Table 1.

Overview of subdomains showing the number of academic studies and grey literature sources reviewed

Domain	Sub-domain	Definition	Academic indicators	Academic studies	Grey literature indicators	Grey literature studies	Example indicator
Monitoring & Evaluation	Surveillance & Laboratory	Indicators that assess the comprehensiveness of surveillance programmes and the capacity and quality of laboratory systems across all sectors.	941	118	486	32	What is the status of the national surveillance system for antimicrobial resistance in live aquatic animals?11
	Reporting	Mechanisms for communicating progress on the national AMR strategy to external stakeholders, including annual progress reports and formal submissions to international and regional surveillance initiatives (e.g., GLASS, ECDC, CAESER, EARS-Net)	56	18	85	12	Does the country report use of antibiotics (ATC classes J01, A07AA, P01AB) and do they report route of administration (oral, parenteral, inhalation, rectal)?63
	Feedback Mechanisms	Indicators that capture the existence and quality of processes for relaying surveillance data and performance information back to regional, organizational, and individual stakeholders	16	6	50	13	Select all that apply: 1) Quality audits of long-term care facilities (LTCFs) include AMR. 2) There is monitoring and evaluation of AMR in LTCFs44.
	Effectiveness	Indicators examine whether structured mechanisms exist at the national level to evaluate if policies or interventions achieve their intended health and economic outcomes.	19	9	17	8	Estimation of the incidence of patients acquiring at least one hospital-acquired infection (HAI) in acute care hospitals per 1000 hospital admissions. Estimation of all types of HAIs per year in acute care hospitals per 1000 hospital admissions13.
Governance & Leadership	Regulations & Legislation	Covers all forms of legislation, incentives, and penalties in place for the containment of AMR.	74	13	54	14	Does the country have legislation in place that limits or prohibits the over-the-counter sale of antibiotics without a prescription?49
	Strategic Vision	Indicators that measure the extent to which there exists a national long-term strategy that has been informed by a situational analysis, with specific, measurable, actionable, relevant and time-bound (SMART) aims for the containment of AMR.	88	26	25	13	Is there a national strategic plan for hospital-acquired infection surveillance (with a focus on priority infections based on the local context) developed by the multidisciplinary technical group?48
	Participation	Indicators that evaluate the extent of inclusive involvement of all relevant stakeholders in development, implementation, monitoring and evaluation of national strategies to address AMR.	47	19	11	7	Who is involved & what is the role for priority setting regarding AMR action and standards?20
	Coordination	Indicators that measure the comprehensiveness of mechanisms in place for coordination across One Health sectors.	30	14	42	16	What is the level of effective integration of laboratories in AMR surveillance in the animal health and food safety sectors?48
	Accountability	Indicators that measure whether responsibility is allocated to deliver objectives and activities listed within the NAP, and whether agreements exist if actions are not undertaken or targets not met.	15	9	7	6	What is the number of focal persons in the network who are reference persons for AMR activities?23
	Transparency	Indicators that measure the extent to which NAPs, progress reports, funding information and other data are publicly available and accessible.	6	6	16	7	Is the information on the national action plan, including progress reports, AMR surveillance data, funding allocation, responsible body, and responsible person/sector within the country, publicly available?75
	Sustainability	Assesses the commitment of relevant stakeholders, the degree to which adequate budgets for present and future activities are allocated, and the consistency with which support is provided for AMR policy development, implementation and monitoring.	18	9	28	14	Is the country’s funding for One Health initiatives in government budget? If Yes, what is the amount of funding? Describe the extent of technical support provided to build capacities to address AMR through support for implementation of international standards and action plans, trainings, and R&D80.
	Equity	Indicators that measure the extent to which AMR policy facilitates equitable access to antimicrobials or mitigates the impact of AMR on disadvantaged and vulnerable populations.	11	3	18	3	Does the country promote equal participation of women, men and other vulnerable groups and/or groups facing discrimination in the multisectoral AMR coordination mechanism and technical working groups?85
Action Areas	Prevention & Control	Measures of the comprehensiveness of IPC programmes, biosecurity mechanisms, and access to clean water, sanitation, and hygiene between countries.	122	35	243	22	Are a minimal set of core indicators for infection, prevention, and control (IPC) within healthcare facilities in the country defined?108
	Social Determinants	Encompass the structural and contextual factors that shape AMR risk between countries, including educational level, climate change, pollution, conflict, nutrition, housing, finance status, demographic trends, technological environments, and individual characteristics.	209	19	23	4	What are the behavioural barriers, including structural barriers, to tackling AMR?32
	Stewardship	Indicators that measure the comprehensiveness of efforts to reduce inappropriate antimicrobial use such as stewardship programmes and guidelines for antibiotic use, and consumption rates and sales of antibiotics	468	80	297	31	Report antimicrobial use for ATC class J01, A07AA, P01AB by AWaRe (Access, Watch, and Reserve) classification (relative use % of Access class antibiotics; relative use % of Watch class antibiotics; relative use % of Reserve class antibiotics)63.
	Community Awareness & Enabling Behaviors	Indicators designed to improve knowledge, shape attitudes, and foster practices that support responsible antimicrobial use.	91	18	18	11	What is the amount of funding mobilised for communication actions on AMR and antimicrobial stewardship per 1000 population?80
	Workforce	Indicators referring to the development, education, and training of teams and individuals across the One Health sectors.	77	22	63	10	Does the country provide training and professional education on AMR to the agriculture (animal and plant), food production, food safety, and environment sectors?11
	Access to Medicines & Health Services	To what extent the population experiences barriers when accessing healthcare services and essential medicines.	70	20	48	11	What is the unmet need for each of the following due to cost, distance, and waiting times? 1) Health care 2) Dental care 3) Prescribed medicines64.
	Research, Innovation, & Digital Technology	Assess whether there is investment in research to examine the drivers of AMR, effectiveness of interventions to mitigate AMR, and whether there are incentives in place that aim to foster innovation.	28	16	22	6	Amount of funding allocated for translational research and late-stage development of AMR medical countermeasures, including clinical trials for antimicrobials80.

The total indicators extracted, and representative example indicators per subdomain. Some indicators and studies appear in multiple subdomains; subdomain sums may exceed the overall total.