Global Health Systems Solutions, Douala, Cameroon.
Ministry of Public Health, Cameroon.
Trop Med Int Health. 2021 Oct;26(10):1231-1239. doi: 10.1111/tmi.13649. Epub 2021 Jul 26.
Rising antimicrobial resistance is a major threat worldwide. WHO has developed a Global Action Plan and has urged all countries to develop and implement a National Action Plan. We analysed the implementation of the Cameroon National Action Plan by identifying the prioritised activities and assessing possible challenges which could limit implementation.
We conducted a review of national documents on the control of antimicrobial resistance, including regulations, policies and guidelines and assessed the health system structure. Publications and other supporting documents were obtained by a systematic literature search. We applied the policy analysis triangle framework and the theory of change to analyse the National Action Plan, actors involved and the process of implementation.
The National Action Plan consisted of six strategic objectives, with the first five being a direct translation of the five pillars of the Global Action Plan. The related activities were to be implemented using a phased approach with allocated targets for each year. Several gaps were identified. There was no timeline of activities set per year, the chronology of activities was not consistent, there were no activities or objectives to ensure the sustainability of the National Action Plan like creating awareness on antimicrobial resistance and the indicators for impact evaluation were not included. Among the actors involved, the Ministry of Public Health had the highest interest in the implementation as the lead stakeholder to oversee the overall implementation. However, there was no clear source of funding, and stakeholders at the primary level of the various sectors responsible for implementation were not clearly defined.
Despite adequate multisectoral collaboration within the prioritised activities relevant to Cameroon, more is needed for effective implementation of the National Action Plan. The timeline of the different activities, as well as the involvement of key stakeholders at the primary level, needs to be improved. The government's overall commitment to healthcare should be increased and implementation of an action plan should commence at the district or regional level, while challenges in mobilising the necessary funds need to be overcome.
抗菌药物耐药性不断上升是全球面临的主要威胁。世卫组织制定了全球行动计划，并敦促所有国家制定和实施国家行动计划。我们通过确定优先活动和评估可能限制实施的挑战，分析了喀麦隆国家行动计划的实施情况。
我们对国家抗菌药物耐药性控制文件进行了审查，包括法规、政策和指南，并评估了卫生系统结构。通过系统文献检索获取出版物和其他支持文件。我们应用政策分析三角框架和变革理论来分析国家行动计划、参与的行动者以及实施过程。
国家行动计划包括六个战略目标，前五个目标直接翻译自全球行动计划的五个支柱。相关活动将采用分阶段方法实施，每年都有目标分配。确定了几个差距。没有按年设定活动时间表，活动的时间顺序不一致，没有活动或目标来确保国家行动计划的可持续性，如提高对抗菌药物耐药性的认识，也没有包括影响评估的指标。在参与的行动者中，作为监督总体实施的牵头利益攸关方，公共卫生部对实施最感兴趣。然而，没有明确的资金来源，负责实施的各部门初级层面的利益攸关方也没有明确界定。
尽管在与喀麦隆相关的优先活动中进行了充分的多部门合作，但仍需要更多的努力来有效实施国家行动计划。需要改进不同活动的时间表以及初级层面关键利益攸关方的参与。政府应增加对医疗保健的总体承诺，并应在区或地区一级开始实施行动计划，同时需要克服筹集必要资金的挑战。
