi, Kennedy Markosyan, Tigran Mbilo, Céline Momanyi, Kelvin N. Özçelik, Ranya Prejit, Nambiar Zinsstag, Jakob Rüegg, Simon R. Front Public Health Public Health Tackling complex public health challenges requires integrated approaches to health, such as One Health (OH). A key element of these approaches is the integration of knowledge across sectors, disciplines and stakeholders. It is not yet clear which elements of knowledge integration need endorsement to achieve best outcomes. This paper assesses 15 OH initiatives in 16 African, Asian and European countries to identify opportunities to improve knowledge integration and to investigate geographic influences on knowledge integration capacities. Two related evaluation tools, both relying on semi-quantitative questionnaires, were applied to two sets of case studies. In one tool, the questions relate to operations and infrastructure, while the other assigns questions to the three phases of “design,” “implementation,” and “evaluation” of the project life cycle. In both, the question scores are aggregated using medians. For analysis, extreme values were identified to highlight strengths and weaknesses. Seven initiatives were assessed by a single evaluator external to the initiative, and the other eight initiatives were jointly assessed by several internal and external evaluators. The knowledge integration capacity was greatest during the project implementation stage, and lowest during the evaluation stage. The main weaknesses pointing towards concrete potential for improvement were identified to be a lack of consideration of systemic characteristics, missing engagement of external stakeholders and poor bridging of knowledge, amplified by the absence of opportunities to learn and evolve in a collective process. Most users were unfamiliar with the systems approach to evaluation and found the use of the tools challenging, but they appreciated the new perspective and saw benefits in the ensuing reflections. We conclude that systems thinking and associated practises for OH require not only specific education in OH core competencies, but also methodological and institutional measures to endorse broad participation. To facilitate meta-analyses and generic improvement of integrated approaches to health we suggest including knowledge integration processes as elements to report according to the COHERE guidelines. Frontiers Media S.A. 2021-06-04 /pmc/articles/PMC8211880/ /pubmed/34150701 http://dx.doi.org/10.3389/fpubh.2021.653398 Text en Copyright © 2021 Hitziger, Berezowski, Dürr, Falzon, Léchenne, Lushasi, Markosyan, Mbilo, Momanyi, Özçelik, Prejit, Zinsstag and Rüegg. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Hitziger, Martin
Berezowski, John
Dürr, Salome
Falzon, Laura C.
Léchenne, Monique
Lushasi, Kennedy
Markosyan, Tigran
Mbilo, Céline
Momanyi, Kelvin N.
Özçelik, Ranya
Prejit, Nambiar
Zinsstag, Jakob
Rüegg, Simon R.
System Thinking and Citizen Participation Is Still Missing in One Health Initiatives – Lessons From Fifteen Evaluations
title System Thinking and Citizen Participation Is Still Missing in One Health Initiatives – Lessons From Fifteen Evaluations
title_full System Thinking and Citizen Participation Is Still Missing in One Health Initiatives – Lessons From Fifteen Evaluations
title_fullStr System Thinking and Citizen Participation Is Still Missing in One Health Initiatives – Lessons From Fifteen Evaluations
title_full_unstemmed System Thinking and Citizen Participation Is Still Missing in One Health Initiatives – Lessons From Fifteen Evaluations
title_short System Thinking and Citizen Participation Is Still Missing in One Health Initiatives – Lessons From Fifteen Evaluations
title_sort system thinking and citizen participation is still missing in one health initiatives – lessons from fifteen evaluations
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8211880/
https://www.ncbi.nlm.nih.gov/pubmed/34150701
http://dx.doi.org/10.3389/fpubh.2021.653398
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