Strengthening strategic management approaches to address antimicrobial resistance in global human health: a scoping review
Author(s)
Ahmad, Raheelah
Zhu, Nina Jiayue
Leather, Andrew JM
Holmes, Alison
Ferlie, Ewan
Type
Journal Article
Abstract
Introduction: The development and implementation of national strategic plans is a critical component towards successfully addressing antimicrobial resistance (AMR). This study aimed to review the scope and analytical depth of situation analyses conducted to address AMR in human health to inform the development and implementation of national strategic plans. Methods: A systematic search of the literature was conducted to identify all studies since 2000, that have employed a situation analysis to address AMR. The included studies are analysed against frameworks for strategic analysis, primarily the PESTELI (Political, Economic, Sociological, Technological, Ecological, Legislative, Industry) framework, to understand the depth, scope and utility of current published approaches. Results: 10 studies were included in the final review ranging from single country (6) to regional-level multicountry studies (4). 8 studies carried out documentary review, and 3 of these also included stakeholder interviews. 2 studies were based on expert opinion with no data collection. No study employed the PESTELI framework. Most studies (9) included analysis of the political domain and 1 study included 6 domains of the framework. Technological and industry analyses is a notable gap. Facilitators and inhibitors within the political and legislative domains were the most frequently reported. No facilitators were reported in the economic or industry domains but featured inhibiting factors including: lack of ring-fenced funding for surveillance, perverse financial incentives, cost-shifting to patients; joint-stock drug company ownership complicating regulations. Conclusion: The PESTELI framework provides further opportunities to combat AMR using a systematic, strategic management approach, rather than a retrospective view. Future analysis of existing quantitative data with interviews of key strategic and operational stakeholders is needed to provide critical insights about where implementation efforts should be focussed, and also how to build contingency at the strategic level for agile responses to macro-level environmental influences.
Date Issued
2019-09-11
Date Acceptance
2019-07-12
Citation
BMJ Global Health, 2019, 4 (5)
ISSN
2059-7908
Publisher
BMJ Publishing Group
Journal / Book Title
BMJ Global Health
Volume
4
Issue
5
Copyright Statement
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
Sponsor
ESRC
National Institute for Health Research
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/31565417
PII: bmjgh-2019-001730
Grant Number
NF-SI-0617-10176
Subjects
health policy
infections, diseases, disorders, injuries
public health
review
Publication Status
Published
Coverage Spatial
England
Article Number
ARTN e001730
Date Publish Online
2019-09-11