Annex: Table I.I.
Reported country progress for human health indicators (NAPs, Multisectoral Coordination and 4 Strategic objectives).
| Reported Indicators for human health | TrACSS 2021 Results | |||
|---|---|---|---|---|
| Progress | ||||
| level (A-E) | Definition | N | % | No response |
| National Action Plans and Multisectoral Coordination | ||||
| Multisector and One Health coordination | 41 | 100 | N/A | |
| A | No formal multi-sectoral governance or coordination mechanism on AMR | 4 | 10 | |
| exists | ||||
| B | Multi-sectoral working group(s) or coordination committee on AMR | 22 | 54 | |
| established with Government leadership | ||||
| C | Multi-sectoral working group(s) is (are) functional, with clear terms of | 5 | 12 | |
| reference, regular meetings, and funding for working group(s) with | ||||
| activities and reporting/accountability arrangements defined | ||||
| D | Joint working on issues including agreement on common objectives | 6 | 15 | |
| E | Integrated approaches used to implement the NAP with relevant data and | 4 | 10 | |
| lessons learned from all sectors used to adapt implementation of the NAP | ||||
| National Action Plan (NAP) development | 41 | 100 | N/A | |
| A | No national AMR NAP | 1 | 2 | |
| B | National AMR NAP under development | 5 | 12 | |
| C | National AMR NAP developed | 14 | 34 | |
| D | National AMR NAP being implemented | 15 | 37 | |
| E | National AMR NAP being implemented and actively monitored through | 6 | 15 | |
| a monitoring and evaluation framework | ||||
| Strategic Objective 1 | ||||
| Raising awareness and understanding of AMR risks and response | 41 | 100 | N/A | |
| A | No significant awareness-raising activities on relevant aspects of risks of | 3 | 7 | |
| AMR | ||||
| B | Some activities in parts of the country to raise awareness about risks of | 9 | 22 | |
| AMR and actions that can be taken to address it | ||||
| C | Limited or small-scale AMR awareness campaign targeting some but not | 20 | 49 | |
| all relevant stakeholders | ||||
| D | Nationwide, government-supported AMR awareness campaign targeting | 8 | 20 | |
| all or the majority of priority stakeholder groups, based on stakeholder | ||||
| analysis, utilizing targeted messaging accordingly within sectors | ||||
| E | Targeted, nationwide government-supported activities regularly | 1 | 2 | |
| implemented to change behavior of key stakeholders within sectors, with | ||||
| monitoring undertaken over the last 2-5 years | ||||
| Training and professional education on AMR in the human health sector | 40 | 100 | 1 | |
| A | No training for human health workers on AMR | 2 | 5 | |
| B | Ad hoc AMR training courses in some human health related disciplines. | 14 | 35 | |
| C | AMR is covered in 1) some pre-service training and in 2) some in-service | 21 | 53 | |
| training or other continuing professional development (CPD) for human | ||||
| health workers | ||||
| D | AMR is covered in pre-service training for all relevant cadres. In-service | 3 | 8 | |
| training or other CPD covering AMR is available for all types of human | ||||
| health workers nationwide | ||||
| E | AMR is systematically and formally incorporated in pre-service training | 0 | 0 | |
| curricula for all relevant human health cadres. In-service training or other | ||||
| CPD on AMR is taken up by relevant groups for human health nationwide, | ||||
| in public and private sectors | ||||
| Strategic Objective 2 | ||||
| National monitoring system for consumption and rational use of antimicrobials in human health | 41 | 100 | N/A | |
| A | No national plan or system for monitoring use of antimicrobials | 18 | 44 | |
| B | System designed for surveillance of antimicrobial use, that includes | 10 | 24 | |
| monitoring national level sales or consumption of antibiotics in | ||||
| health services | ||||
| C | Total sales of antimicrobials are monitored at national level and/or some | 6 | 15 | |
| monitoring of antibiotic use at sub-national level | ||||
| D | Prescribing practices and appropriate antibiotic use are monitored in a | 5 | 12 | |
| national sample of healthcare settings | ||||
| E | On a regular basis (every year/two years) data is collected and reported on: | 2 | 5 | |
| a) Antimicrobial sales or consumption at national level for human use; and | ||||
| b) Antibiotic prescribing and appropriate/rational use, in a representative | ||||
| sample of health facilities | ||||
| National surveillance system for AMR (AMR) in humans | 39 | 100 | 2 | |
| A | No capacity for generating data (antibiotic susceptibility testing and | 4 | 10 | |
| accompanying clinical and epidemiological data) and reporting on | ||||
| antibiotic resistance | ||||
| B | AMR data is collated locally for common bacterial infections in | 14 | 36 | |
| hospitalized and community patients*, but data collection may not | ||||
| use a standardized approach and lacks national coordination and/or | ||||
| quality management | ||||
