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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 Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.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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Securing the future from drug-resistant infections

Interagency Coordination Group on Antimicrobial Resistance IAGG World Health Organisation WHO (2019) C_WHO

Antimicrobial resistance is a global crisis that threatens a century of progress in health and achievement of the Sustainable Development Goals. There is no time to wait. Unless the world acts urgently, antimicrobial resistance will have disastrous impact within a generation.

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National Comprehensive Guidelines on HIV Testing Services

Kenya MInistry of Health, Community Development, Elderly and Children (2019) C1

These guidelines provide a framework for effective action to facilitate access to safe and ethical testing services for different population groups. The implementation of the a comprehensive approach, known as HIV Testing Services (HTS) is cardinal as an effective package of services that diminis... more

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The Democratic Republic of Congo Regional Refugee Response Plan (RRRP) January 2019 - December 2020

UN Office for the Coordination of Humanitarian Affairs (OCHA) (2018) C1

Looking forward, the 2019-2020 Regional Refugee Response Plan (RRRP) for the DRC situation aims at addressing the needs of new arrivals of Congolese refugees in the region, and those in protracted situations. By supporting livelihoods opportunities and through a resilience-based approach, refugees w... more

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Roadmap towards ending TB in children and adolescents
recommended

World Health Organization WHO (2018) C_WHO

2nd edition. The 2018 Roadmap incorporates an additional critical population: adolescents. Despite making up 1 in 6 of the world’s people, adolescents have been largely overlooked as global momentum to address TB has grown. Spanning the ages of 10–19 years, adolescents are both at risk of TB and... more

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Communication Risk in Public Health Emergencies
recommended

World Health Organization (WHO) (2018) C_WHO

A WHO Guideline for Emergency Risk Communication (ERC) policy and practice. Recent public health emergencies, such as the Ebola virus disease outbreak in West Africa (2014–2015), the emergence of the Zika virus syndrome in 2015–2016 and multi-country yellow fever outbreaks in Africa in 2016, h... more

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Integrating palliative care and symptom relief into responses to humanitarian emergencies and crises: a WHO guide

World Health Organization WHO (2018) C_WHO

Humanitarian emergencies and crises (Humanitarian emergencies and crises) are large-scale events that may result in the breakdown of health care systems and society, forced displacement, death, and physical, psychological, social and spiritual suffering on a massive scale. Current responses to Human... more

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Singing to the Lions. A Guide to Overcoming Fear and Violence in Our Lives
recommended

Brakarsh, J.; L. Steinitz Catholic Relief Services CRS (2018) CC

Singing to the Lions is a free training package (facilitator’s guide, supplement and video) by CRS, that is designed to help children and youth lessen the impact of violence and abuse in their lives. The main component is a three-day workshop where participants learn skills that can help them tran... more

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Philippines: Disaster Management Reference Handbook

Center for Excellence in Disaster Management and Humanitarian Assistance (2018) C1

The Philippine Government, International Non-government Organizations (INGOs) and local NGOs are all making attempts to address the impact of disasters and climate change at various levels. The Philippine Government has made significant strides in the implementation of disaster risk reduction (DRR) ... more

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Needs and barriers for mental health and psychosocial support among syrian refugees in lebanon: perspectives for future interventions

European Union Civil protection and Humanitarian Aid European Union Civil protection and Humanitarian Aid (2018) CC

Results Recommendations• NGOs should provide MHPSS services with a focus on empowerment and self-reliance • Introduce interventions focusing on pain mechanisms, coping strategies and physical resilience • Implement livelihood programmes • Increase service accessibility and outreach activ... more

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WHO guidance for contingency planning
recommended

World Health Organization (WHO) (2018) C_WHO

In this contingency planning guidance, a set of actions to prepare for emergencies from all hazards and to help minimize their impact, is proposed. These actions include the development, implementation, simulation, monitoring and regular update of risks-based contingency plans.

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Wound Care Protocol

Medicins Sans Frontieres MSF (2018) C2

Wound care is a regular component of the package of care we offer in the majority of our health care facilities and represents a high volume of activities. The current practices in MSF projects are often based on the habits of each individual supervisor, the wound care material we off... more

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Disability-inclusive social protection research in Nepal

Banks, Lena M., Walsham, Matthew and others International Centre for Evidence in Disability (2018) C1

A national overview with a case study from Tanahun district. The overall aims of this study are (1) to assess the extent to which social protection systems in Nepal address the needs of people with disabilities; and (2) to identify and document elements of good practice, as well as challenges, in th... more

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Risk Communication and Community Engagement Considerations: Ebola Response in Democratic Republic of the Congo

World Health Organization WHO (2018) C_WHO

Overview: Risk communication and community engagement are essential for any disease outbreak response. This is particularly critical during outbreaks of Ebola which may create fear in the public and frontline responders alike due to severe presentation of symptoms, misunderstanding of the causes of ... more

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Adolescent Girls in Crisis: Voices from South Sudan

Plan International (2018) C1

In the last 5 years, the conflict in South Sudan has displaced 4 million people and placed 7 million in need of humanitarian assistance.
This report commissioned by Plan International draws on research conducted with girls and members of their families and communities in multiple sites in South... more

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Rwanda Fourth Health Sector Strategic Plan (July 2018-June 2024)
recommended

Ministry of Health, Rwanda (2018) C2

Rwanda’s fourth health sector strategic plan (HSSP4) is meant to provide the health sector with a Strategic Plan that will highlight its commitments and priorities for the coming 6 years. It will be fully integrated in the overall economic development plan of the Government. HSSP4 will fulfill the... more

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Child-friendly spaces and services for refugee and migrant children in Germany. A Case Study

Unicef (2018) C_UNICEF

With child-friendly places and offers, spaces and relationship opportunities are created in which children can simply be children again. In the international context, the establishment of Child Friendly Spaces in war and crisis regions is firmly established. In high-income countries, however, there ... more

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National Health in All Policies Strategic Framework 2017-2021

Ministry of Health, Zambia (2018) CC

The attainment of Zambia’s goal of being a prosperous and middle-income country by 2030 as stipulated in its Vision 2030 is dependent on among others, a healthy and productive population. Therefore, the Government of the Republic of Zambia (GRZ) has prioritized health as a key socio-economic inves... more

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Climate change and health in small island developing states: a WHO special initiative

World Health Organization (WHO) (2018) C_WHO

This report has been prepared in response to informal requests by SIDS Member States and territories for WHO assistance in confronting the stark and dire situation which climate change has created in their countries and the impact it is having on their peoples

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Global Antimicrobial Resistance Surveillance System (GLASS) Report: Early implementation

World Health Organization WHO (2018) C_WHO

The global emergence of antimicrobial resistance (AMR) is posing a threat to human health. Putting resources into the containment of AMR – including surveillance – is one of the highest-yield investments a country can make to mitigate its impact. In 2015, WHO launched the Global Antimicrobial Re... more

Roadmap towards ending TB in children and adolescents recommended

Communication Risk in Public Health Emergencies recommended

Singing to the Lions. A Guide to Overcoming Fear and Violence in Our Lives recommended

WHO guidance for contingency planning recommended

Rwanda Fourth Health Sector Strategic Plan (July 2018-June 2024) recommended

Roadmap towards ending TB in children and adolescents
recommended

Communication Risk in Public Health Emergencies
recommended

Singing to the Lions. A Guide to Overcoming Fear and Violence in Our Lives
recommended

WHO guidance for contingency planning
recommended

Rwanda Fourth Health Sector Strategic Plan (July 2018-June 2024)
recommended