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Healthcare-associated infections (HAI) are a significant burden globally, with millions of patients affected each year. These infections affect both high- and limited-resource healthcare settings, but in limited-resource settings, rates are approximately twice as high as high-resource settings (15 o
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ut of every 100 patients versus 7 out of every 100 patients). Furthermore, rates of infections within certain patient populations are significantly higher in limited-resource settings, including surgical patients, patients in intensive-care units (ICU) and neonatal units. It is well documented that environmental contamination plays a role in the transmission of HAIs in healthcare settings. Therefore, environmental cleaning is a fundamental intervention for infection prevention and control (IPC).It is a multifaceted intervention that involves cleaning and disinfection (when indicated) of the environment alongside other key program elements to support successful implementation (e.g., leadership support, training, monitoring, and feedback mechanisms). To be effective, environmental cleaning activities must be implemented within the framework of the facility IPC program, and not as a standalone intervention. It is also essential that IPC programs advocate for and work with facility administration and government officials to budget, operate and maintain adequate water, sanitation and hygiene (WASH) infrastructure to ensure that environmental cleaning can be performed according to best practices.
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Guide pratique pour l'amélioration de la qualité des soins grâce à de meilleurs services d'eau, d'assainissement et d'hygiène dans les établissements de santé
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
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
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de santé où les services de première nécessité font défaut, y compris les services d’approvisionnement en eau, d’assainissement et d’hygiène (WASH) et les services de gestion des déchets médicaux. Non seulement l’absence de services WASH dans les établissements de santé compromet la sécurité sanitaire des patients et leur dignité, mais il peut éventuellement exacerber la propagation d’infections résistant aux antimicrobiens et compromettre les efforts faits en vue de l’amélioration de la santé maternelle et infantile.
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A Guide to the Application of the WHO Multimodal Hand HygieneImprovement Strategy and the “My Five Moments for Hand Hygiene”Αpproach
Confronted with the important issue of patient safety, in 2002 the Fifty-fifth World Health Assembly adopted a resolution urging countries to pay the closest possible attention to the problem and to strengthen safety and monitoring systems. In May 2004, the Fifty-seventh World Health Assembly approv
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ed the creation of an international alliance as a global initiative to improve patient safety. The World Alliance for Patient Safety was launched in October 2004 and currently has its place in the WHO Patient Safety programme included in the Information, Evidence and Research Cluster.
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Appui au Comité de Coordination Nationale des Programmes de Santé
Antibiotic Stewardship (AS) is a coordinated program that promotes the appropriate use of antimicrobials to improve patient outcomes, reduce microbial resistance, and decrease the spread of multi-drug resistant organisms. In clinical settings, stewardship activities focus on measuring and improving
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how antibiotics are prescribed by clinicians and used by patients. Improving antibiotic prescribing involves implementing effective strategies to modify prescribing practices to align them with evidence-based recommendations for diagnosis and management.
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The management of information and logistics is an essential component of health product systems. In a context of limited financial resources and morbidity and mortality sustained by persistent diseases, it is necessary to strengthen health systems through competent resources, especially human resour
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ces (HR), to ensure performance, sustainability and independence from external funding. In Burkina Faso, a strong and lasting partnership between the Ministry of Health and the Bioforce Institute has existed since 2005 to address this issue. This partnership has created a favorable environment for the professionalization of health logistics and for the recognition of its significant role in health system performance.
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In 1998 the Swedish Veterinary Association decided to adopt a general policy for the use of antibiotics in animals. Since then specifi c policies for the use of antibiotics in dogs and cats have been adopted and in 2011 Guidelines for the use of Antibiotics in Production animals – Cattle and Pigs,
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were accepted. By decision of the board of the Swedish Veterinary Society (SVS) these guidelines have been updated. Th e over-arching goal of SVS is to achieve a low and controlled use of antibiotics in Swedish animal production so that the fi rst-hand choices of treatment remain effi cient and that the spread of antimicrobial resistance – among animals and herds as well as in the food chain – is kept at a minimum. Keeping antimicrobial resistance in animals low is important also for human health, since we are all part of the same ecosystem. Th e authors of these guidelines hope that they may be useful for veteri-narians in clinical practice when deciding on treatments for common diseases and ailments caused by bacteria. Sometimes the decision may even be to refrain from use of antibiotics and chose other ways of improving herd health.
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According to the United Nations, Yemen has been the "Worst humanitarian crisis in the world," for the past two years. Despite the Hudaydah Agreement signed in December 2018, the fighting continued in many areas of the country, such as Hajjah in the north, Al Dhale' e in the south and Hudaydah along
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the west coast. Within a year, another 400,000 Yemenis were forced to flee their homes, eventually adding up to one-eighth of the entire Yemeni population who had become displaced at least once, over the last five years.
In 2019, unprecedented heavy rain and flooding from May onwards caused catastrophic damage to homes and the families’ livelihoods, adding to their misery. Thousands of families who had already lost their home due to the fighting had yet again, their temporary shelters, beddings and essential kitchen supplies, destroyed.
