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 evidence 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 Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.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.
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Monitoring financial protection and utilization of health services in Mongolia 2009-2018 is based on national representative household socioeconomic surveys. The study finds that between 2009 and 2018, despite ambitious health reforms, the incidence... of catastrophic health spending and impoverishing spending at the relative poverty line have increased. These increases were mainly driven by out-of-pocket spending on medicines and inpatient care. In the same period, inequity in access to and utilization of health services remained constant among population groups. Evidence suggests health financing policies need to be further strengthened to make progress towards universal health coverage. Continuous tracking of out-of-pocket payments and service utilization to inform policymaking is needed.
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Trustworthy, evidence-based health guidelines form the basis of national policies affecting both patients and health-care workers. Emphasizing the link between robust evidence and people’s trust in their health systems, Dr Hans Henri P. Kluge, WHO... Regional Director for Europe said at the launch event, “Trust and transformation are key words for us, especially when we talk about improving and strengthening our health systems. Transformation should first and foremost serve the interests of patients and health-care workers”.
While it is not always easy to demonstrate the immediate effect of guidelines on people’s health, there is no viable alternative to utilizing guidelines based on the best available evidence.
Yet, developing robust guidelines remains a challenge for most countries. “Guidelines need to be both simple to use and timely, they need to address people’s real needs, especially at the local level, and should ultimately reflect the resources available,” said Dr Natasha Azzopardi-Muscat, Director, Country Health Policies and Systems, WHO/Europe. “This means that any successful guideline needs to be adjusted and adapted to local contexts and realities.”
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Refugee protection in the country is provided within the framework of these international and national refugee laws as well as the core international human rights treaties that have been ratified by the country. Continued insecurity within neighbour...ing states has resulted in sustained refugee movements, either directly as a result of internal conflict and human rights abuses or as a result of conflict related to competition for scare natural resources and drought related food insecurity.
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This guide is a resource for physicians and other health care professionals who provide care and treatment to patients with drug-resistant tuberculosis.
The WHO country office for Ghana, began the year 2019 with a 4-day staff retreat at the Busua Beach Resort in the Western Region from 04 to 08 March 2019. The theme for the retreat was ‘Impacting the Health and Lives of the people of Ghana through the Triple Billion Goal”. The staff outlined pri...orities and strategies to strengthen WHO’s contribution to the national health agenda during the year. Working in collaboration with the Ministry of Health/Ghana Health Service and other allied health institutions and stakeholders, the WHO country office, provided support aimed at achieving its
mission which is attaining the highest level of health by the people in the country though its six operational areas which are (i) Communicable Diseases (ii) Non-Communicable Diseases, (iii) Promoting Health through the Life Course (iv), Health Systems, (v) Preparedness, Surveillance and Response (vi) Corporate services and enabling functions.
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The Lancet. 13 March 2022. doi: 10.1016/S0140-6736(21)02868-3. Previous Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) studies have reported
national health estimates for Ethiopia. Substantial regional variations in socioeconomi...c status, population, demography, and access to health care within Ethiopia require comparable estimates at the subnational level. The GBD 2019 Ethiopia subnational analysis aimed to measure the progress and disparities in health across nine regions and two chartered cities.
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Fact Book on WHO Level I and Level II monitoring indicators - To monitor the progress of efforts to improve the global medicines situation, WHO has developed a system of indicators that measure important aspects of a country’s pharmaceutical situation. Level 1 indicators measure the existence and ...performance of key national pharmaceutical structures and processes. Level II indicators measure key outcomes of these structures and processes in the areas of access, product quality and rational use. These indicators can be used to assess progress over time; to compare situations between countries; and to reassess and prioritize efforts based on the results.
This Fact Book gives the results of the assessment of Level I indicators conducted in 2003 and of Level II indicator surveys conducted between 2002 and 2004
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"Achieving, maintaining and improving accuracy, timeliness and reliability are major challenges for health laboratories. Countries worldwide committed themselves to build national capacities for the detection of, and response to, public health event...s of international concern when they decided to engage in the International Health Regulations implementation process. Only sound management of quality in health laboratories will enable countries to produce test results that the international community will trust in cases of international emergency. This handbook is intended to provide a comprehensive reference on Laboratory Quality Management System for all stakeholders in health laboratory processes, from management, to administration, to bench-work laboratorians. This handbook covers topics that are essential for quality management of a public health or clinical laboratory. They are based on both ISO 15189 and CLSI GP26-A3 documents"--Page 7.
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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 responsibilit...y for addressing AMR at country level. Drawing on both 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.
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In recent years, Rwanda has been on the fast track to achieve major health improvements for its entire population. With the support of government agencies and various non-governmental partners, the Ministry of Health (MoH) has endeavored to decentralize Rwanda’s health system and bring health serv...ices closer to the people. Guided by multitude of national and international development frameworks, Rwanda’s healthcare successes include the establishment of a community health insurance scheme (mutuelle de santé), a system of cooperative-financed community health workers in every village, and interventions for researching, preventing, and treating diseases like HIV/AIDS, TB, and malaria.
