The integration of human, animal, and environmental health in the One Health framework is crucial for tackling complex health and environmental issues. Governance structures in One Health initiatives are essential for coordinating efforts, fostering partnerships, and establishing effective policy frameworks. This systematic review, registered with PROSPERO, aims to evaluate governance architectures in One Health initiatives. Searches in PubMed, Scopus, WoS, and Cochrane from 2000 to 2023 were conducted. Key terms focused on peer-reviewed articles, systematic reviews, and relevant grey literature. Nine eligible studies were selected based on inclusion criteria. Data synthesis aimed to assess governance mechanisms' functionality and effectiveness. Among 1277 sources screened, nine studies across diverse regions were eligible. An adapted framework assessed implementation mechanisms of international agreements, categorizing them into Engagement, Coordination, Policies, and Financial domains. The findings highlight the importance of effective governance, stakeholder engagement, and collaborative approaches in addressing One Health's challenges. Identified challenges include deficient intersectoral collaboration, funding constraints, and stakeholder conflicts. Robust governance frameworks are pivotal in One Health paradigms, emphasizing stakeholder engagement and collaboration. These insights guide policymakers, practitioners, and researchers in refining governance structures to enhance human-animal health and environmental sustainability. Acknowledging study limitations, such as methodological variations and limited geographical scope, underscores the importance of further research in this area.
© The Author(s) 2024. Published by Oxford University Press on behalf of the European Public Health Association.