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Policy  –  Develop and implement plan

Engage stakeholders

Ensuring a true engagement of all relevant stakeholders is essential for an antibiotic resistance policy to be successful and to ensure a sustained effort.

Leadership and oversight of a national action plan should be established early to carry the policy through the development and implementation process. To develop and implement a national health policy is as much about “politics” than it is about technical knowledge about the issue at question. Politics affect policymakers and other stakeholders’ ability to develop and implement reform at the sector, institutional, and facility level . Yet, many policy makers in the health sector are not trained in dealing with politics when managing the political process of health reform. Stakeholders play an important role on the agenda setting stage, technical collaborations as well as the consensus building stages of the policy process.

As antibiotic resistance is a complex issue, broad political buy-in is needed for a national action plan to be effective, politically anchored and financially secure. It should be determined which one or more ministries will spearhead a countries work on antibiotic resistance. Ministries that could be included, but are not limited to are health, agriculture, finance, education/research, trade and environment.

Form a multisectoral coordinating group

A multisectoral coordination group should be established to lead for the development and implementation of a national action plan. The role of the coordinating group should be established and their political mandate agreed upon. A national focal point should be indentified in animal health, human health and plant health.

Conduct a stakeholder analysis

A stakeholder analysis is conducted in order to identify and assess the importance of different stakeholders. In a field as complex and multisectoral as the one of antibiotic resistance, a clear picture of the policy landscape and its actors as well as other key players can serve as a foundation for the rest of the policy process. A thorough stakeholder analysis allows policy makers to identify key players; predict whether they might support or block the implementation of reforms; and develop strategies to promote supportive actions and decrease opposing actions before major reforms are decided upon and implemented.

Form a national stakeholder platform

A larger multi-stakeholder platform or coalition should be formed for wider engagement and consultation throughout the development and implementation of the national action plan. In addition to human health, all relevant sectors such as animal health, plant production, and environmental health should be included so they feel ownership in plan. The platform can be brought together several times a year to inform of progress and to solicit input. This group can bring together policy makers, regulatory authorities, academicians, health care professionals, veterinarians, microbiologists, pharmacists, industry, civil society, professional societies, funding organizations, and media amongst others.

Ghana National Platform on Antimicrobial Resistance

When Ghana identified the worrying situation of increasing antibiotic resistance and decided to work towards the development and implementation of a national policy on antimicrobial resistance, they used a multi-stakeholder approach to form a National Platform on Antimicrobial Resistance (NPAR). The Ministry of Health spearheaded the development of the NPAR that brought together a multidisciplinary group with representatives from all relevant sectors including physicians, veterinary medicine, agriculture, pharmacies and regulatory agencies as well as civil society organizations and non-governmental organizations. Read more about the Ghana national policy development under Examples from the field.

Identify and engage champions

Engaging influential individuals, that are on the forefront regarding a specific issue, to promote change is an innovative and evidence-based advocacy strategy. These champions, or opinion leaders, can act as gatekeepers, help change social norms, and accelerate behavior change. In many cases, a public health champion is an influential political leader, health care provider, or other authority figure who uses his or her expertise and professional contacts to facilitate the application of evidence into national policy. A champion can work as a broker between stakeholders and therefore, it is important that champion(s) have a good and influential relationship with the different government departments, and civil society.

Selected Resources

Resource Description
Sample terms of reference for a national multisectoral coordinating group, for a national focal point and for a technical working group (PDF) This is a supporting document developed by WHO, FAO and OIE to accompany the manual for developing national action plans (this page also provides additional supporting material important for the national action plan development process).
Building Coalitions for Containing Antimicrobial Resistance: A Guide This guide by SIAPS offers guidance on how to identify key stakeholders for addressing drug resistance, mobilize their support, formulate and implement a plan and subsequently evaluate outcomes. Also provides a number of templates and sample interview forms that can be adapted for different local contexts. The chapter “Mobilize support” details how to identify stakeholders, organize a working group, and define the key issues. An older version is available in Spanish and French.
Stakeholder Analysis Guidelines (PDF) This WHO manual provides a detailed overview of the necessary steps for conducting a stakeholder analysis from initial planning to the identification of stakeholders and the development and use of relevant tools. The document offers a useful theoretical framework for conducting a stakeholder analysis.
A stakeholder analysis This paper is a short introduction to the relevant points that a stakeholder analysis should address and offers guidance on all steps of the analysis process.


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