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Government policy interventions to reduce human antimicrobial use: A systematic review and evidence map

Van Katwyk, S. R.; Grimshaw, J. M.; et al (2019) C2

BACKGROUND: Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidenc...e map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans. METHODS AND FINDINGS: Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review. CONCLUSIONS: To our knowledge this is the first study to provide policy makers with synthesized evidence on specific government policy interventions addressing AMR. In the future, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published. more

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South Africa National mental health policy framework and strategic plan 2013-2020

Dept. of Health, Republic of South Africa (2013) C1

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Drug Policy and the Sustainable Development Goals

Health Poverty Action, International Drug Policy Consortium (2015) C2

The Sustainable Development Goals (SDGs) were launched in September 2015, made up of 17 Goals and 169 Targets that set out a plan of action that will shape the mainstream development agenda for the next 15 years1. There has already been much debate about how these Goals will be achieved, but the sig... more

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WHO recommends countries move away from the use of western blotting and line immunoassays in HIV testing strategies and algorithms. Policy brief

World Health Organization WHO (2019) C_WHO

WHO recommends replacing western blotting and line immunoassays with simpler tests in HIV testing services. These simpler tests include rapid diagnostic tests (RDTs) that can be used at the point-of-care, and enzyme immunoassays (EIAs). These tests get results to the client faster, produce accura... more

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Sexual and Reproductive Health of HIV-Positive Women in Asia: A Policy Framework for the Future

Treat Asia (Therapeutics Research, Education, AIDS Training); AmfAR (2014) C2

Policy Brief November 2014

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Myanmar Policy for Early Childhood Care and Development

The Republic of the Union of Myanmar (2014) C1

Vision Statement
From birth to 8 years of age, all children of the Republic of the Union of Myanmar will receive holistic, high-quality and developmentally-appropriate care from their parents, caregivers and service providers to ensure they will be happy, healthy, well nourished, socially adept... more

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Policy and Guidelines for Infection Prevention and Control in Health Care Facilities

Ministry of Health, Ghana (2009) C1

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Policy Statement on HIV Testing and Counselling for Refugees and other persons of concern to UNHCR

UNHCR The UN Refugee Agency; World Health Organization; UNAIDS (2014) C2

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WHO policy guidance on integrated antimicrobial stewardship activities

World Health Organization WHO (2021) CC

Member States have requested WHO policy guidance on how to facilitate the implementation of national AMS activities in an integrated and programmatic approach. This policy guidance responds to that demand from Member States and is anchored in public health guiding principles in the human health sect... more

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Development of the first edition of African treatment guidelines for common bacterial infections and syndromes

Craig, J.; I. Frost; A. Sriram; et al. (2022) C1

ournal of Public Health in Africa 2021; volume 12:2009

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HIV and AIDS Policy for the Transport Sector in Zambia

Ministry of Communications and Transport, Lusaka, Zambia (2010) C1

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Nigeria: National Policy And Strategic Plan of Action On Non-Communicable Diseases (NCDs)

Federal Ministry of Health, Nigeria (2013) C1

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Are ending AIDS 2030 and UHC policy objectives jointly attainable in SADC? A fisical perspective

T. Lievens; A. Murray-Zmijewski; P. Booth HIV Economics Reference Group (2015) C2

Oxford Policy Management (OPM) - APW with UNAIDS (thru TSF)

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Rwanda: FAMILY PLANNING POLICY

Government of Rwanda: Ministry of Health, Maternal and Child Health (2012) C2

This policy will serve as a cornerstone from which to address the accessibility of Family Planning services and to encourage its integration with services for HIV/AIDS, maternal health, child health, and other development initiatives. This policy is timely, as Rwanda is embarking on the introduction... more

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WHO Policy Brief on the health aspects of decriminalization of suicide and suicide attempts

World Health Organisation (WHO) (2023) C_WHO

Reducing the global suicide mortality rate by a third by 2030 is a target of both the UN Sustainable Development Goals and the WHO Global Mental Health Action Plan. However, an impediment to meeting this goal is the fact that suicide and suicide attempts remain illegal in at least 23 countries world... more

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Infrastructure, policy and regulatory interventions to increase physical activity to prevent cardiovascular diseases and diabetes: a systematic review

Durão, S.; Burns, J.; Schmidt, B. et al. BMC Public Health (2023) CC

Background Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a...t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity. Methods We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction. Results We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence). Conclusions Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings. more

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Substance Abuse Policy in Thailand: Current Challenges and Future Strategies

Darika Saingam Ashdin Publishing Journal of Drig and Alcohol Research (2018) C2

Review Article

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National Policy and Strategic Plan of Action on Prevention and Control of Non-Communicable Diseases (NCDs) Nigeria

Federal Ministry of Health Nigeria (2013) CC

As part of our commitment to the fight against NCDs, Nigeria was signatory to the political declaration at the UN General Assembly High Level Meeting on NCDs in September 2011. Thus, the purpose of this document is to develop and ensure the implementation of policies and p... more

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Legal and policy trends impacting people living with HIV and key populations in Asia and the Pacific 2014–2019

UNAIDS (2021) CC

The report highlights key trends and developments in laws affecting people living with HIV and key populations in Asia and the Pacific over the five-year period 2014–2019. It updates the legal and policy review conducted in 2016 for UNAIDS, UNDP and the United Nations Economic and Social Commissio... more

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Adjusting health financing for people fleeing conflict: policy guidance for countries in Europe

World Health Organization WHO, Regional Office of Europe (2022) C_WHO

This policy paper outlines key health financing policy actions for countries to ensure universal access to health services and financial protection for people fleeing conflict. It focuses on three policy areas – granting entitlement and ensure access to the full range of needed health services for... more