National Action Plan Research Articles

National action on antimicrobial resistance and the political economy of health care

ABSTRACT Antimicrobial Resistance (AMR) is one of the biggest threats to human health in the twenty-first century. A key dimension of global governance in this domain consists of encouraging governments to create national action plans (NAPs) aimed at improving awareness of AMR, improving knowledge through surveillance and research, reducing infection, optimising the use of antimicrobial medicines, and investing in new drugs, vaccines and other interventions. The adoption and implementation of NAPs occur in the context of great political and institutional diversity across countries, and this article examines the consequences of different ways of financing health care. We expect the implementation of NAPs to be more successful in optimising antibiotics use when governments play a larger role in financing health care compared to private expenditure. An analysis of patterns of antibiotic consumption in 191 countries between 2000 and 2018 supports the hypothesis.

Climate-Induced Migration: Conflict Resolution and Legal Efforts in Pacific, Africa, and South Asia

Climate-induced migration involves people relocating caused by detrimental climate changes affecting their living environment. Pacific, Africa, and South Asia have experienced climate-induced migration resulting from extreme weather events, sea level rise, drought and desertification, and temperature extremes. The purpose of this research is to find out in terms of conflict resolution, what legal efforts have been made by the government of the affected regions to address climate-induced migration. This study uses descriptive qualitative method and case studies. Based on the results obtained from the data, it was found that the affected governments are pursuing various legal efforts to be able to tackle climate-induced migration. Several efforts made, namely “Migration with Dignity” policy, the Pacific Adaptation to Climate Change (PACC) Project, Great Green Wall initiative, the African Union’s Regional Economic Communities (RECs), Bangladesh’s Climate Change Strategy and Action Plan (BCCSAP), the South Asian Association for Regional Cooperation (SAARC) Disaster Management Centre, and India’s National Action Plan on Climate Change (NAPCC). The regional initiatives mentioned earlier play pivotal roles in implementing these frameworks and fostering collaborative endeavors, whilst the innovative legal frameworks, guided by SMART (Specific, Measurable, Achievable, Relevant, and Time-bound) indicators, ensure that climate-induced migration is addressed effectively. To sum up, dealing with climate-induced migration requires a holistic approach involving regional collaboration and innovative legal frameworks.

Opinions of Teachers on Virtual Education Process of Primary School Students with Disabilities Continuing Inclusive Education

With the occurrence of the COVID-19 pandemic in the world in 2019, human life has moved to a different dimension. Accordingly, the education process was carried out remotely in Turkey as well as in the rest of the world. Virtual education was not a new concept for societies, but conducting the entire education process remotely was a very different practice and this practice brought many problems with it. In this context, this study aims to determine the opinions of teachers after the pandemic regarding the virtual education process of primary school students with disabilities who continue inclusive education settings. For this purpose, qualitative research was conducted and data were collected by conducting semi-structured individual interviews with 10 primary school teachers who have students with disabilities in their class. The data were analyzed by content analysis. Research results revealed that teachers did not have any problems in involving students with disabilities who were supported by their parents and who did not have any infrastructure problems in terms of technical equipment, but they have problems in including some children in virtual education. Teachers had difficulty in following the education of students with disabilities during the virtual education process implemented during the COVID-19 pandemic. As a result, it is a very important issue that our national action plans are ready for the education process of students with disabilities, especially for situations such as pandemics and natural disasters that have recently occurred in our country.

A Systematic Review of Antibiotic Use in Humans in Nigeria and Its Potential Contribution to Rising Antimicrobial Resistance

