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Evaluating the Integration of One Health in Surveillance Systems for Antimicrobial Use and Resistance: A Conceptual Framework

Aenishaenslin, Cécile; Häsler, Barbara; Ravel, André; Parmley, E. Jane; Mediouni, Sarah; Bennani, Houda; Stärk, Katharina D. C.; Buckeridge, David L.


Cécile Aenishaenslin

Barbara Häsler

André Ravel

E. Jane Parmley

Sarah Mediouni

Houda Bennani

Katharina D. C. Stärk

David L. Buckeridge


It is now widely acknowledged that surveillance of antimicrobial resistance (AMR) must adopt a "One Health" (OH) approach to successfully address the significant threats this global public health issue poses to humans, animals, and the environment. While many protocols exist for the evaluation of surveillance, the specific aspect of the integration of a OH approach into surveillance systems for AMR and antimicrobial Use (AMU), suffers from a lack of common and accepted guidelines and metrics for its monitoring and evaluation functions. This article presents a conceptual framework to evaluate the integration of OH in surveillance systems for AMR and AMU, named the Integrated Surveillance System Evaluation framework (ISSE framework). The ISSE framework aims to assist stakeholders and researchers who design an overall evaluation plan to select the relevant evaluation questions and tools. The framework was developed in partnership with the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS). It consists of five evaluation components, which consider the capacity of the system to: [1] integrate a OH approach, [2] produce OH information and expertise, [3] generate actionable knowledge, [4] influence decision-making, and [5] positively impact outcomes. For each component, a set of evaluation questions is defined, and links to other available evaluation tools are shown. The ISSE framework helps evaluators to systematically assess the different OH aspects of a surveillance system, to gain comprehensive information on the performance and value of these integrated efforts, and to use the evaluation results to refine and improve the surveillance of AMR and AMU globally.


Aenishaenslin, C., Häsler, B., Ravel, A., Parmley, E. J., Mediouni, S., Bennani, H., …Buckeridge, D. L. (2021). Evaluating the Integration of One Health in Surveillance Systems for Antimicrobial Use and Resistance: A Conceptual Framework. Frontiers in Veterinary Science, 8, -.

Journal Article Type Article
Acceptance Date Feb 8, 2021
Online Publication Date Mar 24, 2021
Publication Date Mar 1, 2021
Deposit Date Mar 24, 2021
Publicly Available Date Mar 25, 2021
Journal Frontiers in Veterinary Science
Publisher Frontiers Media
Peer Reviewed Peer Reviewed
Volume 8
Pages -
Keywords One Health; surveillance; evaluation; framework; methodology; antimicrobial resistance; integrated surveillance
Public URL