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Handbook of supply management at first-level health care facilities. 1st version for country adaptation.
Geneva, Switzerland, WHO, 2006. 73 p. (WHO/HIV/2006.03)All first-level health care facilities, namely primary health care clinics and outpatient departments based in district hospitals, use medicines and related supplies. It takes a team effort to manage these supplies, involving all health care facility staff: doctors, nurses, health workers and storekeepers. This is especially true in small facilities with only one or two health workers. Each staff member should know how to manage all supplies at the health care facility correctly. Each staff member has an important role. The Handbook of Supply Management at First-Level Health Care Facilities describes all major medicines and supply management tasks, known as the standard procedures of medicines supply management at first-level health care facilities. Each chapter covers one major task, explains how the task fits into the process of maintaining a consistent supply of medicines, and recommends which standard procedures to use. Annexes at the back of the handbook contain various checklists and examples of forms which can be introduced as needed at your health care facility. This handbook is part of a package used in an integrated training and capacity-building course targeted at first-level health care facilities. It can be used in conjunction with the existing Integrated Management of Adult and Adolescent Illness (IMAI) strategy developed by WHO. It can also be used for basic training activities independent of IMAI training courses. (excerpt)
Geneva, Switzerland, WHO, 2004 Jan. 118 p. (Integrated Management of Adolescent and Adult Illness [IMAI] No. 1; WHO/CDS/IMAI/2004.1)The IMAI guidelines are aimed at first-level facility health workers and lay providers in low-resource settings. These health workers and lay providers may be working in a health centre or as part of a clinical team at the district clinic. The clinical guidelines have been simplified and systematized so that they can be used by nurses, clinical aids, and other multi-purpose health workers, working in good communication with a supervising MD/MO at the district clinic. Acute Care presents a syndromic approach to the most common adult illnesses including most opportunistic infections. Instructions are provided so the health worker knows which patients can be managed at the first-level facility and which require referral to the district hospital or further assessment by a more senior clinician. Preparing first-level facility health workers to treat the common, less severe opportunistic infections will allow them to stabilize many clinical stage 3 and 4 patients prior to ARV therapy without referral to the district. (excerpt)
AFRICA HEALTH. 1992 Jul; 14(5):10-1.An update on clinical aspects of HIV in africa highlights new proposed clinical definitions of adult AIDS and of tuberculosis in HIV+ adults, and staging of adult HIV infection. The 1986 WHO clinical definition of AIDS has been widely used in Africa, but now research suggests that this definition has several limitations: the definition will pick up several unrelated diseases such as diabetes mellitus and renal failure. It does not ascertain cases of AIDS marked by nonopportunistic infections. Most persons with pulmonary tuberculosis may be wrongly diagnosed with AIDS by this definition. The study showed that the WHO clinical definition has good specificity and positive predictive value for HIV+ people, but its positive predictive value fell to 30% in identifying people with AIDS in Africa. New definitions should take into account any serious morbidity, tuberculosis, neurological disease, both endemic localized Kaposi's, and aggressive typical Kaposi's sarcoma, and HIV serological testing. Tuberculosis is a problem because few HIV+ people suspected of having pulmonary TB (sputum-negative TB) actually have it based on bronchoscopy, while HIV+ persons with TB experience high mortality, often from pyogenic bacteremia. HIV+ persons with TB suffer high rates of relapse, possibly related to insufficient drug treatment or reinfection. 1 study showed that 6 months of isoniazid significantly improved incidence of TB over 30 months of follow-up. Staging of AIDS in Africa based on degree of immunosuppression was proposed as: 1) clinically inapparent HIV infection marked by pulmonary TB, soft tissue infections, and community acquired pneumonia; 2) lymphadenopathy, oral thrush, widespread pruritic maculopapular rash, herpes zoster, enteric illness, dysentery, and Kaposi's sarcoma; and 3) HIV wasting syndrome, chronic pulmonary disease, meningitis, and fever of unknown origin.