INTRODUCTION: The value of medicines is lost when these resources are not used rationally. Out of 12 developing countries, Nigeria has the third highest percentage of antibiotic prescriptions, at 48%. Antibiotic misuse results in limited efficacy, which can lead to the emergence of antimicrobial resistance. We conducted a systematic review to synthesise the evidence on antibiotic use in humans in Nigeria. METHODS: We conducted a systematic review of medicine use behaviour by patients and prescription behaviour by health workers, which were searched for in articles published in English from 2000 to 2017. Data was entered into purpose-built templates. Key quantitative indicators were extracted and summarised as frequencies and proportions, while free-text responses were synthesised. RESULTS: The systematic review determined that the median prevalence of persons using antibiotics without prescription is 46.7%. The drivers of irrational antibiotic use included poor regulation of medicines and premises, a chaotic medicine distribution system, limited licensed medicine prescribers, over-the-counter (OTC) sales of antibiotics, patients’ demand for antibiotics, and access to health insurance. DISCUSSION: Irrational antibiotic use is widespread in humans and animals. We recommend that the government enforce regulations on antibiotic sales to humans and animals and increase awareness of irrational antibiotic use and AMR in Nigerian communities through a whole-of-society approach. The collated information was used to develop a National Action Plan on AMR in 2017.

Surveillance of Antimicrobial Resistance in the ECOWAS Region: Setting the Scene for Critical Interventions Needed.

Antimicrobial resistance poses a significant challenge to public health globally, leading to increased morbidity and mortality. AMR surveillance involves the systematic collection, analysis, and interpretation of data on the occurrence and distribution of AMR in humans, animals, and the environment for action. The West African Health Organization, part of the Economic Community of West African States (ECOWAS), is committed to addressing AMR in the region. This paper examines the status of AMR surveillance in ECOWAS countries using available WHO data from the TrACSS survey and GLASS enrollments. The analysis reveals that while progress has been made, significant challenges remain. Twelve of the fifteen ECOWAS countries are enrolled in GLASS, and ten have developed national action plans (NAPs) for AMR. However, there is a need to ensure all countries fully implement their NAPs, continue reporting to GLASS, and use the data for evidence-based actions and decision making. Surveillance systems for AMR and antimicrobial consumption/use vary across countries with some demonstrating limited capacity. All countries, except Cabo Verde, reported having a reference laboratory for AMR testing. Strengthening laboratory capabilities, data management and use, and multisectoral coordination are crucial for effective AMR surveillance and response. Based on the findings and the regional context, it is essential to prioritize capacity building, data utilization, and the adoption of standardized guidelines for AMR surveillance. Collaboration among ECOWAS countries, the WAHO, and international partners is essential to address AMR comprehensively. Ensuring a consistent supply of essential antimicrobial medications and reagents is vital.

Introducing the UK Antimicrobial Registry (UKAR) study: providing real world data on new antimicrobials to support antimicrobial stewardship and tackle antimicrobial resistance.

The UK Antimicrobial Registry (UKAR) has been developed to capture data on real world usage of antimicrobial agents with an initial focus on those used to treat drug-resistant infections. Several industry partners have committed support for the study, which is included in the National Institute for Health and Care Research (NIHR) portfolio in England with similar arrangements in the three devolved UK nations. The two antimicrobials in the National Institute for Health and Care Excellence (NICE) subscription model pilot (cefiderocol and ceftazidime/avibactam) are included in the UKAR and future expansion of work in this area is planned. This model decouples payment from usage by using a fixed annual fee. The study will provide information on the characteristics of patients receiving study drugs, the infections being treated, treatment effectiveness and adverse events. UKAR potentially provides a novel resource of enduring value to support healthcare in the UK and more widely and contribute to AMR National Action Plan goals for optimal use of antimicrobials.

Perdagangan Manusia Lintas Negara di indonesia

Human trafficking is a very serious problem in Indonesia even though the country has endorsed and disciplined the National Action Plan and to form a notion of duty to stop this crime. The phenomenon of human trafficking has become a social fact besides the economic crisis and natural disasters. The low level of education, the limited employment, free relations and acts of harmony in a family are some of the factors causing human trade. Because human trafficking involves an international criminal network, with the participation of all stakeholders through a systematic approach and strengthening the network is a must in preventing and eradicating this. In providing granting legal protection to victims of trafficking in persons, especially restitution issues have been regulated in Article 48 to Article 50 of Law Number 21 Year 2007, also regulated in Article 35 of Law Number 26 of 2000 concerning the Human Rights Court regulates the protection of human rights for human welfare. According to the 1999 Law on Human Rights, as stated in Article 1 states that human rights (HAM) is a set of rights inherent in the nature and existence of humans as almighty gods and is a gift that must be respected, highly respected, and protected by the state, law, government, and everyone for the sake of honor and protection of human dignity.

