Guidelines
195 entriesSpeciality / institutional guidelines
- Cerebral Arterial Gas EmbolismCerebral Arterial Gas Embolism→
- Cervical CancerThis guideline is intended as a practical guide to patient care for registrars, medical officers, interns and medical students attached to the gynaecology units at the University of the Witwatersrand Academic Hospitals. Anyone can use it.→
- Cervical ScreeningThis booklet is intended as a practical guide to patient care for registrars, medical officers, interns and medical students attached to the gynaecology units at the University of the Witwatersrand Academic Hospitals. Anyone can use it.→
- Changing AntibioticsThis guideline aims to assist healthcare workers with antibiotic prescribing for common clinical syndromes in adult patients in South Africa, utilizing Local and International guidelines, key publications, and expert opinion.→
- Checklist for the Management of Sexual Abuse in ChildrenRainbow Clinic for Abused Children, April 2020→
- Chemical InjuryChemical Injury→
- Chest CompressionsNational Neonatal Resuscitation Guidelines→
- Chest Trauma - BluntBlunt Chest Trauma→
- Chest Trauma - PenetratingPenetrating Chest Trauma→
- Child Abuse vs Trauma (Orofacial Manifestations)And recognising and reporting of suspected cases of abuse→
- Child Contacts: Children Weighing Less Than 25 Kilograms and InfantsTPT should be offered to TPT should be deferred or not offered if the child Management of TPT in children weighing less than 25 kilograms Management of TPT in children living with HIV (irrespective of TB exposure) Management of TPT in TB-exposed newborns (babies born to mothers diagnosed with pre-natal or peripartum TB or with other significant TB exposure) Significant exposure is known (document→
- Chloroquine ToxicityDivision of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences→
- Choice of Insulin and Pump DeviceChoice of Insulin and Pumps Device→
- Choking AlgorithmChoking Algorithm→
- ChorioamnionitisThe guidelines recommend management of common obstetric conditions at primary and referral level, based on local experience and evidence-based practice. They are not intended as strict protocols nor as standard operating procedures, but rather as a guide to safe effective management of common obstetric problems. The guidelines should be most useful to interns, medical officers and registrars.→
- Chronic AsthmaPaediatrics - Chronic Asthma→
- Chronic HypertensionChronic Hypertension→
- Circular 6 March 2025: Supply Constraints with Rifampicin-based combinations for TB treatment - interim therapeutic alternativesThe Primary Healthcare, Adult Hospital-Level, and Pediatric Hospital-Level Standard Treatment Guidelines (STGs) and the Essential Medicines List (EML) currently recommend the use of rifampicin/isoniazid (RH) 150/75 mg and 300/150 mg for the continuation phase of tuberculosis (TB) treatment and TB preventive therapy. However, there is currently an insufficient national supply of RH to meet demand.→
- Circular 01 April 2026: Retraction of Paediatric Abacavir/ Lamivudine/ Dolutegravir (pALD) Fixed Dose Combination TabletThe circular titled Availability of New Antiretroviral Products: Paediatric Abacavir/ Lamivudine/ Dolutegravir (ABC/3TC/DTG) 60 mg/30 mg/5 mg Fixed-Dose Combination Dispersible Tablets (pALD) (Reference: 2026/01/19/EDP/01) was issued on 6 February 2026 to inform provinces, districts, clinical managers, pharmacists, and healthcare workers of the availability of pALD, including its clinical indicat→
- Circular 03 October 2024: Appendix IV Extemporaneous Preparations Morphine ReformulationFollowing the erratum which was circulated to external stakeholders regarding the corrected extemporaneous compounding formula for morphine oral solution on the 21 August 2023 (refer to Circular Number: 2023/08/21/EDP/01), the National Essential Medicines List Committee (NEMLC) reviewed the full guidance and updated the recommendations. The updated recommendations were reviewed with input from pa→
- Circular 04 September 2025: National Essential Medicines List Committee (NEMLC) BulletinAccessing the Latest Documents To get started, you'll need to find the most current versions of the National Health Insurance (NHI) Standard Treatment Guidelines (STGs) and the Essential Medicines List (EML) found on Knowledge Hub elibrary . The best place to find these is on the official NHI webpage . This is the primary source for the latest documents. If you're looking for older or "historic"→
