Standard treatment guidelines (STGs) outline the recommended treatment options for a specific disease or medical condition (e.g., HIV and AIDS) or a range of medical conditions. Along with essential medicine lists and formularies, STGs help promote rational medicine use. Developed in close collaboration with end users through a consultative and consensus-building process, STGs can help standardize and optimize patient care. They also help simplify medicine supply, treatment decisions, trainings, and reimbursements.
SIAPS and its predecessor projects have provided technical assistance to 19 countries throughout Africa, Asia, Europe, and Central and South America to support the development, revision, dissemination, implementation, training, and monitoring of STGs. In South Africa, for example, SIAPS worked with national stakeholders in the development of an electronic application which allows physicians and other health care providers to access to the STGs, along with the essential medicines list, from a smartphone.
SIAPS has also published a guidance document to support development, revision, and implementation of STGs particularly in low- and middle-income country settings.
To be successful, STGs require an evidence-based, transparent, and participatory development process as well as an effective and ongoing implementation strategy. The implementation of STGs requires a multifaceted approach, including educational outreach, interactive education workshops, auditing and feedback, influence of opinion leaders, and integration into pre-service trainings. The SIAPS approach to ensuring a systematic process of developing and implementing STGs hinges on building the capacity of national stakeholders to:
- Establish an STG development and implementation committee
- Develop an overall plan for guidelines
- Identify the diseases that the STGs will cover
- Determine appropriate treatment options
- Determine what information should be included in the STGs
- Draft the STGs for comments and pilot testing
- Finalize, publish, and disseminate the STGs
- Implement STGs
- Monitor use of STGs and treatment outcomes
- Revise and update
Essential Medicines Lists
The careful selection and implementation of a limited list of essential medicines is a proven, effective intervention that enhances access to and rational use of pharmaceuticals, improves quality of care, and supports cost-effective use of resources. The essential medicines concept has become an established approach in the field of international public health and is supported by governments and health care providers around the world. To date, at least 156 countries have adopted national essential medicines lists (EMLs).
With funding from USAID, the SIAPS Program and its predecessors have provided technical assistance to 13 countries to help develop, revise, disseminate, and/or provide orientation and training on EMLs. The countries supported include the Democratic Republic of the Congo, Ethiopia, Ghana, Kenya, Lesotho, Liberia, Malawi, Namibia, Rwanda, Senegal, South Africa, Swaziland, and Zambia.
On the basis of guidance from the World Health Organization, the SIAPS approach is to assist in-country stakeholders in following an established series of steps to develop or revise an EML:
Step 1: Develop working principles for the development or revision of the EML
Step 2: Choose members to form a multidisciplinary expert committee
Step 3: Initiate activities and develop explicit policies on medicine selection
Step 4: Establish a program for revisions, dissemination, and training on the EML
Step 5: Develop a monitoring component for the EML
Effectively developed and implemented EMLs improve medicine access and use, streamline procurement activities, minimize institutional costs, and optimize patient care.
Click here to read the SIAPS flyer on essential medicines lists.