Guidelines
437 entriesNDoH Primary Healthcare STG
- Hyperthyroidism in AdultsHyperthyroidism→
- Hyperthyroidism in Children and AdolescentsHyperthyroidism→
- Hypoglycaemia In DiabeticsDiabetic Emergencies→
- Hypoglycaemia and Hypoglycaemic ComaDescription Emergency Treatment Referral ICD-10 code: E10.0/E11.0/E12.0/E13.0/E14.0/E16.0/E16.1/E16.2 DESCRIPTION Hypoglycaemia is a blood sugar < 3 mmol/L (< 2.6 mmol/L in neonate) and may rapidly cause irreversible brain damage and/or death. Clinical features include: tremor confusion sweating delirium tachycardia coma dizziness convulsions hunger transient aphasia or speech disorders hea→
- Hypothyroidism in AdultsHypothyroidism→
- Hypothyroidism in Children and AdolescentsHypothyroidism→
- Hypothyroidism in NeonatesHypothyroidism→
- Immune Reconstitution Inflammatory Syndrome (IRIS) Please click on the link below to access the most up-to-date version of this guideline. The content on this page is currently being updated to align with the latest publication. Always check the version number at the bottom of the screen to confirm which version you are using. Click here to access the Primary Health Care - PHC Chapter 11: Human Immunodeficiency Virus and Acquired Immune De→
- Immunisation ScheduleThe contents of this chapter are based on the current recommendations from the National Advisory Group on Immunisation (NAGI). Any medical incident that takes place after immunisation and may be potentially related to immunisation should be reported (See: Adverse Events Following Immunisation (AEFI) ). Every clinic day is an immunisation day. Never miss a chance to immunise – neve→
- ImpetigoBacterial Infections of the Skin→
- Impotence/Erectile DysfuctionUrology→
- Infection control for Covid-19 in dentistrySouth African National Essential Medicine List Adult Hospital Level Medication Review Process Component: Dental conditions TITLE: INFECTION CONTROL FOR COVID-19 IN DENTISTRY Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare Level, Updated for the 2023 Edition→
- InfluenzaRespiratory Tract Infections→
- Injectable (Contraception, Hormonal)Using the Progestin-only IM injection Using the Progestin-only SC injection Referral Z30.0/Z30.4 Dual protection with barrier methods is recommended to reduce the risk of STIs, including HIV. Progestin-only injectable contraceptive, e.g.: Medroxyprogesterone (long-acting), IM, 150 mg, 12 weekly LoE:IIIb 14 OR Medroxyprogesterone (long-acting), SC, 104 mg, 12 weekly Progestin-only hormonal contrac→
- Insect Stings, Scorpion Stings and Spider BitesDescription Medicine Treatment Referral ICD-10 code: T63.2-4 + External Cause Code (V, W, X, Y) Poisons Information Helpline: 0861555777 See: Exposure to poisonous substances . DESCRIPTION Spider bites and stings by bees, wasps, scorpions and other insects. Symptoms are usually localised such as pain, redness, swelling and itching. Bees and wasps Venom is usually mild but may provoke severe→
- Intrapartum CareDescription General measures Medicine treatment Referral O80.0-1/O80.8-9 For the comprehensive management of women in labour refer to the most recent National Maternity Care and Intrapartum Care Guidelines. DESCRIPTION Labour is divided into 4 stages: First stage onset of regular painful uterine contractions at term to full dilatation of cervix. Second stage full dilatation to delivery of→
- Intrauterine Contraceptive Copper Device (IUCD)Referral Z30.0/Z30.1/Z30.5 Dual protection with barrier methods is recommended to reduce the risk of STIs including HIV. The copper IUCD (also known as the Copper T) is a long-term contraceptive method that is effective, safe and reversible. It has no hormonal effects or drug interactions. It does not require daily adherence or frequent follow up. HIV infection is NOT a contra-indication to the u→
- IntroductionIntroduction→
- Introduction to ContraceptionContraceptive methods Effectiveness of family planning methods For comprehensive guidance, consult the most recent National Contraception Clinical Guidelines (especially for women with medical conditions), the National Clinical Guidelines for Safe Conception and Infertility, as well as the WHO Medical eligibility criteria for contraceptive use and the WHO family planning handbook for providers. L→
- Irritable Bowel Syndrome (IBS)Description General Measures Medicine Treatment Referral ICD-10 code: K58.0/K58.9 DESCRIPTION IBS (also known as “spastic colon” or “irritable colon”) is defined as recurrent abdominal pain that has occurred at least one day per week in the last three months on average, and is associated with two or more of the following: Related to defecation. Associated with a change in stool frequency. Associa→
