scholarly journals Effectiveness of national and subnational infection prevention and control interventions in high-income and upper-middle-income countries: a systematic review

2018 ◽  
Vol 18 (5) ◽  
pp. e159-e171 ◽  
Author(s):  
Lesley Price ◽  
Jennifer MacDonald ◽  
Lynn Melone ◽  
Tracey Howe ◽  
Paul Flowers ◽  
...  
Keyword(s):  
Systematic Review ◽  
Prevention And Control ◽  
Infection Prevention ◽  
High Income ◽  
Infection Prevention And Control ◽  
Middle Income ◽  
Middle Income Countries ◽  
And Control

scholarly journals Antibiotic Use in Low and Middle-Income Countries and the Challenges of Antimicrobial Resistance in Surgery

Antibiotics ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 497
Author(s):  
Massimo Sartelli ◽  
Timothy C. Hardcastle ◽  
Fausto Catena ◽  
Alain Chichom-Mefire ◽  
Federico Coccolini ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Antibiotic Prescribing ◽  
Prescribing Practices ◽  
Middle Income ◽  
Middle Income Countries ◽  
And Control ◽  
Low And Middle Income

Antimicrobial resistance (AMR) is a phenomenon resulting from the natural evolution of microbes. Nonetheless, human activities accelerate the pace at which microorganisms develop and spread resistance. AMR is a complex and multidimensional problem, threatening not only human and animal health, but also regional, national, and global security, and the economy. Inappropriate use of antibiotics, and poor infection prevention and control strategies are contributing to the emergence and dissemination of AMR. All healthcare providers play an important role in preventing the occurrence and spread of AMR. The organization of healthcare systems, availability of diagnostic testing and appropriate antibiotics, infection prevention and control practices, along with prescribing practices (such as over-the-counter availability of antibiotics) differs markedly between high-income countries and low and middle-income countries (LMICs). These differences may affect the implementation of antibiotic prescribing practices in these settings. The strategy to reduce the global burden of AMR includes, among other aspects, an in-depth modification of the use of existing and future antibiotics in all aspects of medical practice. The Global Alliance for Infections in Surgery has instituted an interdisciplinary working group including healthcare professionals from different countries with different backgrounds to assess the need for implementing education and increasing awareness about correct antibiotic prescribing practices across the surgical pathways. This article discusses aspects specific to LMICs, where pre-existing factors make surgeons’ compliance with best practices even more important.

scholarly journals Health system influences on the implementation of tuberculosis infection prevention and control at health facilities in low-income and middle-income countries: a scoping review

2021 ◽  
Vol 6 (5) ◽  
pp. e004735
Author(s):  
Gimenne Zwama ◽  
Karin Diaconu ◽  
Anna S Voce ◽  
Fiona O'May ◽  
Alison D Grant ◽  
...  
Keyword(s):  
Health System ◽  
Scoping Review ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Health Facilities ◽  
Tuberculosis Infection ◽  
Infection Prevention And Control ◽  
Middle Income ◽  
Middle Income Countries ◽  
And Control

BackgroundTuberculosis infection prevention and control (TB-IPC) measures are consistently reported to be poorly implemented globally. TB-IPC guidelines provide limited recognition of the complexities of implementing TB-IPC within routine health systems, particularly those facing substantive resource constraints. This scoping review maps documented system influences on TB-IPC implementation in health facilities of low/middle-income countries (LMICs).MethodsWe conducted a systematic search of empirical research published before July 2018 and included studies reporting TB-IPC implementation at health facility level in LMICs. Bibliometric data and narratives describing health system influences on TB-IPC implementation were extracted following established methodological frameworks for conducting scoping reviews. A best-fit framework synthesis was applied in which extracted data were deductively coded against an existing health policy and systems research framework, distinguishing between social and political context, policy decisions, and system hardware (eg, information systems, human resources, service infrastructure) and software (ideas and interests, relationships and power, values and norms).ResultsOf 1156 unique search results, we retained 77 studies; two-thirds were conducted in sub-Saharan Africa, with more than half located in South Africa. Notable sociopolitical and policy influences impacting on TB-IPC implementation include stigma against TB and the availability of facility-specific TB-IPC policies, respectively. Hardware influences on TB-IPC implementation referred to availability, knowledge and educational development of staff, timeliness of service delivery, availability of equipment, such as respirators and masks, space for patient separation, funding, and TB-IPC information, education and communication materials and tools. Commonly reported health system software influences were workplace values and established practices, staff agency, TB risk perceptions and fears as well as staff attitudes towards TB-IPC.ConclusionTB-IPC is critically dependent on health system factors. This review identified the health system factors and health system research gaps that can be considered in a whole system approach to strengthen TB-IPC practices at facility levels in LMICs.

Sign in / Sign up

Export Citation Format

Share Document