Planning an IR project using a One Health approach
The importance of flexibility
IR studies employing a One Health approach (or investigating a One Health intervention) need to use study methods that are flexible enough to adapt to changes in both what is being implemented and what is being researched. This flexibility is necessary because systems and health challenges are continuously evolving. Research designs often need to be able to observe and analyse these sometimes iterative and changing elements at several points in time and to consider unintended consequences.19
To illustrate the steps involved in planning a One Health IR study, Table 2 uses an IR conceptual framework detailing a worked example of a hypothetical AMR One Health project.
Defining the research question
The TDR Strategy 2024–2029 includes the application of a “multisector or One Health lens” as one of its criteria for identifying research priorities, recognizing the role that One Health has in clarifying/articulating/elucidating the complex causes of the infectious diseases of poverty.4
When considering a One Health intervention that is not demonstrating its expected impacts, it is important that the research question(s) is broad enough to include the intervention’s human, animal and environmental domains. Equally, interventions addressing complex health issues such as VBDs or AMR should consider that animal and environmental influences may be impacting effectiveness and expected outcomes.
IR questions are often based on intended intervention outcomes. When studying One Health projects or interventions, it is important that outcome-related questions cover all three domains. For example, Table 3 lists sample IR questions for a hypothetical One Health initiative to reduce rabies through a coordinated approach across sectors.
Researchers applying a One Health lens to a human health intervention should exercise caution in exclusively using an outcomes-focus to define research questions. The added value that a One Health lens brings is in identifying broader influences and structural determinants of health that might otherwise be missed, as previously outlined in Table 1.
Selecting appropriate methods for One Health IR
Multidimensional research on complex systems relies on the use of multiple methods and different sources of information to understand an implementation problem. Before considering which methods are most appropriate to use in the context of One Health, researchers should review the toolkit module on research methods.
When using a One Health approach, IR methods should be sufficiently flexible to allow for changes in the intervention as well as evolving systems and health problems. They should also be able to capture the complex interactions between the human, animal and environmental domains. The worked example in Figure 3 suggests methods for an IR study on a hypothetical One Health AMR project.
The methods discussed below are not an exhaustive list. However, they indicate the types of methodologies that can help address the complexity, diversity and evolving nature of One Health.
Mixed methods
Mixed methods research combines qualitative and quantitative data collection and analysis, enabling researchers to understand multiple perspectives and investigate multiple types of outcomes. This makes it a useful approach for IR studies considering influences and impacts across the human–animal– environmental interface.19
Systems analysis
Systems analysis investigates how different parts of a system interact and how changes affect the system over time. These methods help identify and manage ‘mechanisms’ in a system – both expected (those targeted by an intervention) and unexpected (those that the study detects) – and guide adaptations to address contextual influences such as individual motivations, norms, policies and resources.22 This approach is valuable in multifaceted fields like One Health, where human, animal and environmental health are considered holistically.
Participatory action research
Peters et al (2013) state that “a distinguishing feature [of participatory action research] is that the power and control over the process rests with the participants themselves”.19 Given One Health’s emphasis on engaging multidisciplinary stakeholders and actively including community members, this participatory approach can help ensure interventions are relevant and acceptable.
Cost-benefit analysis
Demonstrating the cost effectiveness of an intervention is a useful tool for those advocating for increased investment in One Health initiatives.3 Conducting a cost-benefit analysis in the context of One Health needs to be broad enough to consider how an integrated approach can provide short- and long-term cost- savings across multiple sectors.23,24
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