- Circular 06 May 2024: Availability of Insulin Pen SetsCircular: Availability of Insulin Pen Sets The National Department of Health (NDoH) is committed to ensuring equitable access to quality healthcare for diabetic patients through ensuring the availability of safe, effective, and cost-effective medicines, in the appropriate dosage form at the appropriate level of care. In line with this commitment, the recent tender HP06-2024SVP, advertised on 15 J→
- Circular 08 April 2026: Erratum to the Paediatric Hospital Level Standard Treatment Guidelines and Essential Medicine ListPlease note the following updates have been made to the Paediatric Hospital Level Standard Treatment Guidelines (STGs) and Essential Medicine List (EML) - Review Cycle 2025-2029. Chapter 18: Poisoning Annexure 1: Amoxicillin/clavulanic acid – Weight Band Dosing Table Click here to access pdf . →
- Circular 09 March 2026: Cisatracurium Injection Supply Constraints and Proposed Therapeutic AlternativesThe Standard Treatment Guidelines (STGs) and Essential Medicines List (EML) currently recommends cisatracurium as a non-depolarising muscle relaxant (NDMR) in patients with renal or liver impairment. The contracted supplier of cisatracurium, Accord Healthcare (Pty) Ltd, is however currently unable to meet their contract obligation resulting in supply constraints. Accord Healthcare (Pty) Ltd has i→
- Circular 12 December 2025: Notice - Flucytosine 500mg Tablet Stock Supply and Implications for the Treatment of Cryptococcal MeningitisThe 2024 Adult Hospital Level and 2023 Paediatric Hospital Level editions of the Standard Treatment Guidelines (STGs) and Essential Medicines List (EML) currently recommend oral flucytosine as a critical part of the induction phase treatment regimen of cryptococcal meningitis (CCM) used in combination with intravenous amphotericin B and oral fluconazole. Recently, the supply of oral flucytosine h→
- Circular 12 December 2025: Notice - Updates to the Primary Healthcare and Adult Hospital Level STGs and EMLPlease note the updates (in the document below), made to the 2024 PHC and AHL combined editions of the STGs and EML: Click here to access the pdf .→
- Circular 13 April 2026: Biperiden 5mg per ml Injection 1ml - Stock Supply Shortage and the Proposed Therapeutic AlternativeThe Adult Hospital Level (AHL), Paediatric Hospital Level (PHL), and Primary Healthcare (PHC) Standard Treatment Guidelines (STGs) and Essential Medicines List (EML) 1,2,3 currently recommend biperiden injection as a treatment option for acute dystonic reactions. The contracted supplier of biperiden injection, Pharmaco Distribution (Pty) Ltd, is experiencing supply constraints with this product.→
- Circular 14 February 2025: Morphine for injection containing preservative - caution regarding routes of administrationThe Adult Hospital-Level and Pediatric Hospital-Level Standard Treatment Guidelines (STGs) and the Essential Medicines List (EML) recommend the use of morphine injection for various clinical indications. Currently, 10 mg/mL and 15 mg/mL morphine injections are available through a national contract with Pharma-Q and Unimed Healthcare. However, there are important differences in the excipients used→
- Circular 14 January 2026: Notice - Zinc PicolinateProvinces and Healthcare Facilities are informed of the media statement released by the South African Health Products Regulatory Authority on 08 January 2026 regarding selenium and zinc picolinate-containing products: Warning: Selenium and zinc picolinate-containing products for children https://www.sahpra.org.za/news-and-updates/warning-selenium-and-zinc-picolinate-containing-products-for-childr→
- Circular 14 October 2024: Ethionamide Availability and Therapeutic AlternativeThe Paediatric Hospital Level Standard Treatment Guidelines (STGs) and Essential Medicines List (EML) recommends the use of ethionamide in the regimens for the management of miliary tuberculosis (TB), and TB meningitis (TBM). The available stock of ethionamide expired on 1 October 2024, and currently there is no other stock in the country to service this clinical need. The sourcing of ethionamide→
- Circular 15 April 2024: PHC/Adult Hospital Expert Review Committee: Evidence Summary Isoniazid Preventive Therapy in PregnancyTuberculosis disease during pregnancy and the post-partum period is associated with adverse maternal, pregnancy, infant outcomes.(1) There is consensus regarding the benefit of treating active tuberculosis disease during pregnancy. Additionally, there is consensus regarding the benefit of isoniazid preventive therapy (IPT) in non-pregnant people living with HIV (PLWHIV) to prevent tuberculosis di→