- Isoniazid Mono-Resistant Tuberculosis in AdultsTB, HIV and AIDS→
- Itching (Pruritus)Itching (Pruritus)→
- Levonorgestrel Intra-uterine Device (LNG-IUD) (Contraception, Hormonal)Referral Z30.0/Z30.5/Z30.8 Dual protection with barrier methods is recommended to reduce the risk of STIs including HIV. The LNG-IUD is an effective, safe, reversible, long-term contraceptive method that has minimal hormonal adverse effects and is not prone to drug interactions. It does not require daily adherence or frequent follow up. Progestin-only intrauterine device, e.g.: Levonorgestrel, in→
- Lice (Pediculosis)Parasitic Infestations of the Skin→
- ListeriosisDescription General measures Medicine treatment Referral A32.0-1/A32.7-9 Note: If you have any questions or concerns, visit http://www.nicd.ac.za/ or call the NCID hotline on 082 883 9920 DESCRIPTION Listeriosis is a preventable and treatable bacterial disease spread through food. Most listerial infections are sporadic but outbreaks do occur. Pregnancy is a predisposing factor for dev→
- Lower Abdominal Pain (LAP)Sexual Transmitted Infections→
- MalariaDescription Diagnosis General Measures Medicine Treatment Note: notifiable medical condition. Refer to the most recent Malaria Treatment Guidelines from the Department of Health for the most suitable management in the various endemic areas. Global malaria endemic areas: https://www.iamat.org/risks/malaria?gclid=CjwKEAiAjIbBBRCitNvJ1o257WESJADpoUt072u5_X4Wb0fVtkQLiEFrWye263Ef_on8eykkOwLK_hoC→
- Malaria, Non-severe/UncomplicatedMedicine Treatment Referral ICD-10 codes: B50.9/B51.9/B52.9/B53.0/B54 Note: notifiable medical condition. MEDICINE TREATMENT Artemether/ lumefantrine, oral, 20/120mg, with fat-containing food/ full cream milk to ensure adequate absorption. Give the first dose immediately. Follow with second dose 8 hours later. Then 12 hourly for another 2 days (total number of doses in 3 days = 6). Click on→
- Malaria, ProphylaxisDescription General Measures Medicine Treatment ICD-10 codes: Z29.1 DESCRIPTION In South Africa, malaria chemoprophylaxis should be used, together with preventive measures against mosquito bites, from September to May in moderate-risk malaria-endemic areas. Risk areas in South Africa are shown in the map included in the National Guidelines for the Prevention of Malaria (2018) found at→
- Malaria, Severe/ComplicatedDescription Medicine Treatment Referral ICD-10 codes: B50.0/B50.8 Note: notifiable medical condition. DESCRIPTION Any one of the following is a sign of severe (complicated) malaria, is associated with a higher mortality, and requires urgent referral (after initial artesunate dose as below): prostration (severe general body weakness) sleepiness, confusion, unconsciousness or coma, convulsion→
- Male Urethritis Syndrome (MUS)Sexually Transmitted Infections→
- Management of HIV-Infected Children (<10 years)Update - 20 June 2025 Links not working not linked out - https://www.nacosa.org.za/wp-content/uploads/2016/11/IntegratedAdherence-Guidelines-NDOH.pdf→
- Management of Incomplete Miscarriage in the 1st Trimester, at Primary Health Care LevelGeneral measures Medicine treatment Referral O02.1/O03.4 Both Manual Vacuum Aspiration (MVA) and medical evacuation are equally effective for miscarriage. GENERAL MEASURES Counselling. Evacuation of the uterus. MEDICINE TREATMENT Medical evacuation: Misoprostol, SL/PV/buccal, 800 mcg immediately as a single dose. Repeat after 24 hours if necessary. LoE:IIIb 1 Manual vacuum aspir→
- Management of Suspected Choking/ Foreign Body Aspiration in ChildrenICD-10 code: T17.2-5/T17.8-9/ T18.0-1 Table 21.3: Managing suspected choking/foreign body aspiration in children If the child is able to talk and breathe Encourage the child to cough repeatedly while arranging transfer urgently with supervision. If the child is conscious but with no effective cough or breathing Give up to 5 abdominal thrusts and if ineffective up to 5 back slaps, followed by re-a→
- Management of Termination of Pregnancy at Primary Health Care Level: Gestation up to 12 Weeks and 0 DaysGeneral measures Medicine treatment Referral O04.9 GENERAL MEASURES Confirm pregnancy with urine pregnancy test. Determine gestational age with ultrasound. If ultrasound is unavailable, use dates (LMP) and bimanual (pelvic) examination. If unsure of dates, or examination disagrees with dates, or uterus palpable abdominally, or the woman is obese or difficult to examine, arrange pre-procedure ultr→
- MastitisDescription General measures Medicine treatment Referral O91.2 DESCRIPTION Inflammation of the breast tissue surrounding the milk ducts. Risk factor includes retrograde infection from a fissured nipple and milk stasis. Commonly isolated pathogens include S. aureus and S. epidermidis. Presentation includes painful breast(s), fever, erythema and malaise. GENERAL MEASURES Compresses. Regular express→
