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. 2025 Nov 13;14(1):116.
doi: 10.1186/s40249-025-01380-y.

Adaptation of global One Health evaluation framework to municipal levels in Fukuoka, Japan

Fumihiko Yokota #  1 , Yi-Sheng Ning #  2   3 , Shu-Ning Chen  4 , Hisako Nomura  2 , Shunsuke Managi  4 , Jing-Shu Liu  5 , Xiao-Xi Zhang  5 , Xiao-Nong Zhou  5 , Shuji Shimizu  6
Affiliations

Adaptation of global One Health evaluation framework to municipal levels in Fukuoka, Japan

Fumihiko Yokota et al. Infect Dis Poverty. .

Abstract

Background: The One Health approach recognizes the interconnectedness of human, animal, and environmental health to address global health threats. While the global One Health Index (GOHI) has been applied nationally, its adaptation to sub-national contexts remains unexplored. This study aimed to adapt GOHI to construct localized indicators for Fukuoka, Japan, and assess One Health implementation across municipalities.

Methods: The research followed a three-phase approach: (1) Indicator Selection, where 34 indicators were selected from GOHI and Fukuoka One Health Promotion Action Plan through expert consultation; (2) Data Collection and Score Standardization using robust scaling methods; and (3) Weight Determination using Fuzzy Analytic Hierarchy Process. Fukuoka One Health Index (FOHI) scores were computed and analyzed using descriptive statistics and Latent Class Analysis (LCA).

Results: The mean FOHI score was 52.27 (range: 41.01-63.71), with the lowest average score in Core Drivers Index (47.11) compared to Internal Drivers Index (59.17) and External Drivers (50.43). Municipalities performed strongest in zoonotic disease management (72.33) but weakest in One Health governance (6.36). Miyama City achieved the highest overall score, demonstrating strong governance and integrated implementations. LCA identified two municipal classes differentiated by External Drivers Index scores with clear geographic clustering.

Conclusions: This study demonstrated the feasibility of adapting GOHI to municipal settings and revealed significant variation in One Health implementation across Fukuoka's municipalities. Performance gaps were identified, particularly in One Health governance despite strong health infrastructure. The methodology offers a blueprint for similar adaptations globally, potentially accelerating the operationalization of One Health principles in local governance contexts.

Keywords: Fukuoka Prefecture; Global One Health Index; Health systems evaluation; Japan; Municipal health assessment; One Health.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This research was approved by the ethical committees from the Institute for Asian and Oceanian Studies, Kyushu University on October 29, 2024 (Approval #R6-03). Consent for publication: Not applicable. Competing interests: Xiao-Nong Zhou is the Editor-in-Chief of the journal Infectious Diseases of Poverty. He has not involved in the peer-review or handling of the manuscript. The other authors have no other competing interests to disclose.

Figures

Fig.1
Fig.1
Flowchart of GOHI Adaptation for Construction of FOHI. GOHI Global One Health Index, FOHPAP Fukuoka One Health Promotion Action Plan, FAHP Fuzzy Analytic Hierarchy Process
Fig. 2
Fig. 2
FOHI Scores among 60 municipalities in Fukuoka by Total A, EDI B, IDI C, and CDI D categories. Created based on National Land Numerical Information (Administrative Boundary Data), Ministry of Land, Infrastructure, Transport and Tourism, Japan (https://nlftp.mlit.go.jp/ksj/gml/datalist/KsjTmplt-N03-2025.html), retrieved on November 15, 2024. FOHI Fukuoka One Health Index, EDI External Drivers Index, IDI Internal Drivers Index, CDI Core Drivers Index
Fig. 3
Fig. 3
Top-20 Municipalities in FOHI Score in Total A, EDI B, IDI C, and CDI D by Region. FOHI Fukuoka One Health Index, EDI External Drivers Index, IDI Internal Drivers Index, CDI Core Drivers Index
Fig. 4
Fig. 4
Density Plots Distribution of FOHI Components (A) and CDI Key Indicators (B). FOHI Fukuoka One Health Index, EDI External Drivers Index, IDI Internal Drivers Index, CDI Core Drivers Index
Fig. 5
Fig. 5
Comprehensive heat map of One Health performance across Fukuoka’s 60 municipalities. The B2. Animal Health and Ecosystem Diversity was omitted from the Fig. 5 since all municipalities had full score of 100
Fig. 6
Fig. 6
Latent Class Analysis based on EDI, IDI, CDI Scores across Fukuoka Municipalities. EDI External Drivers Index, IDI Internal Drivers Index, CDI Core Drivers Index
See this image and copyright information in PMC

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