- Circular 15 January 2025: Publication of the NEMLC Approved Updates to the Primary Healthcare Chapters for the STGs and EML 2024 EditionsBelow is a list of the recently published chapters and implementation slides for the 2024 edition of the PHC STGs and EML. Updates to chapters and supporting technical documents (medicine reviews, costing reports, NEMLC reports and PHC implementation slides) for the 2020 to 2024 review cycle are uploaded onto the National Health Insurance (NHI) webpage following finalisation for publication. PHC→
- Circular 15 November 2024: Dasatinib Second Line Therapy in Chronic Myeloid LeukaemiaThe South African National Cancer Registry, lists 268 new leukaemia cases in 2022. The registry does not make provision for the reporting of the different types of leukaemia – it also does not differentiate between acute and chronic leukaemia. Approximately 15 to 20% of new adult leukaemia diagnoses are CML and although the incidence of cases refractory/intolerant to imatinib will be low, due to→
- Circular 16 March 2026: Update to the Dinoprostone Vaginal Gel Stock Constraints and Proposed Therapeutic AlternativesThis is an update to the previous circular: Dinoprostone Vaginal Gel; 1 mg/3g; Prefilled Syringe Stock Supply Shortage and the Proposed Therapeutic Alternatives (Reference: 20260227/EDP01). The Adult Hospital Level (AHL) Standard Treatment Guidelines (STGs) and Essential Medicines List (EML) currently recommends dinoprostone vaginal gel as a treatment option for labour induction for an unfavourab→
- Circular 17 June 2021: Dolutegravir in Pregnant Women and Women of Child-bearing Potential (WOCP)The risk of neural tube defects in infants exposed to dolutegravir in early pregnancy that was first identified in the Tsepamo observational study in Botswana has diminished over time, with the accumulation of further data. The risk difference between dolutegravir and efavirenz is no longer significant. Dolutegravir (especially when combined with tenofovir alafenamide) is associated with more wei→
- Circular 17 October 2024: Analogue insulin - EML status and AnnexuresAs communicated in previous circulars: (1) Availability of Insulin Pen Sets dated 06 May 2024 and (2) Guidance on insulin switching insulin pen sets to insulin vials, and human insulin products to insulin analogue products; there have been significant challenges in accessing human insulin pen sets. Click here for the pdf .→
- Circular 17 October 2024: Ultra-Fast-Acting and Long-Acting Insulin Analogue Interim Essential Medicines List StatusAs communicated in previous circulars: (1) Availability of Insulin Pen Sets dated 06 May 2024 and (2) Guidance on insulin switching insulin pen sets to insulin vials, and human insulin products to insulin analogue products; there have been significant challenges in accessing human insulin pen sets. Click here for the circular .→
- Circular 17 September 2025: Notice - Unfractionated Heparin Stock ConstraintsSouth Africa faces an imminent shortage of unfractionated heparin (UFH) injections, a critical medication for various medical conditions. The sole supplier, Fresenius Kabi, has been ordered by the South African Health Products Regulatory Authority (SAHPRA) to halt production, with existing supplies expected to last only four to five months. This manufacturing pause creates a significant risk of s→
- Circular 18 December 2024: Criteria for Emicizumab use as Routine Prophylaxis in the Management of Patients with Haemophilia A with Factor VIII InhibitorsThe National Essential Medicines List Committee (NEMLC) has approved the inclusion of emicizumab as routine prophylaxis to prevent bleeding or reduce the frequency of bleeding episodes in adults and children with severe haemophilia A (congenital factor VIII deficiency) with factor VIIl inhibitors, as a special access medicine on the Tertiary and Quaternary Level Essential Medicines List (EML). ¹→
- Circular 18 December 2025: Notice - Update to the Guidance on Isoniazid Preventive Therapy (IPT) in PregnancySubsequent to publication of the consensus recommendation for the use of IPT in pregnant women (communication dated 6 December 2025), clinicians raised concerns about deferring IPT until after delivery in pregnant women with advanced HIV, who are at highest risk of developing active tuberculosis. This has prompted a revision of the guidance issued. Click here to access the pdf→
- Circular 19 June 2025: National Essential Medicines List Committe (NEMLC) BulletinAccess to the Standard Treatment Guidelines (STGs) and Essential Medicines List (EML) has never been more convenient, thanks to several digital platforms supported by the National Department of Health (NDoH). The most up-to-date versions of the STGs and EML can be found on the NHI website . This portal houses documents tailored to each Level of Care, along with related technical resources.→