As the MoH continues to design innovative means to reach and surpass its prescribed health outcome targets, it will hold as core principles the integration of service provision, the increase in healthcare capacity, and the attainment of sustainable funding sources. Rwanda is committed to achieving the Millennium Development Goals by 2015 and has declared Family Planning (FP) a national priority for poverty reduction and socioeconomic development of the country. Modern contraceptive use has more than quadrupled from 2005 to 2010, rising from 10% to 45%, but the government’s Economic Development and Poverty Reduction Strategy calls for an increase the modern contraceptive prevalence to 70% by 2016. While structural changes in health care and supply chains have led to noteworthy improvements in FP and other services, there are still many challenges that must be overcome. As such, a strategic plan is needed to coordinate FP efforts around a well-defined set of objectives and responsibilities.
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This document provides a systematic approach in developing a coordinated, standardized, reliable, efficient, cost-effective, and sustainable specimen transport and referral system to support IVHD and VL testing networks. This document provides technical and programmatic recommendations on the approp...riate specimen storage and transportation of specimens for HIV VL and IVHD testing. Along with the national guidelines for specimen storage and transport, these standards should provide guidance on the creation or improvement of specimen referral networks and specimen transport systems. In addition, standard operating procedures (SOPs) targeting drivers and persons responsible for packing of specimens and results return are included in this document.
No publication year indicated in the document.
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The USAID | DELIVER PROJECT, Task Order 4, developed this guide for quantifying health commodities; it will assist technical advisors, program managers, warehouse managers, procurement officers, and service providers in (1) estimating the total commodity needs and costs for successful implementation... of national health program strategies and goals, (2) identifying the funding needs and gaps for procuring the required commodities, and (3) planning procurements and shipment delivery schedules to ensure a sustained and effective supply of health commodities.
The step-by-step approach to quantification presented in this guide is complemented by a set of product-specific companion pieces that include detailed instructions for forecasting consumption of antiretroviral drugs, HIV test kits, antimalarial drugs, and laboratory supplies.
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Civil Society Organisations’ contribution towards community engagement to access and demand health services and encourage communities to practice appropriate health-seeking behaviour in Mon and Chin States. The study recognizes that civil society can promote people-...ght medbox">centered health by creating an enabling environment for broad and active citizen participation. The VHCs/Volunteer Working Groups play a key role in facilitating engagement between the village community and the Basic Health Staff (BHS).
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A case study from Bosnia and Herzegovina Eurasian Harm Reduction Network
The case study was prepared by Samir Ibisevic, President of PROI between March and June 2016 and edited by Graham Shaw.
EHRN is grateful to all who contributed to this document, especially: Dr. Serifa Godinjak, Chairperson... of Country Coordinating Mechanism; Dr. Zlatko Cardaklija, HIV Coordinator for the Federation of Bosnia and Herzegovina (BiH); Dr. Nesad Seremet, Head of the HIV program, United Nations Development Program in Bosnia and Herzegovina; Ms. Gyongyver Jakab, Fund Portfolio Manager, Eastern Europe and Central Asia and Ms. Natalya Bogach, Program Officer, The Global Fund to Fight AIDS, Tuberculosis and Malaria; Dr. Nermana Mehic–Basara, Director of the Institute for Addiction Diseases of Sarajevo Canton; Mr. Denis Dedajic, Director of the Association Margina from the Federation of BiH; Mr. Srdjan Kukolj, Director of Action Against AIDS from the Republic of Srpska.
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The project will support preventive actions, traditional medicine and the coordination and
implementation capacities of the national framework for HIV/AIDS control.
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 Actio...n Plan (NAP)canalready be incorporated within existing 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 responsibilit...y for addressing AMR at country level. Drawing on both 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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Antimicrobial resistant (AMR) organisms are increasing globally, threatening to render existing treatments ineffective against many infectious diseases. In Africa, AMR has already been documented to be a problem for HIV and the pathogens that cause malaria, ...">tuberculosis, typhoid, cholera, meningitis, gonorrhea, and dysentery. Recognizing the urgent need for action, the World Health Assembly adopted the Global Action Plan on Antimicrobial Resistance in May 2015. In accordance with the Global Action Plan and to meet needs specific to Africa, Africa CDC will establish the Anti-Microbial Resistance Surveillance Network (AMRSNET). AMRSNET is a network of public health institutions and leaders from human and animal health sectors who will collaborate to measure, prevent, and mitigate harms from AMR organisms.
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Histoplasmosis is a disease caused by the fungus Histoplasma capsulatum. This disease is highly endemic in some regions of North America, Central America, and South America and is also reported in certain countries of Asia and Africa. It often affects people with impaired immunity, including people ...living with HIV, among whom the most frequent clinical presentation is disseminated histoplasmosis. The symptoms of disseminated histoplasmosis are non-specific and may be indistinguishable from those of other infectious diseases, especially disseminated tuberculosis (TB), thus complicating diagnosis and treatment. Histoplasmosis is one of the most frequent opportunistic infections caused by fungal pathogens among people living with HIV in the Americas and may be responsible for 5–15% of AIDS-related deaths every year in this Region. These guidelines aim to provide recommendations for the diagnosis, treatment, and management of disseminated histoplasmosis in persons living with HIV
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