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Improving Primary Care Pharmaceutical Use

Qazi

(1996)

Asia

TS

MDs

all staff MDs in teaching hospital

ARI

Group training in ARI case mgmt, ongoing supervision, refresher seminars

%  ABs and sent home

% ABs and admitted

Δ = 54.4%22.9% = -31.5%

Δ = 2.0%7.3% = +5.3%

Santoso

(1996)

Asia

RCT

MDs, parameds

90 HCs in 6 districts (30 per group)

Diarrhea

Large group 1-day district seminar (E1) vs. 2-hour small group (E2) training at HC

% antimicrobial use

% antidiarrheal use

ΔE1 = 77.4%60.4% = -17.0%

ΔE2 =  82.3%72.3% = -10.0%

ΔC = 82.6%79.3% = -3.3%

ΔE1 = 20.3%12.5% = -7.8%

ΔE2 = 48.5%27.0% = -21.5%

ΔC = 21.1%20.7% = -0.4%

Curtale

(1995)

Asia

PO&C

CHWs (& mothers)

208 CHWs (105 E; 92 C); (& 1443 mothers (712 E; 731 C))

Diarrhea, ARI, worms, immunization

2.6 days curative tasks for existing CHWs, drug supply, and 3 additional supervisory visits in 6 months

ORS use

Mabendazole use

Co-trimoxazole use

E: 78%  vs C: 43%

E: 82%  vs C: 21%

E: 37% vs C: <1%

Harrison

(1995)

Africa

PO&C

MDs

60 H facilities   

(246 MDs)

ARI

National ARI control program training

% STR for pneumonia

% AB in non-pneumonia

83%

69%

Jancloes

(1982)

Africa

PP-C

Nurses

All nurses at 2 H posts

Malaria (fever)

Training in algorithm for differential Dx & Tx of fever

% specific diagnosis

Consultation time

Δ = 27.2%65.8% = +38.6%

Δ = 45 sec2 min = +167%

Khallaf

(1995)

Africa

PO-C

MDs/ nurses

65 H facilities in 9 governates

ARI

National ARI Program training in case mgmt and improved drug supply

ARI correctly classified

Pneumonia correct Tx

81%

52%

Kundi

(1991)

Asia

PO-C

MDs, Lady Health Visitors

49 hospital ORT corners (25 MDs & 11 LHVs)

Diarrhea

ORT corners staffed by MDs trained in case mgmt at a Diarrhea Training Unit

% working ORT corners

% mothers told how to prepare ORS by MD

51%

41%

-36-

Improving Primary Care Pharmaceutical UseApril, 1997

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