Developing the Botswana Primary Care Guideline: an integrated, symptom-based primary care guideline for the adult patient in a resource-limited setting
Open accessAbstract
BACKGROUND: Botswana's health care system is based on a primary care model. Various national guidelines exist for specific diseases. However, most of the guidelines address management at a tertiary level and often appear nonapplicable for the limited resources in primary care facilities. An integrated symptom-based guideline was developed so as to translate the Botswana national guidelines to those applicable in primary care. The Botswana Primary Care Guideline (BPCG) integrates the care of communicable diseases, including HIV/AIDS and noncommunicable diseases, by frontline primary health care workers. METHODS: The Department of Family Medicine, Faculty of Medicine, University of Botswana, together with guideline developers from the Knowledge Translation Unit (University of Cape Town) collaborated with the Ministry of Health to develop the guideline. Stakeholder groups were set up to review specific content of the guideline to ensure compliance with Botswana government policy and the essential drug list. RESULTS: Participants included clinicians, academics, patient advocacy groups, and policymakers from different disciplines, both private and public. Drug-related issues were identified as necessary for implementing recommendations of the guideline. There was consensus by working groups for updating the essential drug list for primary care and expansion of prescribing rights of trained nurse prescribers in primary care within their scope of practice. An integrated guideline incorporating common symptoms of diseases seen in the Botswana primary care setting was developed. CONCLUSION: The development of the BPCG took a broad consultative approach with buy in from relevant stakeholders. It is anticipated that implementation of the BPCG will translate into better patient outcomes as similar projects elsewhere have done.
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GRADE guidelines: 8. Rating the quality of evidence—indirectness
Guyatt, G. H., Oxman, A. D., Kunz, R., Woodcock, J., Brozek, J., Helfand, M., Alonso-Coello, P., Falck-Ytter, Y., Jaeschke, R., Vist, G., et al. (2011) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2011.04.014 · Cited by 1,843 · see citing works
Health policy-makers' perceptions of their use of evidence: a systematic review
Innvær, S., Vist, G., Trommald, M., & Oxman, A. (2002) · Journal of Health Services Research & Policy · doi:10.1258/135581902320432778 · Cited by 1,006 · see citing works
Personal paper: Beliefs and evidence in changing clinical practice
Grol, R. P. T. M. (1997) · BMJ · doi:10.1136/bmj.315.7105.418 · Cited by 826 · see citing works
Kanchanachitra, C., Lindelöw, M., Johnston, T. A., Hanvoravongchai, P., Lorenzo, F. M. E., Hương, N. L., Wilopo, S. A., & Rosa, J. F. D. (2011) · The Lancet · doi:10.1016/s0140-6736(10)62035-1 · Cited by 325 · see citing works
Zhang, X. H., Lisheng, L., Campbell, N. R. C., Niebylski, M. L., Nilsson, P., Lackland, D. T., & League, T. W. H. (2015) · Journal of Clinical Hypertension · doi:10.1111/jch.12749 · Cited by 205 · see citing works
Fairall, L. R., Zwarenstein, M., Bateman, E. D., Bachmann, M. O., Lombard, C. J., Majara, B. P., Joubert, G., English, R., Bheekie, A., van Rensburg, D. H., et al. (2005) · BMJ · doi:10.1136/bmj.331.7519.750 · Cited by 172 · see citing works
Reasons for intentional guideline non-adherence: A systematic review
Arts, D. L., Voncken, A. G., Medlock, S. K., Abu–Hanna, A., & van Weert, H. C. P. M. (2016) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2016.02.009 · Cited by 146 · see citing works
A Morbidity Survey of South African Primary Care
Mash, R. J., Fairall, L. R., Adejayan, O., Ikpefan, O., Kumari, J., Mathee, S., Okun, R., & Yogolelo, W. (2012) · PLoS ONE · doi:10.1371/journal.pone.0032358 · Cited by 138 · see citing works
Estimates Of Health Care Professional Shortages In Sub-Saharan Africa By 2015
Scheffler, R. M., Mahoney, C. B., Fulton, B. D., Poz, M. R. D., & Preker, A. S. (2009) · Health Affairs · doi:10.1377/hlthaff.28.5.w849 · Cited by 114 · see citing works
Kredo, T., Gerritsen, A. A. M., van Heerden, J., Conway, S., & Siegfried, N. (2012) · Health Research Policy and Systems · doi:10.1186/1478-4505-10-1 · Cited by 96 · see citing works
Tol, W. A., Barbui, C., Bisson, J., Cohen, J., Hijazi, Z., Jones, L., de Jong, J. T. V. M., Magrini, N., Omigbodun, O., Seedat, S., et al. (2014) · PLoS Medicine · doi:10.1371/journal.pmed.1001769 · Cited by 83 · cited 1× · see citing works
“gathered mainly in well-resourced settings thus leading to uncertainty as to what extent the findings can be generalized across diverse sociocultural settings.(29) WHO guidelines for selected mental health disorders were regarded deficient, in terms of knowledge on existing cultural practices for improving mental heal…”
Steel, N., Abdelhamid, A. S., Stokes, T., Edwards, H. E., Fleetcroft, R., Howe, A. C., & Qureshi, N. (2014) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2014.05.020 · Cited by 82 · see citing works
