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 Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.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

WHO (1999) C_WHO

This document introduces four strategic objectives and twelve operational principles for good pharmaceutical procurement. These objectives and principles have been developed and endorsed by the Interagency Pharmaceutical Coordination Group (IPC), involving the pharmaceutical advisers of the United ... more

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Laboratory biosecurity guidance

World Health Organization WHO (2006) C_WHO

The WHO laboratory biosecurity guidance follows and complements the revision of the Laboratory biosafety manual, fourth edition and provides principles and measures to prevent lapses and incidents throughout the whole value chain of handling high-consequence biological material, technology and infor... more

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Management of Severe Acute Malnutrition in children: Working towards results at scale

United Nations Children’s Fund (UNICEF) (2015)

The objectives of this guidance document are to:
1. Strengthen the capacity of country teams to effectively scale up and manage programmes to address severe acute malnutrition
2. Extend the geographic reach of quality treatment for SAM to all vulnerable communities in need
3. Maximize... more

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World mental health report: Transforming mental health for all - executive summary

World Health Organization WHO (2022) C_WHO

Mental health is critically important to everyone, everywhere. All over the world, mental health needs are high but responses are insufficient and inadequate. The World mental health report: transforming mental health for all is designed to inspire and inform better mental health for everyone everyw... more

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Public health resource pack for countries experiencing outbreaks of influenza in animals: revised guidance

World Health Organisation (WHO) (2023) C_WHO

This resource pack was developed for the country offices of the World Health Organization and national Public Health institutions, as an overview of the key information needed for advising their Member States in response to questions raised on human health due to influenza outbreaks or detections in... more

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WASH FIT: A practical guide for improving quality of care through water, sanitation and hygiene in health care facilities (Second edition)

UN Children's Fund UNICEF; World Health Organization WHO (2023) C_WHO

Fully functioning water, sanitation, hygiene (WASH) and health care waste management services are a critical aspect of infection prevention and control (IPC) practices, and ensuring patient safety and quality of care. Such services are also essential for creating an environment that supports the dig... more

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Field Guide for Preparedness and Response to Diphtheria Outbreaks in the Western Pacific Region

World Health Organization WHO (2023) C_WHO

Due to high routine vaccination coverage, overall counts of diphtheria case have significantly declined in the Western Pacific Region recently. However, diphtheria is still prevalent in several countries and areas of the Region and remains a public health issue due to its high case fatality rate. ... more

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Medical Ethics Manual

World Medical Association (2015) CC

Modern healthcare has given rise to extremely complex and multifaceted ethical dilemmas. All too often physicians are unprepared to manage these competently. This publication is specifically structured to reinforce and strengthen the ethical mindset and prac... more

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Framework for collaborative action on tuberculosis and comorbidities

World Health Organization WHO (2022) C_WHO

Addressing comorbidities and risk factors for TB is a crucial component of Pillar one of the End TB Strategy, which focuses on integrated patient-centred care and prevention, including action on TB and comorbidities. The Framework for collaborative action on TB and comorbidities aims to support coun... more

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The Boston Medical Center Patient Navigation Toolkit

The Boston Medical Center AVON Foundation for Women The Boston Medical Center AVON Foundation for Women (2020) C1

This toolkit is designed to help you plan and implement a Patient Navigation program with the best chance of reducing health disparities and improving health outcomes for your patients. It contains evidence-based and experience-based examples, case studies, practical tools, and resources to help you... more

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Interim Guidance Document on Cholera Surveillance

Global Task Force on Cholera Control (GTFCC) World Health Organisation (WHO) (2017) C_WHO

The objective of this guidance document is to support the public health professionals in implementing effective surveillance of cholera in at-risk, endemic and epidemic areas. This document has been developed by the Surveillance Working Group of the Global Task Force for Cholera Control (GTFCC) a... more

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Neonatal Tetanus Elimination Field Guide

Pan American Health Organisation PAHO (2005) C_WHO

In many countries neonatal tetanus is responsible for half of all neonatal deaths due to vaccine-preventable diseases and for almost 14% of al¡ infant deaths. It is estimated that in the 1970s more than 10,000 newborns died annually from neonatal tetanus in the Americas. Neonatal tetanus is prevent... more

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The reality of managing asthma in sub-Saharan Africa – Priorities and strategies for improving care

Mortimer, K.; Masekela, R.; Ozoh, O.; et al. (2022) CC2

Asthma is the most common non-communicable disease in children and remains one of the most common throughout the life course. The great majority of the burden of this disease is seen in low-income and middle-income countries (LMICs), which have disproportionately high asthma-related mortality relati... more

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Generic risk assessment model for insecticide-treated nets, 2nd ed.

World Health Organization (WHO) (2018) C_WHO

Long-lasting insecticidal nets (LNs) constitute a core vector control intervention against malaria. A number of new LN products are under development and will require assessment of risks to humans. This document provides an updated generic model that can be used for the risk assessment of exposure t... more

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Treat as One. Bridging the gap between mental and physical healthcare in general hospitals

National Confidential Enquiry into Patient Outcome and Death (2017) C1

This NCEPOD report highlights the quality of mental health and physical health care for patients aged 18 years or older with a significant mental disorder who are admitted to a general hospital. The report takes a critical look at areas where the care of patients might have been improved. Remediable... more

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Measles SIAs Field Guide

World Health Organization; Regional Office for Africa (2006)

The Regional strategy for measles control recommends that a second opportunity for measles immunization be provided to all children irrespective of their vaccination status or history of clinical measles. The preferred method of provision of a second opportunity is through Supplemental Immunization ... more

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Enhancing mental health pre-service training with the mhGAP Intervention Guide: experiences and lessons learned

World Health Organization WHO (2020) C_WHO

This document was designed to inform educators, amongst others, about enhancing the pre-service curriculum with mental health Gap Action Programme Intervention Guide (mhGAP-IG) materials, which can provide future professionals with the theoretical and clinical knowledge they need to provide mental h... more

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Protocol for Enhanced Isolate-Level Antimicrobial Resistance Surveillance in the Americas. Primary Phase: Bloodstream Infections

Pan American Health Organisation PAHO (2021) C_WHO

Antimicrobial resistance (AMR) surveillance plays an important role in the early detection of resistant strains of public health importance and prompt response to outbreaks in hospitals and the community. Surveillance findings are needed to inform medical practice, antibiotic stewardship, and policy... more

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Catalogue of interventions addressing vaccine hesitancy

European Centre for Disease Prevention and Control ECDC (2017) C1

This catalogue provides tools and information resources to support EU/EEA countries in addressing the challenging issue of vaccine hesitancy. The catalogue provides examples of practices that can serve as a resource for other countries. The project was developed in the context of ECDC’s support fo... more