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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 Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.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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Rwanda: MATERNAL, NEONATAL AND CHILD HEALTH NATIONAL STRATEGY JULY 2013- JUNE 2018

Ministry of Health, Rwanda & Rwanda Biomedical Centre (2013) C2

This document sets out Rwanda's Maternal, Neonatal Child Health (MNCH) national strategy (July 2013- June 2018). The MNCH strategy provides a framework for addressing maternal, neonatal and child health challenges currently facing Rwanda. It is an overarching strategy for scale up of the national re ... more

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Antimicrobial resistance in the Asia Pacific region: a development agenda

World Health Organization WHO (2017) C_WHO

Antimicrobial resistance (AMR) is a serious public health concern with economic, social and political implications that are global in scope, and cross all environmental and ethnic boundaries. As a global threat, AMR risks the achievements of modern medicine, and has the po ... more

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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 students aspire to include international experiences into their academic training. However, the exact meani ... more

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Hepatitis B (chronic): Diagnosis and management of chronic hepatitis B in children, young people and adults

Aftab Ala, Elizabeth Boxall, Steven Bradley et al. National Clinical Guideline Centre (2013)

Clinical guideline, Methods, Evidence and Recommendations In this guideline the following is covered: information needs of people with chronic hep titis B and their carers; where children, young people and adults with chronic hepatitis B a- should be assessed; ... more

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Differentiated Care for Adults at High Risk of HIV Disease Progression: A Call to Action

ICAP (2017) C1

The evidence base for differentiated care for stable patients has grown in recent years. There has been less attention, however, to developing differentiated models of care for patients with advanced or unstable HIV disease. Current clinical guidelines and policies regarding optimal packages of care ... more

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A case study of the role of an Essential Health Benefit in the delivery of integrated health services in Zambia

Luwabelwa, M.; Banda, P; Palale M.; Chama-Chiliba, C. Regional Network for Equity in Health in east and southern Africa (EQUINET) (2017) C1

Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 111
The health services delivery system in Zambia is pyramid in structure, with primary healthcare (PHC) services at community level, at the base, followed by first and second level hospitals at distric ... more

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Culture and reform of mental health care in central and eastern Europe

World Health Organization WHO; Regional Office for Europe (2018) C_WHO

The WHO Regional Office for Europe, the WHO Collaborating Centre on Culture and Health at the University of Exeter (United Kingdom) and the National Institute of Mental Health (Czechia) convened a workshop on culture and reform of mental health care in central and eastern Europe on 2–3 October 201 ... more

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Framework for Strengthening Integration of Mental Health in Programs for Children Orphaned or Made Vulnerable by HIV

4Children (2018) C1

Poverty, HIV and other disease burdens, coupled with common mental disorders including alcohol and other substance use disorders, posttraumatic stress disorder, clinical and postnatal depression, distress, and anxiety, impact how caregivers meet the ... more

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Money calls the shots

Amnesty International (2022) C2

PHARMA’S RESPONSE TO THE COVID-19 VACCINES CRISIS. Update Feb., 14, 2022. In September 2021, Amnesty International published A Double Dose of Inequality, which assessed the extent to which the pharmaceutical industry was restricting access to Covid-19 vaccines. This report updates that ... more

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Health Care Facilities Resilient to Climate Change Impacts

Paterson, J.; P. Berry, K. Ebi and L. Varangu (2014) CC

nt. J. Environ. Res. Public Health 2014, 11(12), 13097-13116; https://doi.org/10.3390/ijerph111213097 Climate change will increase the frequency and magnitude of extreme weather events and create risks that will impact health care facilities. Healt ... more

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Intention to action series: Regional reflections. Analysis from informal regional consultations with people living with noncommunicable diseases and mental health conditions

World Health Organisation (WHO) (2023) C_WHO

This report includes analysis from informal regional consultations in the African Region, the Caribbean and North America, Latin America, South-East Asia Region, European Region, Eastern Mediterranean Region, alongside three forums in the Western Pacific Region. It analyses the overarching similarit ... more

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Preparedness and Response for Chikungunya Virus Introduction in the Americas

Pan American Health Organization; Centers for Disease Control and Prevention CDC (2011) C_WHO

These guidelines provide guidance on how to detect an outbreak of the disease, conduct pertinent epidemiological investigations, and prevent or mitigate the spread of the disease throughout the Region. We encourage everyone working to apply these guidelines to take into account all the knowledge ava ... more

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Recommendations for Implementing Antimicrobial Stewardship Programs in Latin America and the Caribbean: Manual for Public Health Decision-Makers

Pan American Health Organization PAHO (2018) C2

As a public good, antimicrobial medicines require rational use if their effectiveness is to be preserved. However, up to 50% of antibiotic use is inappropriate, adding considerable costs to patient care, and increasing morbidity and mortality. In addition, there is compelling evidence that antimicro ... more

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National Tuberculosis, Leprosy and Lung Disease Orogram Tuberculosis (TB) Isolation Policy

Ministry of Health, Kenya (2018) C1

Apart from implementation of TB infection Prevention and Control measures, treatment of those with active TB of the lungs is key in preventing the spread of the TB bacilli. The Public Health Act CAP 242, section 17 classify TB as notifiable infectious disease and under section 26 as part of preventi ... more

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South Sudan - Emergency Livelihood Response Programme 2021-2023

Food and Agriculture Organization of the United Nations FAO (2021) CC

The situation in South Sudan has proven to be unpredictable and volatile. New hotspots of violent conflict and civil unrest have continued to emerge and levels of severe acute food insecurity have become progressively worse. In addition to years of fighting and political instability, the country fac ... more

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Papua New Guinea: Disaster Management Reference Handbook

Center for Excellence in Disaster Management and Humanitarian Assistance (2016) C1

The 2012 NDRMP lays out the Disaster Risk Management (DRM) architecture of the country and provides guidance for DRM intervention at all levels. However, implementation has been slow and resource challenges exist throughout the government.
The PNG government’s policy and institutional framework ... more