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 Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.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

World Health Organization WHO (2005) C_WHO

A manual for physicians and other senior health workers. This fourth revision of the manual reflects recent clinical experience and research findings in diarrhoea case management. Compared to earlier versions, it includes revised guidelines on the management of children with acute diarrhoea using th... more

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Sierra Leone Food and Nutrition Security Policy Implementation Plan 2012-2016

Government of Sierra Leone (2012) C1

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Uganda: The National Policy Guidelines and Service Standards for Reproductive Health Services

Reproductive Health Division Community Health Department Ministry of Health Uganda (2002)

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Strategy to respond to antimalarial drug resistance in Africa

World Health Organization WHO (2022) C_WHO

The Strategy to respond to antimalarial drug resistance in Africa is a technical and advocacy document, grounded in the best available evidence to date and aimed at minimizing the threat and impact of antimalarial drug resistance of Plasmodium falciparum parasites in Africa. Its objectives are to: i... more

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National Training on Antimalarial Pharmaceuticals Management Participants Manual

Federal Democratic Republic of Ethiopia -Ministry of Health Federal Democratic Republic of Ethiopia -Ministry of Health (2018) C1

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Expanding access to malaria diagnosis and treatment Region of the Americas

Pan American Health Organization PAHO; World Health Organization WHO (2024) C_WHO

The overall objective of this approach is to accelerate efforts toward malaria elimination by increasing access to early diagnosis and treatment. The specific objectives are to: Minimize the barriers that the population faces in accessing timely, quality diagnosis and treatment. Reduce the time bet... more

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Zimbabwe National Pharmacovigilance Policy Handbook, 2nd ed.

Medicines Control Authority of Zimbabwe (MCAZ) | Ministry of Health and Child Care (2016) C2

The Zimbabwe National Pharmacovigilance Policy Handbook, 2nd Edition updates the November 2013 version to indicate the Zimbabwe National Pharmacovigilance (PV) Centre’s compliance with the WHO Pharmacovigilance Indicators Handbook 2015.

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A Policy Guide for Implementing Essential Interventions for Reproductive, Maternal, Newborn and Child Health (RMNCH)

World Health Organization (2014)

The Compendium brings together for the first time key consensus-based policy recommendations and guidance to improve the delivery of proven interventions to women and children. The user-friendly format incorporates icons and tabs to present key health-related policies that support the delivery of es... more

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National Antiretroviral Treatment Guidelines Sierra Leone

Ministry of Health and Sanitation, Sierra Leone (2006) C1

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Community health worker models in South Africa: a qualitative study on policy implementation of the 2018/19 revised framework

Murphy, J.P.; A. Moolla, S. Kgowedi et al. Health Policy and Planning (2020) C1

South Africa has a long history of community health workers (CHWs). It has been a journey that has required balancing constrained resources and competing priorities. CHWs form a bridge between communities and healthcare service provision within health facilities and act as the cornerstone of South A... more

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Regional stakeholder meeting on the response to antimalarial drug resistance in Africa

World Health Organization WHO (2024) C_WHO

Meeting report, Kampala, Uganda, 7–8 November 2023

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Community deployment of intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine: a field guide

World Health Organization WHO (2024) C_WHO

The document outlines essential steps and provides guidance to countries on the adoption and deployment of c-IPTp so that it is integrated into the existing health system. It draws upon best practices and lessons learned from pilot implementation experiences in eight African countries and targets st... more

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Technical consultation to assess evidence on community-based delivery of intermittent preventive treatment in pregnancy for malaria

World Health Organization WHO (2023) C_WHO

Report of a virtual meeting 21–23 June 2022

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Namibia: Community - Based Health Care Policy

Ministry of Health and Social Services (MOHSS) (2007) C1

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Nigeria: National Guidelines for Paediatric HIV and AIDS Treatment and Care

Federal Ministry of Health, Nigeria (2010) C1

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Continuing malaria education modules: Module 1 Severe malaria—triage, diagnosis, and treatment

United States Agency for International Development USAID; U.S. President´s Malaria Initiative; Save the Children, et al. (2017) C1

The MalariaCare Toolkit. Tools for maintaining high-quality malaria case management services. Developed by MalariaCare, this module supports health supervisors in improving the management of severe malaria by providing focused, case-based learning and mentorship. It provides clinical supervisors w... more

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The Chagas disease study landscape: A systematic review of clinical and observational antiparasitic treatment studies to assess the potential for establishing an individual participant-level data plat

Maguire, B.J.; Dahal, P.; Rashan, S. et al. PLOS Neglected Tropical Diseases (2021) CC

PLoS Negl Trop Dis 15(8): e0009697. Chagas disease (CD), caused by the parasite Trypanosoma cruzi, affects ~6–7 million people worldwide. Significant limitations still exist in our understanding of CD. Harnessing individual participant data (IPD) from studies could support more in-depth analyses t... more