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Geneva, Switzerland, WHO, Action Programme on Essential Drugs, 1993. ii, 87 p. (WHO/DAP/93.1; DAP Research Series No. 7)The WHO Action Program on Essential Drugs has developed and field tested a core set of drug use indicators capable of describing drug use patterns and prescribing behaviors in a country, region, or individual health facility. These indicators can be used to measure the impact of interventions designed to change prescribing practices, detect performance problems, and compare the performance of providers and institutions. Three categories have been developed: 1) prescribing indicators--average number of drugs per encounter, percentage of drugs prescribed by generic name, percentage of encounters with antibiotic prescribed, percentage of encounters with injection prescribed, and percentage of drugs prescribed from essential drugs list or formulary; 2) patient care indicators--average consultation time, average dispensing time, percentage of drugs actually dispensed, percentage of drugs adequately labelled, and patients' knowledge of correct dosage; and 3) facility indicators--availability of copy of essential drugs list or formulary and availability of key drugs. All data required to measure the core indicators can be derived from medical records or direct observation. Field testing in developing countries such as Nigeria and Tanzania found these measures both feasible to obtain and informative as first-level indicators. Also presented are descriptions of key issues related to study design and sampling, field methods, analysis, and follow up.
Geneva, Switzerland, WHO, 1987. vii, 80 p.This WHO manual on barrier contraceptives and spermicides covers all methods, their effectiveness, advantages and disadvantages, non-contraceptive advantages, uses in special cases, family program considerations, the logistics of supply, monitoring shelf-life and quality control, and application of condoms in AIDS prevention programs. Condoms and foaming tablets are the most appropriate methods for developing countries, especially those in the tropics. Other methods present problems such as expense (diaphragms, foams, sponges), unavailability outside the U.K. and U.S. (caps, sponges), bulk and expense (canned foams). Certain individuals are particularly good candidates for barriers and spermicides: lactating women, people using abstinence or natural family planning, adolescents, older women, women waiting to start using other methods, and those at risk for contracting sexually transmitted diseases. Program officials should consider providing supplies in their special environments, with limitations such as transport, reliability of shipments, storage requirements, cultural sensitivity, multiple outlets for supplies, and cost both to the program and to the users. Methods of insuring steady supply and techniques of testing condoms are described. Barrier methods, condoms in particular, help stop the spread of gonorrhea, syphilis, Chlamydia, Candida, Trichomonas and HIV. An appendix describes basic information about AIDS and the relevance of barriers and spermicides, as well as monogamy and abstinence, in preventing AIDS transmission. Other appendices list sources of supply for developing countries, addresses of manufacturers and sources of further information, techniques for using these methods, and teaching methods for illiterates and semi-illiterates.