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Improving Primary Care Pharmaceutical Use

Salazar-Lindo

(1991)

Latin America

PP-C

MDs, nurses

37 MDs (M) & 37 nurses (N) from 16 hospitals

Diarrhea

Intensive 2-week courses in rehydration training unit, local workshops in hosps, 2 supervisory visits

% correct use ORT

% AB in inpatients

% AB in outpatients

ΔM = 67.4%87.8% =+20.4%

ΔN = 82.5%95.3% = +12.8%

ΔM = 85.7%64.8% = -20.9%

ΔM = 50.0%51.4% = +1.4%

Thomas

(1996)

Asia

PP-C

MDs

Volunteers from 60 mission hosps

Better drug selection, use

2-day multi-method training workshop on evaluating new drugs, especially ABs

# drugs Rxd

Use of formulary

Areduced@ but not significant

greater use of common formulary

van Roosmalen (1986)

Africa

PP-C

Parameds

107 parameds in 1 district

Knowledge about MCH care

3-day refresher seminars on MCH service provision, including basic curative care

Mean knowledge (Max score = 100)

ΔE = 55.377.4 = +40.0%

2. Community case management

Delacollette

(1996)

Africa

PP&C

CHWs

13000 pop (12 CHWs) E, 14000 pop C

Malaria

Malaria case management (train CHWs, drug supply, supervision)

Prev. acute malaria (/10000 pers-wks)

% untreated cases

ΔE = 14374 = -48.3%

ΔC = 121109 = -9.9%

ΔE = 31%24% = -7%

ΔC = 20%28% = +8%

Fauveau

(1992)

Asia

PP&C

CHWs, parameds

1 subdistrict, 2 as E (110 CHWs), 2 as C

ARI

ARI case mgmt program (train CHWs & paramed supervisors, biweekly HH visits, home Tx, referral)

ARI <5 mortality rate (/1000)

ARI <1 mortality rate (/1000)

ΔE = 4.73.2 = -31.9%

ΔC = 6.56.1 =-6.2%

ΔE = 13.09.1 = -31.5%

ΔC = 15.516.0 = +3.2%

Hetta

(1984)

Africa

TS-C

(repeat msures)

CHWs, parameds

All rural H staff in 2 districts

Diarrhea

4-day multi-method workshop on diarrhea Tx plus follow-up supervision

% sulphonamide use

% ORS use

ΔE = 51%22% = -29%

ΔE = 50% 72% = +22%

-37-

Improving Primary Care Pharmaceutical UseApril, 1997

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