The first edition of the Clinical Guidelines for the Diagnosis and Treatment of Common Hospital Conditions in Kenya responded adequately to the felt needs by Kenyan health workers for a concise, easy-to-carry and easy-to-consult pocket manual that gives clear diagnosis and treatment guidelines as well as optimal dosage protocols.
Although it was not possible to meet the big demand for the guidelines by health workers countrywide, most public, mission and private health institutions received copies which have been and continue to be put to good use. The process of preparing the 2nd Edition has been lengthy and involving. A wide cross section of users provided useful feedback on areas needing revision and expansion through two-day Provincial user/reviewers workshops. A writers' workshop brought together teams of clinicians from the MOH, the KNH and the UON to review, revise, update and rewrite additional material as suggested by the users. The Editors have put in many hours to review, correct and edit the material for publication. All reviewers' comments and suggestions have been taken into account.
The sections on malaria, tuberculosis and STI/HIV/AIDS have been revised with specific attention to the current management of the conditions. Users of the guidelines are advised to keep updated on the management of these diseases since their treatment is rapidly evolving and changing. New material includes a section on orthopaedics, sickle cell anaemia and disaster management.
The Essential Drugs List (EDL) has been revised, obsolete drugs deleted and new ones added as appropriate. Access to drugs for the treatment of life-long conditions such as diabetes, asthma, hypertension, epilepsy and psychiatric illness has been increased. Some of these drugs have been made available at dispensaries and health centres to facilitate filling of prescriptions at less costs.
While the use of these guidelines will to some extent standardise the approach to rational drag use all health workers are encouraged to be aware and observe the existing national laws, regulations and guidelines that govern the registration, procurement, marketing prescribing and use of pharmaceuticals. Health professionals owe it to Kenyans and the world at large to eliminate the existing practice of making nearly all drugs available (with or without prescription) often on considerations that are non-medical: and unethical. Health professionals must accept, perform and take responsibility for the roles they are qualified, registered and licensed to perform. Drugs are not items of trade and monetary-gain even in our liberalised economy.
With financial support from WHO and the PPB, it has been possible to provide a limited number of the Guidelines copies to health institutions countrywide. If demand so dictates printing and distribution of more copies will depend on sales of copies even at subsidised costs.
Finally, the Editors wish to extend their sincere appreciation to all those colleagues who have contributed in any way to the preparation and publishing of this 2nd edition of the Guidelines.
Dr. N.A. Kimathi
Dr. J.N. Micheni
Dr. A. Muriithi
EDITORS
October, 2002