Overlapping Areas Used for Artisanal Fishing and Populations of Franciscana Dolphin (Pontoporia blainvillei) in the Southwest Atlantic Ocean

This study identified the overlap between artisanal fishing areas and the Franciscana dolphin (Pontoporia blainvillei) in the Southwest Atlantic Ocean (SWAO), Brazil, to identify areas where the species was incidentally captured from the perception of artisanal fishers. Using a semistructured questionnaire, ethnographic interviews (n = 330) were carried out from 2012 to 2018 with fishers from ten communities in southeastern (ES and RJ) and southern (PR) Brazil. After the interviews, the fishers presented their fishing routes, locations and areas of incidental capture and occurrence of the Franciscana dolphin. Ninety-five fishers (29%) identified the species: 23 in northern ES, 1 in southern ES, 20 in northern RJ, and 51 in the PR. Among the 235 fishers who could not identify the species, approximately half worked in the distribution gaps. The areas of occurrence noted by the fishers coincided with those described in the “National Action Plan for the Conservation of the Toninha,” an official document from the Brazilian Government and scientific literature. The results indicate that the information provided by fishers is useful for understanding the distribution of the Franciscana dolphin and can be used in the development of management strategies to mitigate the incidental capture of the species.

Long-term effect of intravenous antimicrobial use in a pharmacist-led ASP at a small Japanese acute care hospital

Background: Antimicrobial resistance (AMR) remains a crucial, healthcare issue for which many countries have devised a national action plan. In Japan as well, antimicrobial stewardship programs (ASP) are being implemented in acute care hospitals under this policy framework. Clinical pharmacists play a central role in ASP, often jointly with infectious disease (ID) physicians. However, in Japan, a shortage of ID physicians has resulted in some ASP being led solely by pharmacists. While reports of the short-term effects of this situation are emerging, the long-term impact of pharmacist-led ASP is still largely unknown in Japan. The present study retrospectively examined the long-term effects of pharmacist-led ASP in a small, Japanese, acute care hospital. Method: The present study examined a pharmacist-led ASP in an acute care hospital (287 beds) in Japan which was launched in August 2015 and assessed the duration of therapy per 1000 patient-days (DOT) as the primary outcome by comparing the pre-intervention period (April 2013-July 2015) with the intervention period (August 2015-March 2023) using linear regression analysis. Additionally, segmented time-series analysis was conducted for each, additional intervention, and the impact of reduced activity due to the coronavirus disease 2019 (COVID-19) pandemic during the intervention. The DOT at the study center were compared with the national average of facilities implementing ASP. Result: While the DOT for all intravenous antimicrobials showed a slight increase on linear regression (r=0.01; P=0.1), the DOT of antipseudomonal intravenous antimicrobials significantly decreased (r=-0.027; P < 0 .01). Moreover, a significant reduction in DOT was observed immediately after the initiation of prospective review and feedback for carbapenems and daily prospective review and feedback for all intravenous antimicrobials (-3.2 and -2.4; P < 0 .001 for the intercept). An increase in DOT was observed during the COVID-19 pandemic-related reduction in activity time, and a rapid decline was observed upon the resumption of activities. Conversely, the average, nationwide DOT significantly increased for all intravenous antimicrobials as well as for antipseudomonal intravenous antimicrobials (r=0.02 and r=0.004; P < 0 .01) Conclusion: Sustaining an effective, pharmacist-led antimicrobial stewardship program led to a continual decrease in the DOT of antipseudomonal intravenous antimicrobials in a small, Japanese, acute care hospital despite a nationwide increase in their use following implementation of the national AMR action plan. Detailed analysis of pharmacists’ activities across multiple facilities is necessary to verify these effects.

