E-DRUG: Injection safety (4)
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Thank you Richard and Anthony for your input.
You are absolutely right. Reduction of use of injections and
injection safety is a major aim of promoting rational
prescribing. Education is easiest where it is possible to
insist on use of treatment guidelines (which include injections
only when absolutely necessary) together with exclusive use of
drugs from a standard drug list as in your Romanian orphanages.
It could be possible in very small countries eg. in the Pacific
This strategy was the basis of the PHC essential drugs programs
in Somalia during the 80s. People in communities who had been
used to injections and other irrational medicines were served
by CHWs who had no injections but who could treat 80% of the
community problems with oral medicines and they worked! Other
medicines remained available in shops etc but PHC medicines
were supplied free (unsustainable in the long term). The
community of course liked the free medicines and did learn.
Beverley Snell
International Health Unit
Macfarane Burnet Centre for Medical Research
Email: bev@mbcmr.unimelb.edu.au
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