Practical Approach to Care Kit Botswana
PACK Botswana is a clinical practice guideline that aims to equip nurses and other clinicians to diagnose and manage common adult conditions at primary level. The Knowledge Translation Unit led the guideline adaptation process in Botswana in partnership with the University of Botswana and funded by a Medical Education Partnerships Initiative (MEPI) grant through PEPFAR. This year-long process involved extensive consultation with many local clinicians and managers. The Ministry of Health convened a steering group with representatives of relevant programmes ranging from infectious diseases and non-communicable diseases to maternal health and end-of-life care. Working groups from these programmes gave input into the guideline pages. This process led to the expansion and update of the primary level Essential Drug List which was approved by the National Standing Committee on Drugs (NASCOD). Ministry of Health priorities were to comply with the new World Health Organisation PEN (Package for Essential Non-communicable diseases) guidelines and to add an end-of-life care component to the guideline to support primary level palliative care initiatives. The KTU ran the facility trainers’ workshops in conjunction with the University of Botswana, training nine participants over four days. All trainers went on to deliver on-site training in pilot primary care sites in Mahalapye and Maun. Clinic staff received the training with enthusiasm, but expressed frustration at the gap exposed by the guideline between policy and what was, in reality, available at clinic level. The Ministry of Health is in the process of adopting PACK Adult as a standard of care in the country.