Waterbird diversity of Saman Wetland Complex in Uttar Pradesh: a crucial site for the India’s National Action Plan on migratory birds

The Saman Wetland Complex is formed by five major wetlands present in Etawah and Mainpuri districts of Uttar Pradesh. The habitat is majorly a wetland system with scrub vegetation along the edges and surrounded by agricultural fields; attracting a diverse group of bird species. These wetlands are an ideal habitat for Sarus Crane and are also Important Bird Areas. In the past two decades, the anthropogenic activities have deteriorated the habitat and wetlands no longer support the earlier congregation of birds. The study conducted during 2020–2021 provides baseline information on the present status of the Saman wetland complex, waterbird diversity, threats faced by the wetlands & waterbirds, and suggests future management/ conservation strategies.

Implementation of One Health Approach in Tanzania: Strengths and Challenges

Abstract One Health (OH) approach has recently been defined by the OH High-Level Expert Panel (OHHLEP) as an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals, and ecosystems. Under the Prime Minister’s Office (PMO), the OH section (OHS) is responsible for OH implementation. The OHS task is to bring together multiple sectors and disciplines to work together with clear OH approach coordination in the country. Following the recent revision of the OH strategic plan (2022–2027), the OHS is now eligible to receive funding from the government. In addition, through OHS, Tanzania has supporting documents for OH, including the National Action Plan for Antimicrobial Resistance, the prioritized list of zoonotic diseases, and strategic prevention and control plans. Despite these developments in OH in Tanzania, the Capacitating One Health in Eastern and Southern Africa (COHESA) project helped identify the challenges and gaps that Tanzania faces in OH implementation. A baseline assessment study was conducted in four settings: Desktop Review, Focus Group Discussion (FGD), Key Informants Interview (KII), and OH net mapping. Results showed that the country’s OH challenges include a lack of OH resources, OH education inclusiveness, and OH awareness at the subnational level. There are limited suitable OH monitoring mechanisms to assess the progress of the OH approach in Tanzania. Thus, COHESA supports the country in addressing these challenges to improve at all levels of OH sectoral performance in the context of OH governance, education, and implementation. Information © The Authors 2024

Prevention policies for the marine ecological environment in the South China Sea as a consequence of excessive plastic compound use in Vietnam.

Vietnam suffers from a distressing predicament: It ranks among the most heavily contaminated nations on earth. Its coastal and marine domains are plagued by an excess of plastic waste. Vietnam has consistently discharged a substantial amount of waste into the oceans, ranging from 0.28 to 0.73 million metric tons annually. Numerous areas have emerged as focal points of plastic pollution throughout its extensive seashore and marine areas. The escalating presence of marine litter poses an increasingly grave threat to the intricate equilibrium of Vietnam's marine ecosystems. This comprehensive policy study reveals that the mounting problem of ocean plastic pollution, characterized by the abundance of floating plastic debris, imperils both plant and animal life, placing various marine species such as seabirds, fish, turtles, and cetaceans at risk. The consumption of minuscule plastic particles and the harmful impact of chemical pollutants from plastic waste in the ocean not only endangers the vitality of marine life but also poses a substantial hazard to human well-being because plastic waste infiltrates the food chain. This research reveals that, despite the existence of numerous laws and policies-including the Law on Environmental Protection 2020, the Marine Plastic Waste Management Initiative for the Fisheries Sector 2020-2030, and the National Action Plan for Management of Marine Plastic Litter-a significant amount of plastic waste is infiltrating the river network and eventually infiltrating oceans as a result of improper monitoring and ineffective enforcement of these legislations. Relying primarily on existing data released by the government and other sources and a wide range of gray literature retrieved from reputable databases, this study aims to evaluate the role of Vietnam's legal framework for combating the critical issue of marine plastic pollution in the South China Sea. Integr Environ Assess Manag 2024;20:2088-2106. © 2024 SETAC.

