Unpacking multi-level governance of antimicrobial resistance policies: the case of Guangdong, China.

Publisher: Oxford University Press in association with the London School of Hygiene and Tropical Medicine Country of Publication: England NLM ID: 8610614 Publication Model: Print Cited Medium: Internet ISSN: 1460-2237 (Electronic) Linking ISSN: 02681080 NLM ISO Abbreviation: Health Policy Plan

Original Publication: [Oxford] : Oxford University Press in association with the London School of Hygiene and Tropical Medicine, c1986-

Anti-Infective Agents*/pharmacology ; Drug Resistance, Bacterial*; Animals ; Anti-Bacterial Agents/therapeutic use ; China ; Humans ; Policy

Against the backdrop of universal healthcare coverage and pre-existing policies on antimicrobial use, China has adopted a state-governed, multi-level, top-down policy governance approach around an antimicrobial resistance (AMR) national action plan (NAP). The Plan relies on tightening control over antimicrobial prescription and use in human and animal sectors. At the same time, medical doctors and veterinarians operate in an environment of high rates of infectious diseases, multi-drug resistance and poor livestock husbandry. In exploring the way that policy responsibilities are distributed, this study aims to describe how Guangdong as a province adopts national AMR policies in a tightly controlled public policy system and an economy with high disparity. We draw on an analysis of 225 AMR-relevant Chinese policy documents at the national and sub-national levels. We adopt a multi-level governance perspective and apply a temporal sequence framework to identify and analyse documents. To identify policy detail, we conducted keyword analysis using the Consolidated Framework for Implementation Research (CFIR) on policies that conserve antimicrobials. We also identify pre-existing medical and public policies associated with AMR. Our findings highlight the emphasis and policies around antimicrobial use regulation to address AMR in China.
(© The Author(s) 2022. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.)

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S2017.A8.005.17S Policy Innovation and Co-ordination Office of the Hong Kong Special Administrative Region of China; 219622/Z/19/Z Wellcome Trust Grant Funding; United Kingdom WT_ Wellcome Trust; N_HKU740/19 National Natural Science Foundation of China (NSFC)-Research Grant Council (RGC) Joint Research Scheme; R7033-18F Research Impact Fund, University Grants Committee

Keywords: Antimicrobial use; antimicrobial resistance policy; infectious disease prevention; multi-level governance; national and sub-national policies

0 (Anti-Bacterial Agents)
0 (Anti-Infective Agents)

Date Created: 20220701 Date Completed: 20221014 Latest Revision: 20221020

20221213

PMC9558914

10.1093/heapol/czac052

35775460