This section considers IR evaluation in the context of One Health. For an introduction to measuring IR project results, researchers should review the relevant section of the toolkit.
Despite the recent increase in One Health systems and interventions, there is an apparent lack of standardized evaluation frameworks that can be used to determine the impact and sustainability of the approach.3 IR can play a much- needed role in demonstrating the comparative advantages of a One Health approach over single-sector interventions.24
When evaluating IR interventions using a One Health approach, researchers must look beyond health outcomes and consider interconnected multidimensional impacts.11 Table 2 details a range of evaluation methods to investigate the impact of a hypothetical AMR One Health project across the domains of animal, human and environmental health.
The One Health Scorecard was created using the findings of the TDR-IDRC Research Initiative on Vector-borne Diseases and Climate Change in Africa. It is a multidimensional evaluation method that builds on the fundamentals of One Health, such as systems thinking, transdisciplinarity, community-led adaptive management and risk management. This approach was piloted among the Maasai community of northern Tanzania.29
Composed of four interrelated categories (capacity, intervention science, risk management, and impact and risk), the scorecard has thirty performance indicators to evaluate the degree of local One Health operationalization.11 Figure 5 provides an example of a One Health Scorecard used to assess a VBD intervention in the context of climate change.
An important use of IR findings is to inform scale up. Too often interventions that prove successful as pilot studies, fail to meet intended impacts when rolled out nationally.30
Using a One Health approach can help researchers identify barriers to the effective scale up of complex health interventions by breaking down silos and investigating multidimensional challenges and influences.
The case study from Lao People’s Democratic Republic highlights the role of IR in scaling up One Health initiatives effectively.