National action plan on antimicrobial resistance in India: A call to action

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Status on management of access to genetic resources, traditional knowledge and benefit sharing

The management of access to genetic resources, traditional knowledge (TK), and benefit sharing among indigenous people and local communities in the worldwide is extensively addressed in international legal instruments, including the Convention on Biological Diversity (CBD) and its Nagoya Protocol on Access to Genetic Resources and the Fair and Equitable Sharing of Benefits (ABS) Arising from their Utilization. The CBD aims to promote the conservation of biological resources, the sustainable use of biodiversity components and the equitable, fair sharing of benefits arising from the use of genetic resources. The Nagoya Protocol sets out core obligations for its contracting Parties to take measures in relation to ABS and compliance. In 2021, the Secretariats of the CBD released the first draft of the Post-2020 Global Biodiversity Framework with the mission for the period up to 2030, aiming towards the 2050 vision: “To take urgent action across society to conserve and sustainably use biodiversity and ensure the fair and equitable sharing of benefits from the use of genetics resources, to put biodiversity on a path to recovery by 2030 for the benefit of planet and people.” Therefore, capacity building and development for the implementation of the Nagoya Protocol are crucial, especially for developing countries. One of the most commonly identified new capacity building needs is digital sequence information on genetic resources and their roles in ABS. As a member of the CBD and the Nagoya Protocol, Vietnam has obligations to develop the National Strategy Framework on Biodiversity to 2030, with a vision to 2050, consistent with the requirements of the Post-2020 Global Biodiversity Framework, Protocols, and relevant Agreements. This includes developing recommendations on management of access to genetic resources and TK, as well as benefit sharing within the Draft of the National Biodiversity Strategy and Action Plan. This research aims to contribute to implement the Post-2020 Global Biodiversity Framework and the Nagoya Protocol in Vietnam by assessing the status of management regarding access to genetic resources, TK, and benefit sharing.

National action plan of Pakistan: where does the epilepsy surgery fall?

National action plan of Pakistan: where does the epilepsy surgery fall?

Dental antibiotic policies, stewardship, and implementation in India: A policy document analysis.

Dental antibiotic stewardship is crucial in low- and middle-income countries where the burden of antimicrobial resistance (AMR) is high and antibiotic misuse is common. Given that India is the most populous country, the largest antibiotic consumer and has a large dental prescriber population, this study investigated the extent to which current Indian policy and practice for dental antibiotic prescribing and stewardship aligns with the global policy and best practice. The READ approach was used to identify and extract data and synthesize the findings. Policy documents on dental antimicrobial stewardship were identified using a systematic search strategy involving nine medical and grey literature databases (Medline, Global Health, Web of Science, Cochrane, CINAHL, Eldis, Global Index Medicus, Proquest and Opengrey), targeted websites (government organizations and dental regulatory bodies) and contact with experts. Framework analysis was used to code extracted data into themes related to dental antimicrobial stewardship. Of the 3039 records screened, 25 documents were included in the final analysis. The analysis showed a lack of guidelines or toolkits for appropriate antibiotic prescribing in dentistry in India. The treatment guidelines for antimicrobial use in common syndromes published by the Indian Council of Medical Research had no section or content for dental practitioners. Furthermore, the undergraduate dental curriculum developed by the Dental Council of India (DCI), included little content on appropriate antibiotic prescribing and no mention of AMR or stewardship. There were no educational resources either for dental practitioners or patients in the documents. This document analysis showed that there was little or no mention of dental antibiotic prescribing guidelines in key policy documents such as the National Action Plan on AMR. In addition, contradictory and subjective information provided in some policy documents could encourage dentists and other health professionals such as general practitioners to prescribe antibiotics for common dental conditions for which they are contra-indicated. There is an urgent need to develop relevant guidelines and include these in Indian policy documents on AMR particularly the National Action Plan on AMR.