| C | AMR data are collated nationally for common bacterial infections in | 8 | 21 | |
| hospitalized and community patients, but national coordination and | ||||
| standardization are lacking | ||||
| D | There is a standardized national AMR surveillance system collecting data | 12 | 31 | |
| on common bacterial infections in hospitalized and community patients, | ||||
| with established network of surveillance sites, designated national | ||||
| reference laboratory for AMR | ||||
| E | The national AMR surveillance system links AMR surveillance with | 1 | 3 | |
| antimicrobial consumption and/or use data for human health | ||||
| National AMR Laboratory network in human health | 40 | 100 | 1 | |
| A | Information not available | 6 | 15 | |
| B | The National Reference Laboratory (NRL) and/or the National | 11 | 28 | |
| Regulatory Authority (NRA) has not agreed and approved national | ||||
| guidelines for AST (e.g CLSI or EUCAST), bacterial isolation and | ||||
| identification protocols | ||||
| C | The NRL and/or NRA have issued national guidelines, based on | 5 | 12 | |
| international standards for AST(e.g CLSI or EUCAST), bacterial | ||||
| isolation and identification for use within the bacteriology laboratory | ||||
| network | ||||
| D | The NRL and/or NRA have issued national guidelines for AST(e.g CLSI | 7 | 18 | |
| or EUCAST), bacterial isolation and identification for use within the | ||||
| bacteriology laboratory network and National Reference Laboratory | ||||
| participates in an international external quality assurance | ||||
| E | The National Reference Laboratory supports the bacteriology laboratory | 11 | 28 | |
| network in identification of pathogens and AMR through a systematic | ||||
| approach to cascade training and supportive supervision and it has | ||||
| established a National External Quality Assurance program provided to | ||||
| the national bacteriology laboratory network | ||||
| Strategic Objective 3 | ||||
| Infection Prevention and Control (IPC) in human health care | 40 | 100 | 1 | |
| A | No national IPC programme or operational plan is available | 5 | 12 | |
| B | A national IPC programme or operational plan is available. National IPC | 12 | 30 | |
| and water, sanitation and hygiene (WASH) and environmental health | ||||
| standards exist but are not fully implemented | ||||
| C | A national IPC programme and operational plan are available and national | 16 | 40 | |
| guidelines for health care IPC are available and disseminated. Selected | ||||
| health facilities are implementing the guidelines, with monitoring and | ||||
| feedback in place | ||||
| D | National IPC programme available according to the WHO IPC core | 6 | 15 | |
| components guidelines* and IPC plans and guidelines implemented | ||||
| nationwide. All health care facilities have a functional built environment | ||||
| (including water and sanitation), and necessary materials and equipment | ||||
| to perform IPC, per national standards | ||||
| E | IPC programmes are in place and functioning at national and health facility | 1 | 3 | |
| levels according to the WHO IPC core components guidelines. Compliance | ||||
| and effectiveness are regularly evaluated and published. Plans and | ||||
| guidance are updated in response to monitoring | ||||
| Strategic Objective 4 | ||||
| Optimizing antimicrobial use in human health | 40 | 100 | 1 | |
| A | No/weak national policies for appropriate use | 14 | 35 | |
| B | National policies for antimicrobial governance developed for the | 7 | 18 | |
| community and health care settings | ||||
| C | Practices to assure appropriate antimicrobial use being implemented in | 15 | 37 | |
| some healthcare facilities and guidelines for appropriate use of | ||||
| antimicrobials available | ||||
| D | Guidelines and other practices to enable appropriate use are implemented | 4 | 10 | |
| in most health facilities nationwide. Monitoring and surveillance results | ||||
| are used to inform action and to update treatment guidelines and essential | ||||
| medicines lists | ||||
| E | Guidelines on optimizing antibiotic use are implemented for all major | 0 | 0 | |
| syndromes and data on use is systematically fed back to prescribers | ||||
| Adoption of AwaRe categorization | 40 | 100 | 1 | |
| A | Country has no knowledge or information about the AWaRe classification | 4 | 10 | |
| of antibiotics | ||||
| B | Country has knowledge about the AWaRe classification of antibiotics and | 20 | 50 | |
| country has intention to adopt it in the next few years | ||||
| C | Country has adopted the AWaRe classification of antibiotics in their | 11 | 28 | |
| National Essential Medicines List | ||||
| D | Country is monitoring its antibiotic consumption based on the AWaRe | 3 | 8 | |
| classification of antibiotics | ||||
| E | Country has incorporated AWaRe classification of antibiotics into its | 2 | 5 | |
| antimicrobial stewardship strategies | ||||