Evaluation of the implementation of the One Health approach in Guinea: Application of the NEOH framework to decentralized One Health platforms.

Zoonotic diseases pose a major threat to human, animal, and environmental health, particularly in sub-Saharan Africa, where intersectoral coordination mechanisms remain limited. The One Health (OH) approach offers an integrated framework to strengthen surveillance, preparedness, and prevention of these threats. In Guinea, eight regionals OH platforms have been established; however, their performance has not been systematically evaluated. This study aimed to assess the systemic performance of these platforms and identify their strengths and weaknesses using the six dimensions of the Network for Evaluation of One Health (NEOH) framework. A cross-sectional descriptive study was conducted across eight regions (n = 20 participants per region). The standardized NEOH questionnaire (0-1 scale) was completed individually. Dimension scores were aggregated using medians and interquartile ranges (IQR). The One Health Index (OHI) and the One Health Ratio (OHR) were calculated to assess overall integration and internal balance between operational and support components, respectively. Marked regional heterogeneity was observed. N'zérékoré demonstrated the most balanced profile and the highest OHI value (0.33 [0.43]). In contrast, Boké, Kindia, and Mamou exhibited low scores in Sharing, Learning, and Systemic Organisation. Significant imbalances in OHR were observed in several regions, indicating misalignment between operational activities and structural support mechanisms. Decentralized One Health platforms in Guinea display uneven levels of maturity. Strengthening information sharing, collective learning, and intersectoral governance mechanisms is essential to enhance systemic coherence and improve preparedness and response to priority zoonotic diseases.