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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 Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.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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Preventing injuries and violence: an overview

World Health Organisation (WHO) (2022) C_WHO

This brief advocacy document highlights the burden, risks and prevention of injuries and violence, which took the lives of 4.4 million people in 2019 and constitute 8% of all deaths. Among the injury-related causes of death include road traffic crashes, drowning, falls, burns, poisoning and violence... more

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Guidelines for diagnosing, preventing and managing cryptococcal disease among adults, adolescents and children living with HIV
recommended

World Health Organization (WHO) (2022) C_WHO

Cryptococcal disease is one of the most common opportunistic infections among people living with advanced HIV disease and is a major contributor to severe illness, morbidity, and mortality, particularly in sub-Saharan Africa. These guidelines update the recommendations that were first released i... more

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Africa’s Health Financing in a New Era

Africa Centres for Disease Control and Prevention (Africa CDC) (2025) CC

Africa’s health sector is facing an unprecedented financing crisis, driven by a sharp decline of 70% in Official Development Assistance (ODA) from 2021 to 2025 and deep-rooted structural vulnerabilities. This collapse is placing immense pressure on Africa’s already fragile health systems as ODA ...is seen as the backbone of critical health programs: pandemic preparedness, maternal and child health services, disease control programs are all at risk, threatening Sustainable Development Goal 3 and Universal Health Coverage. Compounding this is Africa’s spiraling debt, with countries expected to service USD 81 billion by 2025—surpassing anticipated external financing inflows—further eroding fiscal space for health investments. Level of domestic resources is low. TThe Abuja Declaration of 2001, a pivotal commitment made by African Union (AU) member states, aimed to reverse this trend by pledging to allocate at least 15% of national budgets to the health sector. However, more than two decades later, only three countries—Rwanda, Botswana, and Cabo Verde—have consistently met or exceeded this target (WHO, 2023). In contrast, over 30 AU member states remain well below the 10% benchmark, with some allocating as little as 5–7% of their national budgets to health. In addition, only 16 (29%) of African countries currently have updated versions of National Health Development Plan (NHDP) supported by a National Health Financing Plan (NHFP). These two documents play a critical role in driving internal resource mobilisation. At the same time, public health emergencies are surging, rising 41%—from 152 in 2022 to 213 in 2024—exposing severe under-resourcing of health infrastructure and workforce. Recurring outbreaks (Mpox, Ebola, cholera, measles, Marburg…) alongside effects of climate change and humanitarian crises in Eastern DRC, the Sahel, and Sudan, are overwhelming systems stretched by chronic underfunding. The situation is worsened by Africa’s heavy dependency with over 90% of vaccines, medicines, and diagnostics being externally sourced—leaving countries vulnerable to global supply chain shocks. Health worker shortages persist, with only 2.3 professionals per 1,000 people (below the WHO’s recommended 4.45), and fewer than 30% of systems are digitized, undermining disease surveillance and early warning. Without decisive action, Africa CDC projects the continent could reverse two decades of health progress, face 2 to 4 million additional preventable deaths annually, and a heightened risk of a pandemic emerging from within. Furthermore, 39 million more Africans could be pushed into poverty by 2030 due to intertwined health and economic shocks. This is not just a sectoral crisis—it is an existential threat to Africa’s political, social, and economic resilience, and global stability. In response, African leaders, under Africa CDC’s stewardship, are advancing a comprehensive three-pillar strategy centered on domestic resource mobilization, innovative financing, and blended finance. more

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Kangaroo mother care: a transformative innovation in health care

World Health Organisation (WHO) (2023) C_WHO

This document puts forward the joint position and vision of an expert, global, multistakeholder working group on implementing Kangaroo Mother Care (KMC) for all preterm or low birth weight (LBW) infants as the foundation for small and/or sick newborn care within maternal, newborn, and child health p... more

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How to support survivors of gender-based violence when a GBV actor is not available in your area

Inter-Agency Standing Committee (2023) CC

KEY MESSAGES Always talk to a GBV specialist first to understand what GBV services are available in your area. Some services may take the form of hotlines, a mobile app or other remote support. Be aware of any other available services in your area. Identify services provided by humanitarian pa...rtners such as health, psychosocial support, shelter and non-food items. Consider services provided by communities such as mosques/ churches, women’s groups and Disability Service Organizations. Remember your role. Provide a listening ear, free of judgment. Provide accurate, up-to-date information on available services. Let the survivor make their own choices. Know what you can and cannot manage. Even without a GBV actor in your area, there may be other partners, such as a child protection or mental health specialist, who can support survivors that require additional attention and support. Ask the survivor for permission before connecting them to anyone else. Do not force the survivor if s/he says no. Do not proactively identify or seek out GBV survivors. Be available in case someone asks for support. Remember your mandate. All humanitarian practitioners are mandated to provide non-judgmental and non-discriminatory support to people in need regardless of: gender, sexual orientation, gender identity, marital status, disability status, age, ethnicity/tribe/race/religion, who perpetrated/committed violence, and the situation in which violence was committed. Use a survivor-centered approach by practicing: Respect: all actions you take are guided by respect for the survivor’s choices, wishes, rights and dignity. Safety: the safety of the survivor is the number one priority. Confidentiality: people have the right to choose to whom they will or will not tell their story. Maintaining confidentiality means not sharing any information to anyone. Non-discrimination: providing equal and fair treatment to anyone in need of support. If health services exist, always provide information on what is available. Share what you know, and most importantly explain what you do not. Let the survivor decide if s/he wants to access them. Receiving quality medical care within 72 hours can prevent transmission of sexually transmitted infections (STIs), and within 120 hours can prevent unwanted pregnancy. Provide the opportunity for people with disabilities to communicate to you without the presence of their caregiver, if wished and does not endanger or create tension in that relationship. If a man or boy is raped it does not mean he is gay or bisexual. Gender-based violence is based on power, not someone’s sexuality. Sexual and gender minorities are often at increased risk of harm and violence due to their sexual orientation and/or gender identity. Actively listen and seek to support all survivors. Anyone can commit an act of gender-based violence including a spouse, intimate partner, family member, caregiver, in-law, stranger, parent or someone who is exchanging money or goods for a sexual act. Anyone can be a survivor of gender-based violence – this includes, but isn’t limited to, people who are married, elderly individuals or people who engage in sex work. Protect the identity and safety of a survivor. Do not write down, take pictures or verbally share any personal/identifying information about a survivor or their experience, including with your supervisor. Put phones and computers away to avoid concern that a survivor’s voice is being recorded. Personal/identifying information includes the survivor’s name, perpetrator(s) name, date of birth, registration number, home address, work address, location where their children go to school, the exact time and place the incident took place etc. Share general, non-identifying information To your team or sector partners in an effort to make your program safer. To your support network when seeking self-care and encouragement. more

