Background: One Health has become a global consensus to deal with complex health problems. However, the development process of One Health practice in various countries is still relatively slow, and there is a lack of systematic evaluation index. The purpose of this study was to establish an indicator framework for global One Health Intrinsic Drivers index (GOH-IDI) to evaluate human, animal and environmental health development process globally.
Method: First, 82 studies were deeply analyzed by a grounded theory (GT) method, including open coding, axial coding, and selective coding, to establish a three-level indicator framework, which was composed of three first-level indicators, 19 second-level indicators, and 79 third-level indicators. Then, through semi-structured interviews with 28 health-related experts, the indicators were further integrated and simplified according to the inclusion criteria of the indicators. Finally, a fuzzy analytical hierarchy process (FAHP) was used to assign weights to the indicators, thus, forming the evaluation indicator framework of human, animal and environmental health development process.
Results: An indicator framework for GOH-IDI was formed consisting of three first-level indicators, 15 second-level indicators and 61 third-level indicators. There were six second-level indicators for “Human Health”, of which “Reproductive, Maternal, New-born, and Child Health” had the highest weight (20.63%) and “Health Risk” had the lowest weight (13.01%). There were four second-level indicators for “Animal Health”, of which “Animal Epidemic Disease” had the highest weight (31.87%) and “Animal Nutritional Status” had the lowest weight (17.36%). Five second-level indicators were set under “Environmental Health”, among which, “Air Quality and Climate Change” had the highest weight (23.82%) and “Hazardous Chemicals” had the lowest weight (17.52%).
Conclusions: An indicator framework for GOH-IDI was established in this study. The indicators were universal, balanced, and scientific, and established a tool for scientifically measuring the development level of human, animal and environmental health in different regions globally.