- Circular 22 January 2025: Anastrozole Availability and Therapeutic AlternativeThe Tertiary and Quaternary Essential Medicines List (EML) recommends the use of the aromatase inhibitors for the management of adjuvant and metastatic breast cancer. The aromatase inhibitors recommended are: anastrozole, letrozole and exemestane. See table below outlining the NEMLC recommendation. Click here to access the circular .→
- Circular 23 March 2026: Rifabutin 150mg Capsules Supply Constraints – Interim Therapeutic AlternativesThe Primary Healthcare (PHC) and Adult Hospital Level (AHL) Standard Treatment Guidelines (STGs) and Essential Medicines List (EML) currently recommend the use of rifabutin 150mg capsules for select indications in the management of TB disease and mycobacterium avium complex infection. There is a reported supply constraint with rifabutin 150mg capsules. The Affordable Medicines Directorate has ini→
- Circular 24 March 2026: Publication of the NEMLC Approved Updates to the PHC, AHL and PHL Chapters for the STGs and EML: 2025 - 2029 Review CycleIn this notice find the list of the recently published 2026 chapter updates to previous editions of the PHC, AHL and PHL STGs and EML. Updates to chapters and supporting technical documents (medicine reviews, costing reports, NEMLC reports, implementation slides for PHC level) for the 2025-2029 review cycle are uploaded onto the National Health Insurance (NHI) webpage following finalisation for p→
- Circular 27 February 2025: National Essential Medicines List Committee (NEMLC) BulletinAccess to the Standard Treatment Guidelines (STGs) and Essential Medicines List (EML) has never been more convenient, thanks to several digital platforms supported by the National Department of Health (NDoH). The most up-to-date versions of the STGs and EML can be found on the NHI website . This portal houses documents tailored to each Level of Care, along with related technical resources. For he→
- Circular 27 February 2026: Availability of Nevirapine 50mg/ 5ml Suspension 100ml and 240mlNevirapine (NVP) suspension, together with zidovudine (AZT) syrup, is indicated for infants as part of the Prevention of Mother to Child Transmission (PMTCT) programme. There is currently a shortage of NVP 50mg/5ml suspension. The shortage has arisen due to manufacturing constraints reported by the suppliers, which have resulted in delayed production and limited availability of stock. Although th→
- Circular 27 March 2025: National Essential Medicines List Committe (NEMLC) BulletinThe following formats of the STGs and EML are accepted by the National Department of Health (NDoH): NHI website (latest version of the STGs and EML): The STGs and EML can be accessed by clicking here . Click on the relevant tab to access the STGs, EMLs and technical documents for each Level of Care. Refer to Annexure A for guidance on how to navigate the website and access the relevant documents.→
- Circular 29 April 2026: Non-availability of Ethambutol 400mg TabletsThe availability of ethambutol 400 mg tablets is currently constrained. Although the Affordable Medicines Directorate (AMD) has identified a supplier willing to supply the tablets; deliver is only expected around mid‑May 2026. The existing ethambutol stock is due to expire at the end of April 2026. As there may be reluctance to issue medicines expiring within a month, the Cluster: Tuberculosis (T→
- Circular 29 July 2025: Primary Healthcare and Adult Hospital Level Errata - eGFR Monitoring Intervals for Patients on Tenofovir Disoproxil Fumarate (TDF)Kindly note that the complete editions of the 2024 PHC (8th edition) and the AHL (6th edition) STGs and EMLs are now published on the National Department of Health website at: https://www.health.gov.za/nhi-edp-stgs- eml/ . The complete editions replace the PHC (2020) and AHL (2019) versions. Additionally, please note the corrections to the individually published versions of the PHC Chapter 11: HI→
- Circular 3 April 2025: Interruption in the Supply of Betamethasone Disodium Phosphate 4mg/ml InjectionThis is an update to the published circular ref: CMU 04/2025 disseminated on 26 February 2025, see Annexure 1. The circular update outlines the Standard Treatment Guidelines (STG) alternatives Betamethasone Disodium Phosphate; 4mg/ml; injection; 1 ml which is currently out of stock and the recommended routes of administration. The National Department of Health (NDoH) has sourced stock of Betameth→