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First, Do No Harm - Examining the impact of the IFC’s support to private healthcare in India

Anjela Taneja and Amitabha Sarkar Oxfam International (2023) CC

This report examines the support to private healthcare provision in India by the World Bank’s private sector arm, the International Finance Corporation (IFC). Despite supporting private healthcare in the country since 1997, no healthcare results for lending and investments have been disclosed sinc... more

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Recommendations for Establishing a National Maternal Near-miss Surveillance System in Latin America and the Caribbean

Pan American Health Organization (PAHO) (2022) C_WHO

Maternal mortality has fallen significantly in recent years, especially in countries that have emphasized the prevention of its main causes, such as hemorrhagic and infectious complications and hypertension , including in the Region of the Americas. In its final report on the Plan of Action to Accel... more

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Guidelines for grading pharmacy professionals in Rwanda

National Pharmacy Council (NPC) (2017) C2

Grading of Pharmacy professionals emanated from the fact that there was no proper grading system for Health Professionals in place. Designating the Grading Criteria based on internationally acceptable standards, the National Pharmacy Council through its Education, Research and CPD committee initiate... more

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Ukraine: Equivalence between medicines registered in Ukraine and other countries. Information for healthcare professionals and patients

Advancing pharmacy worldwide (2022) C2

Ukrainian Title: УКРАЇНА: Еквівалентність лікарських засобів, зареєстрованих в Україні та інших країнах. Інформація для працівників охорони здоров'я та пацієнтів To support t... more

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Survey on human resource capacity in public health - Supply chain management in Burkina Faso

Bioforce Development Institute – Burkina Faso Country Survey (2011) C2

This survey is part of a series of eight country surveys conducted in the context of the People that Deliver Initiative (peoplethatdeliver.org). This global initiative, which brings together the world’s largest organizations, aims to improve health services performance through the professionalizat... more

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Law establishing the Rwanda Allied Health Professions Council and determining its organisation, functioning and competence

Government of Rwanda (2013) C2

N°46/2012 of 14/01/2013 - Official Gazette n° Special of 17/01/2013 - LAW No 45/2012 OF 14/01/2013 ON ORGANISATION, FUNCTIONING AND COMPETENCE OF THE COUNCIL OF PHARMACISTS

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Ghana: GUIDELINES FOR SAFETY MONITORING OF MEDICINAL PRODUCTS

Food and Drug Authority (FDA), Ghana (2016) C2

Document No. : FDA/SMC/SMD/GL-SMP/2015/05 | These guidelines are for information, guidance and strict compliance by Marketing Authorization Holders and Local Representatives of regulated products to help in the continuous safety monitoring of products granted marketing authorization in Ghana.

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In Control - A Practical Guide for Civilian Experts Working in Crisis Management Missions

Center for International Peace Operations (2016) CC

Hands-on information and practical advice for everyday life and work in the field as well as background information on crisis management structures in international organizations lie at the heart of the new handbook. It has been developed in the realm of Europe’s New Training Initiative for Civili... more

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Nigeria: Essential Medicines List

Federal Ministry of Health, Nigeria (2016) C2

6th edition, 2010. | Published in collaboration with World Health Organisation and Clinton Health Access Initiative.

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WHO Technical specifications of Neonatal Resuscitation Devices

World Health Organization WHO (2016) CC

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Ethiopian Medicines Formulary
recommended

Food, Medicine and Health care Administration and Control Authority of Ethiopia (FMHACA) (2013) C1

2nd edition

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List of Medicines for Rural Drug Vendor, Ethiopia (LMRDV)

Food, Medicine and Health care Administration and Control Authority of Ethiopia (FMHACA) (2011) C1

Fourth edition

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Over-the-Counter Medicines List for Ethiopia

Food, Medicine and Health care Administration and Control Authority of Ethiopia (FMHACA) (2012) C1

2nd edition

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List of Medicines for Community Pharmacy, Ethiopia (LMCP)

Food, Medicine and Health care Administration and Control Authority of Ethiopia (FMHACA) (2012) C1

Fourth Edition

Guidelines for diagnosing, preventing and managing cryptococcal disease among adults, adolescents and children living with HIV recommended

Ethiopian Medicines Formulary recommended

Guidelines for diagnosing, preventing and managing cryptococcal disease among adults, adolescents and children living with HIV
recommended

Ethiopian Medicines Formulary
recommended