Across Uganda, task shifting means that nurses diagnose and prescribe medication for a wide range of conditions. After visiting a range of medical facilities, it became clear that the quality of drug prescribing varied wildly. Some staff prescribed with clarity, consistency and
quality while others were inconsistent. Dangerous medications such steroids were being used in high doses for infections and allergies. Injections were being used un-necessarily.
Patients were often given five or six different medications, when one or two would have been enough.
Nurses and clinical officers in Uganda do a great job given their short training and lack of resources, and receive very little training or help on their core work – treating the most common medical conditions. ‘Basic Guidelines for Common Conditions” was design in response to this. This tool is designed to help clinicians make the best decisions possible for their patients, using the best value drugs available. It is designed specifically for Nurses and Clinical Officers working at Health Center 2 and 3 level, who have minimal laboratory tests available.
These guidelines are basic and not trying to replace more comprehensive and authoritative guidelines. In many cases these guidelines do not provide enough information to manage the patient adequately. When this is the case, you should refer to IMCI, Uganda Clinical Guidelines and World Health Organisation guidelines as well as talking to senior colleagues. Never be afraid to refer to high levels of care if you are not comfortable with the patient’s situation. These guidelines are updated regularly, to keep up with the latest research as well as antibiotic resistance which Uganda has been remarkably free from up to now.