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Strengthening strategic management approaches to address antimicrobial resistance in global human health: a scoping review

Title: Strengthening strategic management approaches to address antimicrobial resistance in global human health: a scoping review
Authors: Ahmad, R
Zhu, NJ
Leather, AJM
Holmes, A
Ferlie, E
Item 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.
Issue Date: 11-Sep-2019
Date of Acceptance: 12-Jul-2019
URI: http://hdl.handle.net/10044/1/75097
DOI: 10.1136/bmjgh-2019-001730
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/Funder: ESRC
National Institute for Health Research
Funder's Grant Number: NF-SI-0617-10176
Keywords: health policy
infections, diseases, disorders, injuries
public health
health policy
infections, diseases, disorders, injuries
public health
Publication Status: Published
Conference Place: England
Article Number: ARTN e001730
Online Publication Date: 2019-09-11
Appears in Collections:Department of Infectious Diseases