Publications
HST provides free electronic access to over 500 health systems research related reports, publications and papers. Close to 300 of these are publications that have been commissioned and funded by the Trust. Topics include among others district systems development, drug supply management, human resource development, informatics, legislation, finance, environmental health, mental health, lessons learnt, nutrition and sexually transmitted diseases / HIV/AIDS. The main publication of the HST is the annual South African Health Review. From 2005 all HST publications will be available in low resolution only. To explore the range of publications HST offers use the Advanced search to search using a variety of criteria.

Many districts have identified Drug Management as a key area that deserves improvement. Often the first problem that is identified is that district health facilities (mostly clinics) do not have drugs in stock. However, ensuring an adequate supply of medicine to clinics is only addressing half the problem. It is also necessary to address drug use patterns and ensure that drug use is rational. Drugs are used rationally when patients "receive medications appropriate to their clinical needs, in doses that meet their individual requirements, for an adequate period of time, and at the lowest cost to them and their community".

This Kwik-Skwiz deals with the measurement of drug use patterns and prescribing behaviour and also with the structures which can be used to promote rational drug use at district level and how they can use such measurement information (indicator data). Examples from an indicator study completed in the Kalahari district of the Northern Cape are used to illustrate the use of such data.

Indicators which measure key parts of the drug use process have been developed by the World Health Organisation. These are standard measures that have been applied in many settings and can therefore be used with confidence. This is obviously not a complete list of aspects that can be measured. For example, it might be useful to know what percentage of prescriptions for a specific indication comply with a Standard Treatment Guideline. When measuring antibiotic use, tuberculostatics are usually excluded. Routine immunisations are also not counted as injection usage. The WHO Core Drug Use Indicators are:

Prescribing indicators Prescribing indicators Prescribing indicators Prescribing indicators Prescribing indicators

1. average number of drugs per encounter
2. percentage of drugs prescribed by generic name
3. percentage of encounters with an antibiotic prescribed
4. percentage of encounters with an injection prescribed
5. percentage of drugs prescribed from an essential drugs list or formulary