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 Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.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

Protecting Civilians from the Effects of Explosive Weapons - An Analysis of International Legal and Policy Standards

Brehm, M United Nations Institute for Disarmament Research (UNIDIR)ESEARCH (2012) C3

The use of explosive weapons, such as bombs, rockets, and mortar and artillery shells, in cities, towns and villages and in other populated areas has devastating humanitarian consequences. Explosive weapons act mainly through the projection of blast and fragmentation wi ... more

Impact of the COVID-19 pandemic on blood supply and demand in the WHO African Region

Loua, A.; et al. (2021) C_WHO

VOX Sanguinis, 2021: The coronavirus disease 2019 (COVID-19) affected millions of people worldwide and caused disruptions at the global level including in healthcare provision. Countries of the WHO African region have put in place measures for the COVID-19 pandemic containment that may adversely a ... more

ECDC/EFSA/EMA second joint report on the integratedanalysis of the consumption of antimicrobial agents andoccurrence of antimicrobial resistance in bacteria fromhumans and food-producing animals

European Centre for Disease Prevention and Control (ECDC), European Food Safety Authority (EFSA) andEuropean Medicines Agency (EMA) (2017) C_CDC

The second ECDC/EFSA/EMA joint report on the integrated analysis of antimicrobial consumption (AMC) and antimicrobial resistance (AMR) in bacteria from humans and food-producing animals addressed data obtained by the Agencies’ EU-wide surveillance networks for 2013–2015. AMC in both sectors, exp ... more

Health Care Facilities Resilient to Climate Change Impacts

Paterson, J.; P. Berry, K. Ebi and L. Varangu (2014) CC

nt. J. Environ. Res. Public Health 2014, 11(12), 13097-13116; https://doi.org/10.3390/ijerph111213097 Climate change will increase the frequency and magnitude of extreme weather events and create risks that will impact health care facilities. Health care facilities will need to assess climate chang ... more

The World Medcines situation 2011 Rational use of Medicines

World Health Organization WHO (2011) C_WHO

Millennium Development Goal 8E aims for affordable access to essential medicines. Essential medicines, as defined by WHO, are those that “satisfy the health-care needs of the majority of the population” and that should therefore “be available at all times in adequate amounts”. However, there ... more

The impact of residual infections on Anopheles-transmitted Wuchereria bancrofti after multiple rounds of mass drug administration

D. K. de Souza; Ansumana, R.; Sessay, S.; Parasites & Vectors (2015) CC

Many countries have made significant progress in the implementation of World Health Organization recommended preventive chemotherapy strategy, to eliminate lymphatic filariasis (LF). However, pertinent challenges such as the existence of areas of residual infections in disease endemic districts pose ... more

Malacological survey to identify transmission sites for intestinal schistosomiasis on Ijinga Island, Mwanza, north-western Tanzania

Fuss, A.; H. D. Mazigo and A. Mueller (2020) CC

Acta Trop. 2020 Mar:203:105289. doi: 10.1016/j.actatropica.2019.105289 The role of malacological surveys to identify potential transmission sites for schistosomiasis control in this era of mass drug administration have received little attention. In that context, the present ... more

Cartagena Declaration on Refugees for Latin America

Colloquium on the International Protection of Refugees (1984) CC2

The Cartagena Declaration on Refugees was adopted by the Colloquium on the International Protection of Refugees in Central America, Mexico and Panama on November 22, 1984. The declaration is a non-binding agreement but has been incorporated in refugee law in various countries. The Cartagena Declarat ... more

Lesotho Nursing Task Analysis Report

Stender, Stacie; Christensen, Alice et al. (2013) C1

Lesotho’s predominantly rural population faces significant health challenges within a setting of inadequate human resources for health. It is essential that nurses and nurse-midwives, who together make up the largest health workforce in the country, be adequately prepared to address Lesotho’s He ... more

Prevalence of Schistosoma mansoni, soil-transmitted helminths and intestinal protozoa in orphans and street children in Mwanza city, Northern Tanzania

Franz, A.; A. Fuss, H.D. Mazigo, (2023) CC

Infection 2023 Oct;51(5):1399-1406. doi: 10.1007/s15010-023-01999-9. Epub 2023 Feb 20. The results indicate a significantly higher rate of infections with S. mansoni in street children compared with orphans. This might be explained by the lack of access to adequate sanitation for street children ... more

