Standardizing Clinical Practices in Swaziland

A common practice in a health system is to have standard treatment guidelines by which all health practitioners use to ensure rational use of medicines and methods. In Swaziland, however, several doctors and health workers apply a variety of approaches to managing common illnesses because they receive their training from different medical schools outside of the country.

Because of an amalgam of treatment approaches, the availability of medicines is at risk.

Swaziland Minister of Health Benedict Xaba, Photo by MSH Staff.

Swaziland Minister of Health Benedict Xaba, Photo by MSH Staff.

The Ministry of Health (MOH) in Swaziland worked with the USAID funded Strengthening Pharmaceutical Systems (SPS) Program and currently SIAPS in developing comprehensive national treatment guidelines.

The purpose of the standard treatment guidelines/essential medicines list (STG/EML) is to provide health care practitioners with clinical practice guidelines to help them make informed medical decisions on proper treatment using proven interventions. The document is a result of a major collaborative effort and wide consultations with practitioners and academics from a wide variety of health fields, including specialists from the public and private sectors of Swaziland.

The process of developing STG/EML of Common Medical Conditions in the Kingdom of Swaziland began in 2008, but due to personnel changes in the office of the Chief Pharmacist, the process was put on hold and resumed in 2010 with a task team appointed by the Principal Secretary and SPS Program as secretariat.

Finalized and printed in June 2012, the STG/EML was officially launched by the Minister of Health, Benedict Xaba, at a ceremony on September 20, 2012 at the Royal Swazi Spa Convention Centre in Ezulwini. Also officiating at the launch was the WHO Country Representative, Dr. Owen Kaluwa and PEPFAR/CDC Country Director, Dr. Peter Ehrenkranz.

The STG/EML will be made available in all health facilities in Swaziland in electronic and hard copy forms to ensure quality health care for all Swazis. The STG/EML is designed for common medical conditions in Swaziland except specialist managed conditions.

STG/EML Task team, Photo by MSH Staff.

STG/EML Task team, Photo by MSH Staff.

A number of supporting job aids, such as posters and algorithms on selected priority disease conditions will also be provided. SIAPS will work closely with the Ministry and various committees such as Pharmacy Therapeutics Committees to ensure the STG/EML is implemented and its use monitored. Induction trainings will be conducted for health workers in the four regions of the country to familiarize them on the use of these guidelines.

A pre-implementation assessment was conducted to identify current practices and gaps in ensuring rational medicines use. After the application of the document, a post implementation assessment will be conducted, the purpose of which will be to determine if there is any meaningful change in the gaps identified.

The STG/EML documents are a time honored tool enabling the MOH to achieve a key tenet of the National Pharmaceutical Policy—to ensure that medicines are not only made available, but are also used rationally and in a cost-effective manner.

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