Rational use assessment tool   

Developed by: World Health Organization

Objective: To measure specific aspects of the behaviour of health providers in health facilities. This data can be quickly and efficiently used to assess potential problems in drug use, and to prioritise and focus efforts to correct these problems.

Output: An assessment of medicines use in primary health care facilities, using a number of objective drug use indicators that cover the areas of prescribing, patient care and healthcare facility.

Additional information: The methodology allows a rapid assessment of the drug use situation in a country, region or individual health facility. Such an assessment allows health planners, managers and researchers to make basic comparisons between situations in different areas or at different times. Thus, when an intervention is undertaken to improve aspects of drug use, the indicators can be used to measure impact. Indicators can also serve as simple supervisory tools to detect problems in performance by individual providers or health facilities.           

Process and resources:

• Clearance from the relevant authorities is needed before any health facilities can be visited.
• The techniques for using the indicators have been well tested, and can be implemented in a standard way by individuals without special training or access to many resources. However, the leader of any indicator study should be a healthcare professional.
• The time and funding needed to conduct a survey depends whether it is a survey of one health facility, a region or a national cross-section of facilities.
• A national survey will involve the employment of a study coordinator, employment and training of data collectors, transport costs etc. Such costs will vary according to local conditions but if external support is needed, the costs are likely to be in the region of US$30,000 per country.
• A complete set of training course materials (available in English, French and Russian) for conducting surveys using medicine use indicators as well as other rational medicine use resources can be found at: http://archives.who.int/PRDUC2004/RDUCD/TOC.htm.

Link to the tool: http://apps.who.int/medicinedocs/en/d/Js2289e/

Country Experience: These indicators have become the benchmark for measuring medicines use in primary care in developing and transitional countries, having been used in all regions of the world and in more than 100 countries.

Medicines Use in Primary Care in Developing and Transitional Countries. Fact Book Summarizing Results from Studies Reported between 1990 and 2006 http://apps.who.int/medicinedocs/documents/s16073e/s16073e.pdf