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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 Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.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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Antibiotic Stewardship - From Principles to Practice / Ebook

British Society for Antimicrobial Chemotherapy BSAC (2019) C2

This book provides significantly expanded content and experience in relation to a broader stewardship context- for example, stewardship in specific populations, different countries as well as the role of different professions in stewardship to political and media engagement. We hope this book has so... more

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A conceptual framework for the environmental surveillance of antibiotics and antibiotic resistance

Patricia M.C. Huijbers, Carl-Fredrik Flach, D.G. Joakim Larsson Centre for Antibiotic Resistance Research (CARe), University of Gothenburg (2019) C2

The systematic surveillance of antibiotic use and antibiotic re-sistance prevalence in humans and animals is imperative for managingbacterial infectious disease (JPIAMR, 2019;WHO, 2015). Many low-income countries currently face substantial challenges in building national surveillance systems due to ... more

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Inequality monitoring in immunization: a step-by-step manual

World Health Organization WHO (2019) C_WHO

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Monitorização Das Desigualdades Na vacinação

World Health Organization WHO (2019) C_WHO

Um Manual Passo A Passo

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The Challenge of Environment and Climate Justice: Imperatives of an Eco-Theological Reformation of Christianity in African Contexts

Humboldt University Berlin, Research Programme on Religious Communities and sustainable developpment (2019) CC

Religion and Development 01/2019. Discussion Paper Series of the Research Programme on Religious Communities and Sustainable Development

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Kairos for Creation - Confession Hope for Earth

Andrianos, L.; M.Biehl, R. Gütter ,et al. Brot für die Welt; WCC; EKD; et al. (2019) CC

The “Wuppertal Call” – Contributions and Recommendations from an International Conference on Eco-Theology and Ethics of Sustainability Wuppertal, Germany, 16 – 19 June 2019

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Lifestyle Diseases – An Increasing Cause Of Health Loss

Helen K., Gladwell G., Calestus N. and Wangia E. UNFPA, WHO, World Bank, et al. (2019) C1

Kenya in undergoing an epidemiological transition marked by a decline in morbidity and mortality due to communicable conditions, and an increase in the burden of non-communicable diseases (NCDs), which include diseases such as diabetes, cancers, cardiovascular diseases and chronic respiratory infect... more

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Southeast Myanmar Field Report: Militarisation, environmental pollution and sexual violence against children, July to December 2019

Karen Human Rights Group KHRG (2019) C1

Over the reporting period, economic actors continued to carry out their activities with little regard for their impacts on the livelihoods of the communities living in the surrounding areas. In Doo Tha Htoo (Thaton) District, cold dust from a Tatmadaw-run cement factory contaminated nearby waterways... more

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Water, sanitation and hygiene in healthcare facilities: practical steps to achieve universal access to quality care

World Health Organization WHO, Unicef (2019) C_WHO

Purpose of this document: to present eight practical steps that Member States can take at the national and sub-national level to improve WASH in health care facilities

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Eau, assainissement et hygiène dans les établissements de santé : mesures pratiques pour parvenir à un accès universel à des soins de qualité

World Health Organization WHO; UNICEF (2019) C_WHO

Personne ne se rend dans un établissement de soins de santé pour tomber malade. On s’y rend pour aller mieux, pour accoucher, pour se faire vacciner. Cependant, des centaines de millions de gens sont confrontés à un risque accru d’infection quand ils se font soigner dans des établissements ... more

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Kenya National Cancer Treatment Protocols

Ministry of Health, Kenya Ministry of health (2019) C1

The key areas covered are diagnosis, imaging, pathology, surgery, rehabilitation, palliative care and survivorship. It emphasizes a multi-disciplinary team approach which is paramount for quality cancer care. The specific cancers covered are breast, central nervous system, gastroint... more

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Averting risks to the food chain

FOOD AND AGRICULTURE ORGANIZATION OF THE UNITED NATIONS FAO (2019) C2

As the number of transboundary pest and animal and foodborne disease outbreaks rises, so does the number of people who are chronically hungry due to these and other factors. The correlation can be explained by the link between our health and that of the planet. We rely on land and sea for the produc... more

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When the Drugs Don’t Work – Antibiotic Resistance as a Global Development Problem

The Dag Hammarskjöld Foundation and ReAct (2019) C2

This paper focuses on the Sustainable Development Goals related to poverty, economic growth, inequality, health, food production and the environment. It presents concrete examples of the underlying and complex aspects of antibiotic resistance and its impacts across different Sustainable Development ... more

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Improving the quality of health services: tools and resources

World Health Organization WHO (2019) C_WHO

This compendium collates current tools and resources on quality improvement developed by the WHO Service Delivery and Safety Department and provides examples of how the tools and resources have been applied in country settings. The target audience for this document are ministries of health, facility... more