title: The "child size medicines" concept: policy provisions in Uganda.
abstract: BACKGROUND
  In 2007, the World Health Organization (WHO) launched the 'make medicines child size' (MMCS) campaign by urging countries to prioritize procurement of medicines with appropriate strengths for children's age and weight and, in child-friendly formulations of rectal and flexible oral solid formulations. This study examined policy provisions for MMCS recommendations in Uganda.
  
  
  METHODS
  This was an in-depth case study of the Ugandan health policy documents to assess provisions for MMCS recommendations in respect to oral and rectal medicine formulations for malaria, pneumonia and diarrhea, the major causes of morbidity and mortality among children in Uganda- diseases that were also emphasized in the MMCS campaign. Asthma and epilepsy were included as conditions that require long term care. Schistomiasis was included as a neglected tropical disease. Content analysis was used to assess evidence of policy provisions for the MMCS recommendations.
  
  
  RESULTS
  For most medicines for the selected diseases, appropriate strength for children's age and weight was addressed especially in the EMHSLU 2012. However, policy documents neither referred to 'child size medicines' concept nor provided for flexible oral solid dosage formulations like dispersible tablets, pellets and granules- indicating limited adherence to MMCS recommendations. Some of the medicines recommended in the clinical guidelines as first line treatment for malaria and pneumonia among children were not evidence-based.
  
  
  CONCLUSIONS
  The Ugandan health policy documents reflected limited adherence to the MMCS recommendations. This and failure to use evidence based medicines may result into treatment failure and or death. A revision of the current policies and guidelines to better reflect 'child size', child appropriate and evidence based medicines for children is recommended.
authors: Child Health and Development Center, College of Health Sciences, Makerere University, Kampala, Uganda.
authors: Xavier
authors: X
authors: Nsabagasani
authors: Department of Pharmacology and Therapeutics, Gulu University, Gulu, Uganda.
authors: Jasper
authors: J
authors: Ogwal-Okeng
authors: Department of Community Health, Ministry of Health Uganda, Kampala, Uganda.
authors: Anthony
authors: A
authors: Mbonye
authors: School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.
authors: Freddie
authors: F
authors: Ssengooba
authors: Child Health and Development Center, College of Health Sciences, Makerere University, Kampala, Uganda.
authors: Rebecca
authors: R
authors: Nantanda
authors: Child Health and Development Center, College of Health Sciences, Makerere University, Kampala, Uganda.
authors: Herbert
authors: H
authors: Muyinda
authors: Department of Pharmacy, Section for Social and Clinical Pharmacy, University of Copenhagen, Universitetsparken, Copenhagen, Denmark.
authors: Ebba
authors: E
authors: Holme Hansen
keywords: Essential medicines; Guidelines; Policy; Uganda; ‘Child size medicines’