Antibiotic resistance in Vietnam: moving towards a One Health surveillance system.
Antibiotic resistance in Vietnam: moving towards a One Health surveillance system.
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DOI：
10.1186/s12889-018-6022-4
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发表时间：
2018-09-24
影响因子：
4.5
通讯作者：
Goutard FL
中科院分区：
文献类型：
--
作者：
Bordier M;Binot A;Pauchard Q;Nguyen DT;Trung TN;Fortané N;Goutard FL
国际社会强烈主张根据“同一健康”概念，执行多部门监测政策，以有效应对抗生素耐药性。为了遵守这些国际建议，越南政府发布了一项跨部门抗生素耐药性监测战略，包括一个综合监测系统。然而，人们可能会质疑监督利益相关者实施所需合作的能力和意愿。为了评估在全国范围内实施这一战略的可行性，我们探讨了关键利益相关者在战略中的作用，以及他们遵守战略的能力。我们进行了一项基于迭代利益相关者绘图和分析的定性方法，分为三个不同的步骤：（1）描述国家监测战略的结构（2）分析主要利益攸关方对该战略的立场（半结构化访谈）;（3）确定影响合作监测战略运作的因素（比较第一步和第二步收集的数据）。监测系统的分布以及根据组织和职能特征对主要利益攸关方的描述，强调了部门间监测举措确实存在，但国家监测系统的组织仍然高度孤立。基于利益相关者的观点，我们确定了可能影响国家一级实施“一个健康”战略的七个因素：治理和业务框架、机构文化的差异、知识水平、技术能力、资源分配、商业利益冲突和国际合作伙伴的影响。该研究表明，合作监测战略的运作需要利益攸关方的充分支持和提供适当的资源。基于这些发现，我们提出了一个指导框架，并提出了一些建议，以建立更合适的治理和运营模式，用于越南的抗生素耐药性监测。为推动和促进成功的部门间合作，可采用参与性的“边做边学”进程，根据对监测价值的预期积极影响，通过确定适当的合作水平，指导、规范和指导利益攸关方。
The international community strongly advocates the implementation of multi-sectoral surveillance policies for an effective approach to antibiotic resistance, in line with the One Health concept. To comply with these international recommendations, the Vietnamese government has issued an inter-ministerial surveillance strategy for antibiotic resistance, including an integrated surveillance system. However, one may question the ability and willingness of surveillance stakeholders to implement the collaborations required. To assess the feasibility of operationalising this strategy within the national context, we explored the role of key stakeholders in the strategy, as well as their abilities to comply with it. We conducted a qualitative approach based on an iterative stakeholder mapping and analysis, in three distinct steps: (1) a description of the structure of the national surveillance strategy (literature review, key informant interviews); (2) an analysis of the key stakeholders’ positions regarding the strategy (semi-structured interviews); (3) the identification of factors influencing the operationalisation of the collaborative surveillance strategy (comparison of data collected at the first and second steps). The mapping of the surveillance system, as well as the characterisation of key stakeholders according to organisational and functional attributes, underlined that inter-sectoral surveillance initiatives do exist, but that the organisation of the national surveillance system remains highly silo-oriented. Based on stakeholder perspectives, we identified seven factors that may influence the implementation of the One Health strategy at national level: governance and operational frameworks, divergence of institutional cultures, level of knowledge, technical capacities, allocation of resources, conflicting commercial interests and influence of international partners. The study suggests that the operationalisation of the collaborative surveillance strategy requires the full adhesion of stakeholders and the provision of appropriate resources. Based on these findings, we have proposed a guidance framework together with recommendations to move towards a more suitable governance and operational model for One Health surveillance of antibiotic resistance in Vietnam. To lever and promote successful inter-sectoral collaboration, a participatory “learning by doing” process could be applied to guide, frame and mentor stakeholders through the identification of appropriate levels of collaboration, depending on the expected positive impacts on the value of surveillance.
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DOI：
10.1016/j.ijantimicag.2016.06.014
发表时间：
2016-10-01
影响因子：
10.8
作者：
Queenan, Kevin;Hasler, Barbara;Rushton, Jonathan
通讯作者：
Rushton, Jonathan
影响因子：
--
作者：
Napoli C;Iannetti S;Rizzo C;Bella A;Di Sabatino D;Bruno R;Sauro F;Martini V;Santucci VU;Declich S;Calistri P
通讯作者：
Calistri P
影响因子：
5.4
作者：
Bradley, JE;Mayfield, MV;Rukonge, A
通讯作者：
Rukonge, A
影响因子：
7.2
作者：
Bozeman, B;Corley, E
通讯作者：
Corley, E
影响因子：
2.4
作者：
Johnson, I.;Hansen, A.;Bi, P.
通讯作者：
Bi, P.