| Clinical guidelines - Diagnostic and treatment manual |
In developing countries there are enormous needs and limited resources. The resources should be aimed at the diseases, amenable to effective treatment in the field, which are causing high mortality and morbidity (priority diseases).
Priority diseases can vary from one geographical region to another, but a standard epidemiological profile remains. In order to get an accurate profile an initial assessment is necessary. It should be qualitative (descriptive), and if possible, quantitative (incidence, morbidity and mortality rates). This evaluation will characterise the most common diseases (e.g. diarrhoea, acute respiratory infections...) and will identify the exposed and high risk groups in the population (e.g. children < 5 years, pregnant women...). These diseases and high risk groups should be the targets of the program. This does not mean that curative care should be limited to these diseases and groups of people, but rather that the resources, particularly at the primary health care level, should be targeted at these groups.
In some instances (e.g. displaced or isolated persons) a complete evaluation is necessary. In other instances, such as a rehabilitation program or a study to reinforce an existing program, the Ministry of Health (MOH) may already have qualitative or quantitative data available and only a partial evaluation may be necessary.
The health care program can be defined and carried out as soon as priorities have been defined, and health policy and local resources identified (e.g. essential drug list, MOH management protocols, medical personnel and their training and the medical structure).
This manual, "Essential drugs - practical guidelines" and "Principales conduites a tenir en dispensaire" are additional tools to help evaluate, define and establish a health care program (e.g. management protocols, training, guidelines...).