Montori, V. M., LeBlanc, A., Buchholz, A., Stilwell, D., & Τσάπας, Α. (2013) · BMC Medical Informatics and Decision Making · doi:10.1186/1472-6947-13-s2-s5 · Cited by 81 · see citing works
Zwarenstein, M., Fairall, L. R., Lombard, C., Mayers, P., Bheekie, A., English, R. G., Lewin, S., Bachmann, M. O., & Bateman, E. (2011) · BMJ · doi:10.1136/bmj.d2022 · Cited by 77 · see citing works
Human resources for health in Botswana: The results of in-country database and reports analysis
Nkomazana, O., Peersman, W., Willcox, M. L., Mash, R. J., & Phaladze, N. (2014) · African Journal of Primary Health Care & Family Medicine · doi:10.4102/phcfm.v6i1.716 · Cited by 62 · see citing works
Self-citationStein, J., Lewin, S., Fairall, L., Mayers, P., English, R., Bheekie, A., Bateman, E., & Zwarenstein, M. (2008) · BMC Health Services Research · doi:10.1186/1472-6963-8-240 · Cited by 59 · see citing works
Fairall, L. R., Bachmann, M. O., Zwarenstein, M., Bateman, E. D., Niessen, L. W., Lombard, C. J., Majara, B. P., English, R., Bheekie, A., van Rensburg, D. H., et al. (2010) · Tropical Medicine & International Health · doi:10.1111/j.1365-3156.2009.02455.x · Cited by 43 · see citing works
Kane, J. C., Adaku, A., Nakku, J. E. M., Odokonyero, R. F., Okello, J., Musisi, S., Augustinavicius, J., Greene, M. C., Alderman, S., & Tol, W. A. (2015) · Implementation Science · doi:10.1186/s13012-016-0400-z · Cited by 40 · see citing works
Bheekie, A., Buskens, I. C. M., Allen, S. J., English, R., Mayers, P. M., Fairall, L. R., Majara, B. P., Bateman, E. D., Zwarenstein, M., & Bachmann, M. O. (2006) · International Nursing Review · doi:10.1111/j.1466-7657.2006.00520.x · Cited by 37 · see citing works
Sousa, A., Scheffler, R. M., Koyi, G., et al. (2014) · Human Resources for Health · doi:10.1186/1478-4491-12-55 · Cited by 30 · see citing works
Moosa, S., Wojczewski, S., Hoffmann, K., Poppe, A., Nkomazana, O., Peersman, W., Willcox, M. L., Derese, A., & Mant, D. (2014) · British Journal of General Practice · doi:10.3399/bjgp14x680089 · Cited by 29 · see citing works
Self-citationSchull, M. J., Cornick, R., Thompson, S., Faris, G., Fairall, L., Burciul, B., Sodhi, S., Draper, B., Joshua, M., Mondiwa, M., et al. (2011) · Implementation Science · doi:10.1186/1748-5908-6-82 · Cited by 25 · see citing works
Bachmann, M. O., Fairall, L. R., Lombard, C. J., Timmerman, V., der Merwe, V., Bateman, E. D., & Zwarenstein, M. (2010) · PubMed · Cited by 22 · see citing works
South African Guideline Excellence (SAGE): What’s in a name?
Kredo, T., Machingaidze, S., Louw, Q. A., Young, T., & Grimmer, K. A. (2015) · South African Medical Journal · doi:10.7196/samj.2016.v106i1.10286 · Cited by 22 · see citing works
Monyatsi, G., Mullan, P. C., Phelps, B. R., Tolle, M. A., Machine, E. M., Gennari, F., Makosky, J., & Anabwani, G. M. (2011) · PubMed · Cited by 21 · see citing works
South African Guidelines Excellence (SAGE): Clinical practice guidelines - quality and credibility
Machingaidze, S., Kredo, T., Louw, Q. A., et al. (2015) · South African Medical Journal · doi:10.7196/samjnew.7697 · Cited by 19 · see citing works
Hölzel, L. P., Ries, Z., Zill, J. M., et al. (2014) · Trials · doi:10.1186/1745-6215-15-265 · Cited by 16 · see citing works
South African Guidelines Excellence (SAGE): Adopt, adapt, or contextualise?
Dizon, J. M. R., Grimmer, K. A., Louw, Q. A., et al. (2016) · South African Medical Journal · doi:10.7196/samj.2016.v106.i12.11374 · Cited by 12 · see citing works
A novel method for constructing an alternative spacer for patients with asthma.
Zar, H. J., GREEN, C. W., Mann, M., et al. (1999) · PubMed · Cited by 8 · see citing works
Practical tools for improving global primary care
Fairall, L., & Walsh, K. (2015) · BMJ · doi:10.1136/bmj.h5361 · Cited by 2 · see citing works
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Thornicroft, G., Ahuja, S., Barber, S., Chisholm, D., Collins, P. Y., Docrat, S., Fairall, L., Lempp, H., Niaz, U., Ngo, V., et al. (2019) · The Lancet Psychiatry · doi:10.1016/s2215-0366(18)30298-0 · Cited by 138 · see citing works
Basu, S., Wagner, R. G., Sewpaul, R., Reddy, P., & Davies, J. (2019) · The Lancet Global Health · doi:10.1016/s2214-109x(18)30450-9 · Cited by 69 · see citing works
- Authors
- Tsima, Setlhare, V., & Nkomazana, O.
- Affiliations
- University of Botswana (BW)
- Venue
- Journal of Multidisciplinary Healthcare
- Publisher
- Informa UK Limited
- Published
- 2016-08
- Volume
- Volume 9
- Pages
- 347-354
- ISSN
- 1178-2390 (ISSN-L)
- PMC
- PMC4986912
- OpenAlex
- W2482076314
- Cited by
- 30
- References
- 31
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 8 · 2023: 1 · 2021: 1 · 2020: 2 · 2019: 3 · 2018: 10 · 2017: 1
- FWCI
- 4.63
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Multidisciplinary Healthcare (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Funders
- Health Resources and Services Administration (T84HA21125)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
- Keywords
- primary care, resource-limited settings, HIV/AIDS, non-communicable diseases, infectious diseases, nurse prescribers, prescribing rights, essential medicines list, knowledge translation, stakeholder engagement, guideline implementation, Botswana
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