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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 Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.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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A Roadmap to combat postpartum haemorrhage between 2023 and 2030

World Health Organization WHO (2023) C_WHO

WHO today released its first roadmap to tackle postpartum haemorrhage (PPH) – defined as excessive bleeding after childbirth - which affects millions of women annually and is the world’s leading cause of maternal deaths. Despite being preventable and treatable, PPH results in around 70 000 de... more

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OCHA Policy Brief on Gendered Drivers, Risks and Impacts of Food Insecurity in the Sahel and the Horn of Africa

UN Office for the Coordination of Humanitarian Affairs (2023) CC

It is widely understood that the food insecurity crisis in the Sahel and the Horn of Africa is one of the world’s fastest growing and most neglected crises. It lacks sufficient global focus, resources and urgency. As in so many crises, women and girls are disproportionately affected and shoulder t...he consequences of protracted neglect, with unconscionable impacts on their safety, life chances and agency. Gaining a holistic view of the gendered drivers, risks and impacts of food insecurity in the Sahel and the Horn of Africa is difficult. This is due to a lack of data and prioritization, and the large geographical and socioeconomic terrain covered by both regions. However, what we do know about this crisis is more than enough to urgently address the needs of women and girls. An OCHA discussion paper on this topic (which will be published imminently, and from which this policy brief is drawn) found that there is: A strong risk of profound regression in gender equality gains made to date in the countries of concern, including on education, sexual and reproductive health, and the economic independence of women and girls (with knock-on effects on broader humanitarian and development outcomes). An increasing challenge to reverse what must be recognized as a protracted and growing gender-based violence (GBV) emergency in the Sahel and the Horn of Africa. The food insecurity crisis in the Sahel and the Horn of Africa is protracted, multidimensional and highly gendered, with spiralling impacts on gender equality and food security outcomes. It is driven by interwoven and overlapping factors, including climate change, political instability, conflict, socioeconomic conditions, migration and displacement and, more recently, COVID-19 and the war in Ukraine. Interlinked with these factors are gendered structural drivers of food insecurity, including deeply entrenched gender inequalities and harmful social norms. Gendered risks and impacts of food insecurity include alarming limitations on access to education, sexual and reproductive health rights, women’s agency and participation, and dramatic increases in different existing forms of GBV and the emergence of new ones. Recognition of such gendered dimensions of food insecurity and of the need for a multisectoral approach in the response is key to addressing the crisis, along-side sustained commitment and adequate allocation of resources. This policy brief draws out key findings from the OCHA discussion paper on this topic, which includes a desk review of studies, assessments and reports, and interviews with local women’s organizations on the front lines of the food insecurity crisis in communities across both regions. Below are the most pressing gendered drivers, risks and impacts of food insecurity (not in order of priority), as well as key gaps in the current humanitarian response to food insecurity, and recommendations to take forward. more

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Climate Smart Agriculture in Uganda

Feed the Future (2019) CC

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Toolkit for developting a national TB research plan

N. Gebreselassie , C. Lienhardt, L. Anderson et al. World Health Organization (2016) C_WHO

The End TB Strategie

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Global Policy Opportunities for Planetary Health

Panorma Perspectives (2017) C2

A Review of Existing Policy Frameworks. Report III Conversations on Planetary Health

Regional Migrant Response Plan for the Horn of Africa and Yemen, 2022

International Organization for Migration IOM (2022) CC

The regional Migrant Response Plan (MRP) for the Horn of Africa and Yemen includes urgent life-saving humanitarian and protection interventions to improve safe and dignified access to basic services for migrants and host communities while ensuring medium- to long-term actions aimed at addressing the... more

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WHO COUNTRY COOPERATION STRATEGY 2010–2015 NAMIBIA

World Health Organisation (WHO) Regional Office for Africa (2010) C_WHO

Second Generation, WHO Country Cooperation Strategy, 2010–2015, Namibia

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A Decade of Tracking Progress for Maternal, Newborn and Child Survival: The 2015 Report

United Nations Children’s Fund (UNICEF), World Health Organization (WHO) (2015)

National surgical, obstetric and anesthesia plan 2018-2024

Ministry of Health, Rwanda (2018) CC

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Healthcare waste

USAID (2019) C1

Sector Environmental Guidelines, Full technical Update

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WHO Country Cooperation Strategy Uganda 2016-2020

World Health Organization (WHO) (2015) C_WHO

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Nepal: National Communication Strategy for Maternal, Newborn and Child Health 2011-2016

Government of Nepal, Ministry of Health and Population (2011) C1

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La resistencia a los antimicrobianos y el marco de cooperación de las Naciones Unidas para el desarrollo sostenible: orientaciones para los equipos de las Naciones Unidas en los países
recommended

World Health Organisation (WHO) (2021) C_WHO

Organización Mundial de la Salud, Organización de las Naciones Unidas para la Alimentación y la Agricultura & Organización Mundial de Sanidad Animal. (‎2021)‎. La resistencia a los antimicrobianos y el marco de cooperación de las Naciones Unidas para el desarrollo sostenible: orientaciones ... more

National surgical, obstetric and anesthesia strategic plan (NSOASP) Year 2017-2021

Ministry of Health, Zambia (2017) CC

External Link

Patient-Planetary Health Co-benefit Prescribing: Emerging Considerations for Health Policy and Health Professional Practice

N. Redverse (2021) C1

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EU Drug Strategy

EU European Union (2022) CC

The Strategy aims to protect and improve the well-being of society and of the individual, to protect and promote public health, to offer a high level of security and well-being for the general public and to increase health literacy. The Strategy takes an evidence-based, integrated, balanced and ... more

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Analysis of the Situation of Children and Women in Bangladesh 2015

UNICEF (2015)

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Résistance aux antimicrobiens et plan-cadre de coopération des Nations Unies pour le développement durable : orientations pour les équipes de pays des Nations Unies

World Health Organisation (WHO) (2021) C_WHO

Organisation mondiale de la Santé, Organisation des Nations Unies pour l’alimentation et l’agriculture & Organisation mondiale de la santé animale. (‎2021)‎. Résistance aux antimicrobiens et plan-cadre de coopération des Nations Unies pour le développement durable : orientations pour le... more

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Evaluation of Community Management of Acute Malnutrition (CMAM): Nepal Country Case Study

UNICEF (2012)

La resistencia a los antimicrobianos y el marco de cooperación de las Naciones Unidas para el desarrollo sostenible: orientaciones para los equipos de las Naciones Unidas en los países recommended

La resistencia a los antimicrobianos y el marco de cooperación de las Naciones Unidas para el desarrollo sostenible: orientaciones para los equipos de las Naciones Unidas en los países
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