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The Ghanaian Cabinet approved the antimicrobial resistance (AMR)Policy and Implementation plan(hereafter referred to as the national action plan or NAP)in December 2017, whilst the country case study was in progress. This has set in motion the implementation phase for Ghana, which is a long awaited
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event since the drafting of the Policy started in 2011. This case study, whilst limited in its ability to interact with all stakeholders, has identified entrypoints within the operational divisions of Ghana Health Services,as potential areas where the AMR policy platform may seek to embed AMR activities. Much work has already been done within Ghana to identify the key entrypoints within the various ministries and government agencieswhere AMR can be incorporated. These stakeholders already form part of the AMR Policy Platform which is the governance structure for AMR and have been participating actively in the development of the AMR Policy and NAP activities formulation.
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The most significant finding of the case study for integrating antimicrobial resistance (AMR)into existing programs and mobilising resources for funding in Nigeria, is that most of the AMR activities within the Nigerian National Action Plan (NAP)canalready be incorporated within exi
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sting programs of the Federal Ministry of Health (FMOH), Federal Ministry of Agriculture and Rural Development (FMARD) and their agencies or institutes. Certain programs and initiatives already have an AMR element incorporated or could,with little effort,include some additional AMR actions, however much is already being planned and has started with existing federal funding and existing staffing and other resources including development partner support and is being driven by significant political will from the ministries as well as implementation support from the Nigerian Centers for Disease Control as the focal point.
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This working paper was conceived to offer practical tips and suggestions on how to establish and sustain the multisectoral coordination needed to develop and implement National Action Plans on AMR (NAPs). It is intended for anyone with responsibility for addressing AMR at country level. Drawing on b
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oth the published literature and the operational experience of four ‘focal countries’ (Ethiopia, Kenya, Philippines and Thailand), it summarizes lessons learned and the latest thinking on multisectoral working to achieve effective AMR action. The experience in focal countries points to a number of tools and tactics that can be used to help establish and enhance sustainable multisectoral collaboration for AMR action. These can be grouped into four categories: political commitment, resources, governance mechanisms, and practical management.
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Le présent document a été élaboré pour aiderles comités de coordination RAM et d’autres comités chargés de la RAM au niveau des pays àparvenir à cet objectif. S’appuyant sur la littérature publiée ainsi que sur l’expérience opérationnelle et l’expertise de différents PRFI, le
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document présente six stratégies clés pour atteindre l’objectif et offre une série de conseils pratiques et de suggestions sur la façon de mettre en œuvre chacune d’entre elles.
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This paper was developed to support AMR coordination committees and others tasked with addressing AMR at country level to do just that. Drawing on the published literature and the operational experience and expertise of different LMICs, the paper points to six key strategies for success and offers a
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series of practical tips and suggestions on how to implement each one.
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L’Assemblée mondiale de la Santé, tenue en mai 2015, a adopté un Plan d’action mondial pour combattre la résistance aux antimicrobiens, qui définit 5 objectifs:
mieux faire connaître et comprendre le problème de la résistance aux antimicrobiens grâce à une communication, une éduc
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ation et une formation efficaces;
renforcer les connaissances et les bases factuelles par la surveillance et la recherche;
réduire l’incidence des infections par des mesures efficaces d’assainissement, d’hygiène et de prévention des infections;
optimiser l’usage des médicaments antimicrobiens en santé humaine et animale;
dégager les arguments économiques en faveur d’investissements durables qui tiennent compte des besoins de tous les pays et accroître les investissements dans la mise au point de nouveaux médicaments, outils diagnostiques, vaccins et autres interventions.
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This document updates the 2014 Core Elements for Hospital Antibiotic Stewardship Programs and incorporates new evidence and lessons learned from experience with the Core Elements. The Core Elements are applicable in all hospitals, regardless of size. There are suggestions specific to small and criti
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cal access hospitals in Implementation of Antibiotic Stewardship Core Elements at Small and Critical Access Hospitals (12).There is no single template for a program to optimize antibiotic prescribing in hospitals. Implementation of antibiotic stewardship programs requires flexibility due to the complexity of medical decision-making surrounding antibiotic use and the variability in the size and types of care among U.S. hospitals. In some sections, CDC has identified priorities for implementation, based on the experiences of successful stewardship programs and published data. The Core Elements are intended to be an adaptable framework that hospitals can use to guide efforts to improve antibiotic prescribing. The assessment tool that accompanies this document can help hospitals identify gaps to address.
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The product of all this work is the Standard Treatment Guideline and Essential Medicines List of Common Medical Conditions in the Kingdom of Swaziland. These systematically developed statements are designed to assist practitioners in making decisions about appropriate treatment for specific clinical
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conditions. They are meant to reflect expert consensus based on a review of current and published scientific evidence of acceptable approaches to diagnosis, man-agement, or prevention of specific conditions.It is enlightening to note that section A of the document contains the STG, and effort has been made to have the conditions commonly encountered in Swaziland classified according to systems. Written in simple, clear language, each section consists of a short definition followed by common symptoms and signs of the disease or condition and then management (pharmacological and nonpharmacological)
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The infectious disease burden in India is among the highest in the world. A large amount of antibiot-ics are consumed in fighting infections, some of them saving lives, but every use adding to antibiotic resistance in bacteria. Antibiotic use is increasing steadily (table 1), particularly
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certain antibiotic classes (beta-lactam antibacterials), most notably in the more prosperous states. Resistance follows in lock-step.
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