Epidemiologic and clinical investigations during a chikungunya outbreak in Rio Grande do Norte State, Brazil

Monteiro , J.D.; J. Gardel Valverde , I. Camara Morais (2020) CC

PLOS One November 20, 2020 https://doi.org/10.1371/journal.pone.0241799 . The first autochthonous case of chikungunya virus (CHIKV) infection in Brazil was in September 2014 in the State of Amapá, and from there it rapidly spread across the country. The present ... more

Barriers and determinants of asthma control in children and adolescents in Africa: a systematic review

Mphahlele, R.E.; Kitchin, O.; Masekela, R. BMJ Open (2021) CC

The article "Barriers and determinants of asthma control in children and adolescents in Africa: a systematic review" analyzes factors contributing to poor asthma control in African youth. Based on studies conducted between 2014 and 2019 in Nigeria, Uganda, and South Africa, the review identifies key ... more

Health workforce development and retention in Guinea: a policy analysis post-Ebola

van de Pas R., Kolie D., Delamou A., Van Damme W. BMC - Biomed Central (2019) CC

The state of the Guinean health workforce is one of the country’s bottlenecks in advancing health outcomes. The impact of the 2014–2015 Ebola virus disease outbreak and resulting international attention has provided a policy window to invest in the workforce and reform the health system. This re ... more

Maternal and Newborn Health in Urban India: A Monograph based on Literature Review Exercise

Save the Children (2016) C2

India contributes to 16% of the global maternal deaths and around 27% of global newborn deaths. Reducing the burden of maternal and newborn mortality and morbidity in urban poor settings today requires an expansion of effective Maternal and Newborn Health (MNH) care services and lowering the barrier ... more

Qualitative assessment of community health workers’ perspective on their motivation in community-based primary health care in rural Malawi

Ndambo, M.K.; Munyaneza, F.; Aron, M.B. et al. BMC Health Services Research (2022) CC

Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based primary health care through screening, treatment, referral, psychosocial support, and accompaniment. With a broad scope of work, CHW programs must balance the breadth and depth of tasks to mainta ... in CHW motivation for high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to enhance their programmatic activities. Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose. Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal- lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi- tive work environment through supportive relationships between CHWs and supervisors enables the CHWs. Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec- tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance, manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha- sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided to the patients and communities, along with building supportive systems to recognize the work done by CHWs for the primary health care systems. more

Detection of Schistosoma mansoni DNA using polymerase chain reaction from serum and dried blood spot card samples of an adult population in North-western Tanzania

Fuss, A.; H. D. Mazigo and A. Mueller (2021) CC

Infect Dis Poverty (2021) 10:15. Real-time polymerase chain reaction (PCR) is a sensitive and specific method for diagnosing schistoso- miasis. However, this method should be performed in a laboratory, usually located distant from the sample collection site. Therefore, it is important to have fas ... more

The failure of community-based health insurance schemes in Tanzania: opening the black box of the implementation process

Kigume, R.; Maluka, S. (2021) CC2

Globally, there is increased advocacy for community-based health insurance (CBHI) schemes. Like other low and middle-income countries (LMICs), Tanzania officially established the Community Health Fund (CHF) in 2001 for rural areas; and Tiba Kwa Kadi (TIKA) for urban population since 2009. This ... more

Economic Evaluation of Community Based Practitioners In Low-And Middle-Income Countries - A literature review, country case studies and a generalized cost-effectiveness model

global health workforce alliance World Health Organization (2015) C_WHO

Community-based strategies play a significant role in many health systems in low- and middle-income countries, especially in light of critical shortages in the health workforce. The term community health worker has been used to refer to volunteers and salaried, professional or lay health workers wit ... more

Challenges in the diagnosis of asthma in children, what are the solutions? A scoping review of 3 countries in sub Saharan Africa

Magwenzi, P.; Rusakaniko, S.; Sibanda, E.N. et al. Respiratory Research (2022) CC

The article is a scoping review that explores the challenges in diagnosing asthma in children in three sub-Saharan African countries: Nigeria, South Africa, and Uganda. It identifies key barriers, such as a lack of community awareness, inadequate healthcare access, limited diagnostic tools like spir ... more