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Geneva, Switzerland, WHO, 1991. vii, 72 p.Members of WHO's Technical Working Group on Essential Obstetric Functions at First Referral Level have prepared a book geared towards district, provincial, regional, national, and international decision makers, particularly those in developing countries, whose areas of expertise include planning, financing, and organization and management of obstetric services. The guidelines should allow them to improve referral services' standards at the district level. They should also help them decide how far and by what means they may possibly expand some of these services to more peripheral levels, e.g., renovating facilities and improving staff. When developing these guidelines, WHO took in consideration that many countries confront serious economic obstacles. The book's introduction briefly discusses maternal morbidity and mortality in developing countries and maternity care in district health systems. The second chapter, which makes up the bulk of the book, addresses primary components of obstetric care related to causes of maternal death. This chapter's section on surgical obstetrics examines cesarean section and repair of high vaginal and cervical tears among others. Its other sections include anesthesia, medical treatment, blood replacement, manual procedures and monitoring labor, family planning support, management of women at high risk, and neonatal special care. The third section provides guidelines for implementation of these services, including cost and financial considerations. It emphasizes the need at the first referral level to have the least trained personnel perform as many health care procedures as possible, as long as they can do so safely and effectively. Other implementation issues are facilities, equipment, supplies, drugs, supervision, evaluation, and research. Annexes list the required surgical and delivery equipment, materials for side ward laboratory tests and blood transfusions, essential drugs, and maternity center facilities and equipment.
WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES. 1988; (770):1-63.This booklet incorporates both guidelines and criteria for establishing national programs for essential drugs, and a suggested list of approximately 250 essential drugs. It is important to emphasize that it is up to each country to decide whether to implement an essential drug policy, and how to adapt the list to their own changing needs. Guidelines for a national program include accepting recommendations by a local committee; using generic names and providing a cross index; providing a drug information sheet to accompany the list; regulation or constant testing of quality of the drugs; deciding on the level of expertise needed to prescribe each drug; administration of supply, storage and distribution. Choice of drugs is based on quality, bioavailability, safety, price and availability. Criteria for selection of drugs for primary health care involves evaluation of existing medical care systems, the national health infrastructure, trained personnel and available supplies, and the pattern of endemic disease. Each agent is listed by its international nonproprietary name (INN), is accompanied by substitutions and complementary drugs, and is described by its route of administration, dosage form and strength. Listings are by category and alphabetically.