title: Use of medicines and adherence to standard treatment guidelines in rural community health centers, Timor-Leste.
abstract: The use of medicines and nurses'/midwives' adherence to standard treatment guidelines (STGs) were examined in Timor-Leste during the early stage of the nation's new health system development. A cross-sectional study was conducted as the quantitative element of mixed methods research. Retrospective samples from patient registration books and prospective observations were obtained in 20 randomly selected rural community health centers. The medicines use indicators, in particular the level of injection use, in Timor-Leste did not suggest overprescription. Prescribers with clinical nurse training prescribed significantly fewer antibiotics than those without such training (P < .01). The adjusted odds ratio of prescribing adherence for clinical nurse training, after accounting for confounders and prescriber clustering, was 6.6 (P < .01). STGs for nonphysician health professionals at the primary health care level have potential value in basic health care delivery, including appropriate use of medicines, in resource-limited communities when strategically developed and introduced.
authors.affiliation: London School of Hygiene & Tropical Medicine, London, UK Nagoya University School of Medicine, Nagoya, Japan m.m.higuchi@med.nagoya-u.ac.jp.
authors.forename: Michiyo
authors.initials: M
authors.lastname: Higuchi
authors.affiliation: Nagasaki University Institute of Tropical Medicine, Nagasaki, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Okumura
authors.affiliation: Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Aoyama
authors.affiliation: Gadjah Mada University School of Medicine, Yogyakarta, Indonesia.
authors.forename: Sri
authors.initials: S
authors.lastname: Suryawati
authors.affiliation: London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: John
authors.initials: J
authors.lastname: Porter
mesh_terms: D000328:Adult; D003151:Community Health Centers; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008880:Midwifery; D011247:Pregnancy; D011320:Primary Health Care; D011446:Prospective Studies; D012189:Retrospective Studies; D019035:Rural Health Services; D049648:Timor-Leste