The Uganda Clinical Guidelines (UCG) has evolved out of the National Standard Treatment Guidelines 1993 and is designed to provide updated, practical and useful information for lower level health facilities (HC1-HC4) on the diagnosis and management of all the common conditions presenting in Uganda.
The guidelines are also intended to establish a strong foundation for the appropriate and cost-effective use of essential medicines.
Inadequate annual budgetary provisions for drugs and medical supplies together with continuing drug supply management deficiencies mean that required essential drugs for public sector health facilities may sometimes be in short supply or even out-of-stock.
Compounding this problem is the fact that even the few drugs which may be available are often not properly used by health professionals and patients. Thus even the meagre resources available may be wasted and the patient suffers from inadequate, inappropriate or complete lack of treatment.
In some cases, the patient may be given a prescription for drugs to be bought at a private sector clinic at an unaffordably high cost.
These issues are of great concern to the Ministry of Health and its partners in the sector. Consequently sustained and intensive efforts are being made to address these problems with the aim of ensuring both the regular availability of, and equitable access to, required essential medicines and the appropriate use of these by health professionals, patients and the public in general.
Appropriate use of medicines means that patients receive medicines which satisfy their clinical needs, in doses which meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and the community.
By providing:
information on the essential elements of clinical diagnosis
guidance on required basic investigations
details of cost-effective treatment and relevant alternatives
guidance on when to refer and admit patients,
the UCG should become a vital tool in the day-to-day work of health professionals, particularly those working in public-sector facilities.
It should, however, also prove equally useful to all other health practitioners working in both the private-not-for-profit and private commercial health sectors who are strongly encouraged by the Ministry of Health to ensure that they also take care with their diagnoses and make the most appropriate use of the medicines available to them.
Although the UCG provides details of recommended treatment regimes, as always clinical judgement and experience will still be required to adjust these to meet the particular needs of specific individuals.
The UCG is meant to be used together with the Essential Drugs List of Uganda (EDLU) which provides guidance on the appropriate selection of drugs for each level of health care/facility.
In the near future these documents will be joined by a national formulary which will provide detailed information on all the drugs used in the UCG. The correct utilisation of the information provided by these three publications will facilitate the appropriate selection and utilisation of essential drugs, thereby minimising waste and maximising potential health benefits.
As with earlier therapeutic guidelines, the compilation of the UCG has only been possible through a prolonged process of consultation with key prescribers and subsequent detailed discussion and approval by the NDA Committee on Essential Drugs. The UCG also had the benefit of thorough review and approval at a special national consensus workshop organised by the Ministry of Health.
I would like to thank the Committee for their careful, thorough and dedicated work and indeed all those who contributed to the preparation of this excellent publication. Your efforts are recognised and greatly appreciated.
Therapeutics is a dynamic area. It is therefore important that national guidelines like the UCG are subjected to constant review and are regularly updated to take account of currently accepted therapeutic practices. Thus your continuing feedback on the usefulness, relevance and accuracy of UCG information is vital in making any decisions on future modifications and improvements.
It is the strong hope and indeed expectation of the Ministry of Health that familiarisation with and daily use of these guidelines by our health professionals will lead to greatly improved diagnosis and prescribing and that this, coupled with improvements in the drug supply system and dispensing practices will ensure that our patients receive the best service possible and thus the best chance of obtaining required health benefits.
Brig. Jim K Muhwezi MP
Minister of Health
Kampala, January 2003
