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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 evidence 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 Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.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

Education, Social Restrictions, and Justice in Taliban-Held Afghanistan

Human Rights Watch (2021) CC

On February 29, 2020, the United States and the Taliban signed an agreement outlining a phased withdrawal of US forces from Afghanistan in exchange for Taliban commitments not to allow attacks on the US or its allies from Afghan territory. The troop ... more

“Complicit in Exclusion” South Africa’s Failure to Guarantee an Inclusive Education for Children with Disabilities

Human Rights Watch (2015) C2

This report from Human Rights Watch found that South Africa has failed to guarantee the right to education for many of the country’s children and ... more

On the Margins. Education for Children with Disabilities in Kazakhstan

Human Rights Watch (2019) C1

The government of Kazakhstan has committed to ensuring that children with disabilities have access to inclusive education and it has taken the important step of ratifying international human rights ... more

“They Stay until They Die” A Lifetime of Isolation and Neglect in Institutions for People with Disabilities in Brazil

Human Rights Watch (2018) C1

This report found that many people with disabilities enter institutions as children and remain there for their entire lives. Most of these institutions visited by Human Rights Watch researchers did ... more

A Roadmap for Ending Exploitation, Abuse of Talibés in Senegal

Human Rights Watch (2020) C2

For over a decade, Senegalese and international journalists, human rights advocates, and child protection experts have documented and denounced the ongoing exploitation, abuse and neglect of childre ... more

Report on the right to freedom of opinion and expression in South Sudan since the July 2016 crisis

UN Office of the High Commissioner for Human Rights, UN Mission in South Sudan (2018)

This report is jointly released by the Human Rights Division (HRD) of the United Nations Mission in South Sudan (UNMISS) and the Office of the United Nations High Commissioner for Human Rights (OH ... more

“I Would Like To Go To School”. Barriers to Education for Children with Disabilities in Lebanon

Human Rights Watch (2018)

This report finds that although Lebanese law bars schools from discriminating against children with disabilities, public and private schools exclude many children with disabilities. For those allowed to enroll, schools often lack reasonable accommodations, such ... more

Textbooks for Sustainable Development - A guide to embedding

United Nations Educational, Scientific and Cultural Organization Mahatma Gandhi Institute of Education for Peace and Sustainable Development (UNESCO MGIEP) (2017)

This valuable and timely guidebook represents an innovative contribution to enhancing quality education through textbooks. It will change the way textbook authors, publishers and educators, ... more

National guidance and district-level practices in the supervision of community health workers in South Africa: a qualitative study

Assegaai, T. and H. Schneider Human Resources for Health (2019) C1

Supportive supervision is considered critical to community health worker programme performance, but there is relatively little understanding of how it can be sustainably done at scale. Supportive supervision is a holistic concept that encompasses th ... more

Internationalizing Medical Education: The Special Track Curriculum 'GlobalHealth' at Justus Liebig University Giessen

Knipper, M.; A. Baumann, C. Hofstetter, et al. (2015) CC

GMS Zeitschrift für MedizinischeAusbildung 2015, Vol. 32(5),ISSN 1860-3572 Internationalizing higher education is considered to be a major goal for universities in Germany and many medical stude ... more

Safeguarding human health in the Anthropocene epoch: report of The Rockefeller Foundation–Lancet Commission on planetary health | Sustainable Development Goals - Resource Centre

Whitmee S., Haines A. et al. (2015) C2

By almost any measure, human health is better now than at any time in history. Life expectancy has soared from 47 years in 1950–1955, to 69 years in 2005–2010, and death rates in children younger than 5 years of age have decreased substantially, ... more

Education for Students with Intellectual Disabilities in Kenya: Challenges and Prospects

M.J. Chomba, S.G. Mukuria, P.W. Kariuki, S. Tumuti, B.A. Bunyasi Disability Studies Quarterly (2015) C2

Kenya has great potential for enhancing education for individuals with intellectual disabilities. The fact that it has recognized the need to care for learners with special needs is commendable. In comparison to many African countries, Kenya and Nig ... more

Network HPN Paper: The role of education in protecting children in conflict

Susan Nicolai and Carl Triplehorn Humanitarian Practice Network (HPN); Overseas Development Institute (ODI) (2003) C1

Education in emergencies is a young area; the evidence of its impact is often anecdotal, and although its status as ... more

Promoting the Right to work of Persons with disabilities - Toolkit for the Private Sector

SAHRC (2015) C1

The Toolkit is a resource that may be used by businesses of all sizes in the different sectors. The guidelines provided in the Toolkit are intentionally general so they can easily be adapted by employers to their specific business culture, working e ... more

A Roadmap to combat postpartum haemorrhage between 2023 and 2030

World Health Organization WHO (2023) C_WHO

WHO today released its first roadmap to tackle postpartum haemorrhage (PPH) – defined as excessive bleeding after childbirth - which affects millions of women annually and is the world’s leading cause of maternal deaths. Despite being prevent ... able and treatable, PPH results in around 70 000 deaths every year. For those who survive, it can cause disabilities and psychological trauma that last for years. “Severe bleeding in childbirth is one of the most common causes of maternal mortality, yet it is highly preventable and treatable,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This new roadmap charts a path forward to a world in which more women have a safe birth and a healthy future with their families.” The Roadmap aims to help countries address stark differences in survival outcomes from PPH, which reflect major inequities in access to essential health services. Over 85% of deaths from PPH happen in sub-Saharan Africa and South Asia. Risk factors include anaemia, placental abnormalities, and other complications in pregnancy such as infections and pre-eclampsia. Many risk factors can be managed if there is quality antenatal care, including access to ultrasound, alongside effective monitoring in the hours after birth. If bleeding starts, it also needs to be detected and treated extremely quickly. Too often, however, health facilities lack necessary healthcare workers or resources, including lifesaving commodities such as oxytocin, tranexamic acid or blood for transfusions. “Addressing postpartum haemorrhage needs a multipronged approach focusing on both prevention and response - preventing risk factors and providing immediate access to treatments when needed - alongside broader efforts to strengthen women’s rights,” said Dr Pascale Allotey, WHO Director for Sexual and Reproductive Health and HRP, the UN’s special programme on research development and training in human reproduction. “Every woman, no matter where she lives, should have access to timely, high quality maternity care, with trained health workers, essential equipment and shelves stocked with appropriate and effective commodities – this is crucial for treating postpartum bleeding and reducing maternal deaths.” more

WHO Competency Framework for Health Workers’ Education and Training on Antimicrobial Resistance

World Health Organization WHO (2018) C_WHO

The framework is to be used as a reference guide, applied according to local priorities and needs, and targeted at academic institutions, educators, accreditation bodies, regulatory agencies and oth ... more

The Planetary Health Education Framework

Guzman C., Potter T. (2020) CC

The Planetary Health Education Framework is a project of the Planetary Health Alliance (planetaryhealthalliance.org). The Planetary Health Alliance is a ... more

Technical note: Girls’ Education, Empowerment, and the Elimination of Female Genital Mutilation - arabic version

UN Children's Fund UNICEF (2021) C_UNICEF

The coronavirus disease 2019 (COVID-19) pandemic has created a global and gendered crisis that is compounding existing inequalities and disproportionately affecting girls and women. Emerging evidence from the COVID-19 crisis in 2020 shows school clo ... more