- Maternal Mental HealthIn vulnerable women, pregnancy exacerbates the risk of developing a mental illness. Approximately one in three women in South Africa have depression and/or anxiety in the perinatal period. Globally, postpartum psychosis affects 1 to 2 women in every 1000 after childbirth. Risk factors for maternal mental illness include past history of mental illness, recent major life event, (e.g. bereavement) e→
- MeaslesCase Definition Description General Measures Medicine Treatment Referral ICD-10 codes: B05.0-4/B05.8-9 Note: Notifiable medical condition CASE DEFINITION Fever. AND Red maculopapular (blotchy) rash. AND Cough or coryza (runny nose) or conjunctivitis. Inform the local EPI co-ordinator about all cases of suspected measles, (i.e. which fulfil the case definition criteria). Send clotted bl→
- Medicines used in Palliative Care: IntroductionMedicines used in Palliative Care→
- MeningitisSee: Acute meningitis Meningococcal meningitis, prophylaxis Cryptococcal meningitis Click here to access the pdf . Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2020-4_Version 1.0_26 May 2025 Chapter 15: Central Nervous System Conditions_15.8 Meningitis→
- MeningitisSee: Central nervous system . Click here to access the pdf . Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2020-2024_Version 1.1_20 January 2025 Chapter 10: Infections and Related Conditions_10.9 Meningitis→
- Meningococcal Meningitis, ProphylaxisMeningitis→
- Mental Health Conditions NEMLC Recommendations for Medicine Amendments (2020-2023 Review Cycle)South African Primary Healthcare Level Essential Medicine List. Medicine amendment recommendations, with supporting evidence and rationale are listed below. Kindly review the medicine amendments in the context of the respective standard treatment guideline (STG). Click here for the Mental health conditions NEMLC Recommendations for medicine amendments (2020-2023 Review Cycle) Click here for→
- Mental Health Conditions: IntroductionNurses with authorisation as provided by Section 56(6) of the Nursing Act 33 of 2005 may initiate and/or maintain treatment with medicines as per the STGs and in accordance with their scope of practice. Precepts of the Mental Health Care Act (MHCA) No. 17 of 2002 include: All people with mental illness and/or intellectually disability must be managed under the Act and its regulations as either Vo→
- MiscarriageDescription General measures Medicine treatment Referral O02.1/O03.4/O03.9 DESCRIPTION Bleeding from the genital tract < 22 weeks' gestation, which may or may not be associated with lower abdominal pain (LAP). Miscarriage is classified as follows Cervix closed on digital examination Cervix dilated on digital examination - Threatened miscarriage: - mild vaginal bleeding, usual→
- Missed Pills (Contraception, Hormonal)Progestin only pills Efficacy is rapidly lost if one pill is forgotten or taken >3 hours late. Recommend dual contraception for all scenarios for at least 7 days. LoE:IVb 23 Scenario Action One pill forgotten or pill taken >3 hours late, and unprotected sexual intercourse has not occurred in the past 5 days. Take pill as soon as remembered and continue taking one pill daily at the usual tim→
- Moderate acute malnutrition (MAM) *New*ICD-10 code: E44.0 Description General measures Medicine treatment Referral DESCRIPTION Children and infants older than 6 months who have either: A WHZ-score between -2 and -3. MUAC between 11.5 cm and 12.5 cm. No pitting oedema or SAM danger signs (see Severe acute malnutrition (SAM) ). Good appetite. All cases require careful assessment for possible TB or HIV. GENERAL MEASURES Provide ready to→
- Molluscum ContagiosumMolluscum Contagiosum→
- Mood DisordersDescription The person’s thoughts and behaviour are driven by their mood, which may be depressed, sad, angry, happy, elated, manic, or any of these in combination. Mood disorders may be: Due to another medical condition, e.g. HIV, TB, anaemia of any cause, malignancy, hypothyroidism, and chronic pain conditions. Comorbid with other medical conditions e.g. epilepsy, diabetes, and cardiovascular di→
- MumpsDescription General Measures Medicine Treatment Referral ICD-10 codes: B26.0-3/B26.8-9 DESCRIPTION Incubation period: 14–21 days. A viral infection primarily involving the salivary glands. Signs and symptoms: Fever. Pain on opening the mouth or eating. About two days later a tender swelling appears below the ears at the angle of the jaw, often first on one side and later on the→