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在泰国实施国家抗菌药物耐药性战略:潜在挑战与解决方案。

Implementing national strategies on antimicrobial resistance in Thailand: potential challenges and solutions.

机构信息

International Health Policy Program, Ministry of Public Health, Tivanond Road, Amphur Muang, Nonthaburi, 11000, Thailand.

International Health Policy Program, Ministry of Public Health, Tivanond Road, Amphur Muang, Nonthaburi, 11000, Thailand.

出版信息

Public Health. 2018 Apr;157:142-146. doi: 10.1016/j.puhe.2018.01.005. Epub 2018 Mar 20.

Abstract

BACKGROUND

Thailand has developed a national strategic plan on antimicrobial resistance (NSP-AMR) and endorsed by the Cabinet in August 2016. This study reviewed the main contents of the NSP-AMR and the mandates of relevant implementing agencies and identified challenges and recommends actions to mitigate implementation gaps.

METHODS

This study analysed the contents of NSP-AMR, reviewed institutional mandates and assessed the implementation gaps among agencies responsible for NSP-AMR.

RESULTS

Two of six strategies are related to monitoring and surveillance of AMR and antimicrobial consumption in human and animal. Two other strategies aim to improve antibiotic stewardship and control the spread of AMR in both clinical and farm settings. The remaining two strategies aim to increase knowledge and public awareness on AMR and establish national governance for inter-sectoral actions. Strategies to overcome implementation challenges are sustaining cross-sectoral policy commitments, effective cross-sectoral coordination using One Health approach, generating evidence which guides policy implementation, and improving enforcement capacities in regulatory authorities.

CONCLUSIONS

To address AMR, Thailand requires significant improvements in implementation capacities in two dimensions. First, technical capacities among implementing agencies are needed to translate policies into practice. Second, governance and organizational capacities enable effective multi-sectoral actions across human, animal, and environmental sectors.

摘要

背景

泰国制定了国家抗微生物药物耐药性战略计划(NSP-AMR),并于 2016 年 8 月获得内阁批准。本研究回顾了 NSP-AMR 的主要内容以及相关执行机构的任务授权,并确定了挑战和建议采取行动以减轻执行差距。

方法

本研究分析了 NSP-AMR 的内容,审查了机构任务授权,并评估了负责 NSP-AMR 的机构之间的执行差距。

结果

六项战略中的两项与人类和动物中抗微生物药物耐药性和抗微生物药物消耗的监测和监测有关。另外两项战略旨在改善抗生素管理,控制临床和农场环境中抗微生物药物耐药性的传播。其余两项战略旨在提高对抗微生物药物耐药性的认识和公众意识,并建立国家治理框架,以开展部门间行动。克服执行挑战的战略包括维持跨部门政策承诺、采用“同一健康”方法进行有效的跨部门协调、生成指导政策执行的证据以及提高监管机构的执法能力。

结论

为了解决抗微生物药物耐药性问题,泰国需要在两个方面显著提高执行能力。首先,执行机构需要技术能力将政策转化为实践。其次,治理和组织能力使人类、动物和环境部门能够有效地开展多部门行动。

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