Page 9 - Learnwell EVS
P. 9
Introduction
III - Means to consider and measures to develop
In certain situatio ns (d isp laced p o p ulatio ns, refugees), entire system s m ust be created .
In o ther situatio ns, an existing system is evaluated and m ay be sup p o rted if necessary.
Infrastructure and health staff
T h e training and co m p etence level o f m ed ical staff ( m ed ical auxilaries, m ed ical
assistants, nurses, m id w ives, d o cto rs etc.) vary by co untry and health structure (health
p o st, d isp ensary, health centre, ho sp ital).
E valuatio n sh o uld id entify th eir tech nical level w h ile reco gnising th at in so m e
situatio ns, the staff have no t alw ays received p rio r training.
Drugs
S electio n o f d rugs d ep end s o n the p rio rities and need s, but also o n o ther criteria:
– effectiveness, lo cal resistance, ad verse effects
– ad m inistratio n ro ute, length o f treatm ent, num ber o f d o ses p er d ay, exp ected
co m p liance
– stability, availability, p rice
T he W H O E ssential M ed icines L ist is the basic fram ew o rk , but the cho ice o f d rugs
has
to be ad ap ted to th e ep id em io lo gical p ro file, th e co m p etence o f th e staff and th e
p o ssibility (o r lack thereo f) to refer very sick p atients.
C ertain d rugs p ro p o sed in th is m anual are no t includ ed in th e W H O E ssential
M ed icines L ist.
Treatment protocols
S tand ard p ro to co ls im p ro ve d iffusio n and use o f effective treatm ent. T hey sho uld :
– give p recise instructio ns ( IN N o f th e m ed icatio n, ind icatio ns, d o sage, ro ute o f
ad m inistratio n, length o f treatm ent, co ntra-ind icatio ns, ad verse effects, p recautio ns);
– favo ur the m o st effective d rug w ith the least ad verse effects;
– be sup p o rted by clinical, ep id em io lo gical and scientific d ata and be d iscussed and
agreed up o n by the users;
– be p ractical, sim p le, und erstand able and ad ap ted to the field ;
– facilitate the training and retraining o f m ed ical staff;
– facilitate the o rganiz atio n o f health services (e.g. m anagem ent, p harm acy);
– be evaluated .
T he treatm ent p ro to co ls includ e d rug p rescrip tio n, as w ell as o ther m easures (curative
and p reventive), ind icatio ns fo r referral to a higher level o f care and an ind icatio n o f
w hich d iseases m ust be rep o rted (cho lera, m easles etc.).
F o rm ulatio n d ep end s o n th e training o f th e p rescribing m ed ical staff: d o cto rs are
trained in term s o f d iseases ( p neum o nia, m alaria etc.) w hile m ed ical auxilaries use a
sym p to m atic ap p ro ach (co ugh and d ifficulty in breathing, fever and chills etc.).
9
III - Means to consider and measures to develop
In certain situatio ns (d isp laced p o p ulatio ns, refugees), entire system s m ust be created .
In o ther situatio ns, an existing system is evaluated and m ay be sup p o rted if necessary.
Infrastructure and health staff
T h e training and co m p etence level o f m ed ical staff ( m ed ical auxilaries, m ed ical
assistants, nurses, m id w ives, d o cto rs etc.) vary by co untry and health structure (health
p o st, d isp ensary, health centre, ho sp ital).
E valuatio n sh o uld id entify th eir tech nical level w h ile reco gnising th at in so m e
situatio ns, the staff have no t alw ays received p rio r training.
Drugs
S electio n o f d rugs d ep end s o n the p rio rities and need s, but also o n o ther criteria:
– effectiveness, lo cal resistance, ad verse effects
– ad m inistratio n ro ute, length o f treatm ent, num ber o f d o ses p er d ay, exp ected
co m p liance
– stability, availability, p rice
T he W H O E ssential M ed icines L ist is the basic fram ew o rk , but the cho ice o f d rugs
has
to be ad ap ted to th e ep id em io lo gical p ro file, th e co m p etence o f th e staff and th e
p o ssibility (o r lack thereo f) to refer very sick p atients.
C ertain d rugs p ro p o sed in th is m anual are no t includ ed in th e W H O E ssential
M ed icines L ist.
Treatment protocols
S tand ard p ro to co ls im p ro ve d iffusio n and use o f effective treatm ent. T hey sho uld :
– give p recise instructio ns ( IN N o f th e m ed icatio n, ind icatio ns, d o sage, ro ute o f
ad m inistratio n, length o f treatm ent, co ntra-ind icatio ns, ad verse effects, p recautio ns);
– favo ur the m o st effective d rug w ith the least ad verse effects;
– be sup p o rted by clinical, ep id em io lo gical and scientific d ata and be d iscussed and
agreed up o n by the users;
– be p ractical, sim p le, und erstand able and ad ap ted to the field ;
– facilitate the training and retraining o f m ed ical staff;
– facilitate the o rganiz atio n o f health services (e.g. m anagem ent, p harm acy);
– be evaluated .
T he treatm ent p ro to co ls includ e d rug p rescrip tio n, as w ell as o ther m easures (curative
and p reventive), ind icatio ns fo r referral to a higher level o f care and an ind icatio n o f
w hich d iseases m ust be rep o rted (cho lera, m easles etc.).
F o rm ulatio n d ep end s o n th e training o f th e p rescribing m ed ical staff: d o cto rs are
trained in term s o f d iseases ( p neum o nia, m alaria etc.) w hile m ed ical auxilaries use a
sym p to m atic ap p ro ach (co ugh and d ifficulty in breathing, fever and chills etc.).
9