Unleashing India's Solar Potential: A Review of the National Solar Mission and the Path to Sustainable Energy in India

India possesses vast potential for generating clean energy from Renewable Energy Sources (RES), specifically hydro, wind, and solar. This potential has been appropriately recognized, indicating India's commitment to reducing its carbon footprint as a developing nation. The significance of this endeavor is becoming increasingly evident worldwide. The objectives of this review study are to provide an overview of the abundant solar energy resources in India, including availability, current status, strategies, perspectives, challenges, achievements, and future prospects. The review study examines the Government of India's Jawaharlal Nehru National Solar Mission (JNNSM), launched in 2009 to promote clean energy. This mission, initiated on January 11, 2010, is one of the eight missions under the National Action Plan on Climate Change (NAPCC–2008). The JNNSM aims to deploy 22,000 MW of solar power through grid-connected and off-grid solar power plants. The review results show that as of August 2023, India has achieved a cumulative installed solar power capacity of 63,000 MW, exceeding the initial target of 22,000 MW set under the JNNSM. The country has seen a significant increase in solar energy deployment, with an average annual growth rate of 18% over the past five years. India's solar energy potential is estimated to be around 750 GW, indicating vast untapped resources. The review study recommends that India should continue to strengthen its policy and regulatory frameworks, incentivize private sector participation, and invest in research and development to further harness its solar energy potential. Addressing challenges related to grid integration, storage, and financing will be crucial for the sustainable growth of the solar energy sector in India.

Assessing the impacts of canal rehabilitation and lining on groundwater conditions

ABSTRACT The Nile Delta aquifer stands as Egypt’s second primary freshwater source following the Nile River. Its replenishment deriveed from various sources, including the Nile branches, the surface irrigation networks, and the infiltration of excess irrigation water. The expanded demand for irrigation water causes water shortages at the canal tails of some irrigation canals across Egypt. Farmers have resorted to addressing this issue by illegally excavating shallow wells, employing them in times when surface water is inaccessible. Among the national action plans to improve water availability at canal tails is the lining of distributary canals. However, this intervention potentially obstructs the natural replenishment source of the Nile Delta aquifer, consequently contributing to the deterioration of groundwater quality. Hence, this research aims to evaluate the impacts of lining distributary canals on groundwater status through numerical modeling. Utilizing the MODFLOW package, the study determines the natural infiltration rates from the canals into the adjoining groundwater system. Two prevalent hydrological conditions in Egypt were selected for numerical modeling. The first case study focuses on a Canal, located in Qalyoubia governorate, represents the semi-confined aquifer conditions prevalent in the Nile Delta. The second case study is a Canal, situated in Sharqia governorate, represents the phreatic aquifer conditions present in the Nile Delta. Piezometers were implemented to determine the groundwater levels and for the calibration process. The calibrated models were employed to simulate the expected impacts of canal lining for each case and contrasted with pre-lining infiltration rates. Findings indicate that while canal lining effectively reduces water seepage into shallow groundwater in sandy soils, it is of little avail in clayey top soils. The research recommends implementing integrated water resource management to mitigate the possible impacts of lining. It also suggests prioritizing regular maintenance practices for canal linings, especially in areas with sandy soils.

Opportunities and challenges in antimicrobial resistance policy including animal production systems and humans across stakeholders in Argentina: a context and qualitative analysis

IntroductionGaps in antimicrobial resistance (AMR) surveillance and control, including implementation of national action plans (NAPs), are evident internationally. Countries’ capacity to translate political commitment into action is crucial to cope...

Beyond conflict-related sexual violence: the continuum of violence in Iraq’s Women, Peace and Security action plans

Women’s experiences of conflict and their roles in its prevention have become an increasingly large focus for feminist scholars, particularly since the adoption of the Women, Peace and Security agenda in 2000. Iraq has been at the forefront of engagement with the Women, Peace and Security agenda, being the first Middle East state to adopt a national action plan. This article analyses Iraq’s Women, Peace and Security action plans, largely drafted by women’s civil society organisations, using the concept of the ‘continuum of violence’. In doing so, the article shows how a fuller breadth of violence is used by Iraqi women writing and working on Women, Peace and Security inside Iraq than what appears in Women, Peace and Security resolutions. The article therefore contributes to critical engagements with the Women, Peace and Security agenda by addressing two themes: the agenda’s limited capture of gendered violence in conflict; and the agenda’s top-down nature when it comes to reconceptualising the agenda, its limits and its opportunities.