Guidelines
314 entriesNDOH Standard Treatment Guidelines and clinical protocols
- Chest Trauma - PenetratingPenetrating Chest TraumaOther→
- ChickenpoxDescription General Measures Medicine Treatment Referral ICD-10 codes: B01.9/B01.8 DESCRIPTION A mild viral infection that presents 2–3 weeks after exposure, with: mild fever preceding the rash lesions beginning on the trunk and face, later spreading to the arms and legs small, red, itchy spots that turn into blisters and crusts. These stages may all be present at the same time. ChickenpoxPrimary Care→
- Child Abuse vs Trauma (Orofacial Manifestations)And recognising and reporting of suspected cases of abuseOther→
- 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 (documentOther→
- Childhood Immunisation ScheduleThe contents of this chapter are based on the current recommendations from the National Advisory Group on Immunisation (NAGI). Immunisation schedule Catch-up doses Immunisation schedule Age of child Vaccine At birth OPV0 BCG 6 weeks OPV1 RV1 Hexavalent (DTaP-IPV-HB-Hib)1 PCV1 10 weeks Hexavalent (DTaP-IPV-HB-Hib)2 14 weeks RV2 Hexavalent (DTaP-IPV-HB-Hib)3 PCV2 6 months Measles/RuPrimary Care→
- Childhood PsychosisChildhood PsychosisPEML (Paeds)→
- Childhood malnutrition, including not growing well/growth faltering *New*ICD-10 codes: E40 / E41 / E42 / E43 / E44.0 / E44.1 / E45 / E46 In all children, check for malnutrition and anaemia: Plot the weight on the Road to Health chart/booklet. Look at the shape of the weight curve: Is the weight curve rising parallel to the reference lines? OR is it flattening? OR is there weight loss? Look for visible wasting. Look and feel for oedema of both feet. Look for palmPrimary Care→
- Children With Prosthetic Heart ValvesDescription Medicine treatment ICD-10 code: Z95.2 DESCRIPTION Valve replacement may be required for severe valvular disease when valve repair is not feasible or advisable. The valves may be mechanical valves or bioprosthetic valves or preserved human tissue valves. In children, bioprosthetic valves tend to degenerate, calcify and have structural deterioration more frequently and more rapidlPEML (Paeds)→
- Chloroquine ToxicityDivision of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health SciencesOther→
- Choice of Insulin and Pump DeviceChoice of Insulin and Pumps DeviceOther→
- Choking AlgorithmChoking AlgorithmOther→
- Cholecystitis, Acute and Cholangitis, AcuteGeneral measures Medicine treatment Referral ICD-10 code : K81.0/K83.0 GENERAL MEASURES Surgical drainage/cholecystectomy according to indication and/or patient's condition. MEDICINE TREATMENT Acute cholecystitis Mild and asymptomatic cases without risk factors may not require antibiotic treatment. If signs of infection present and/or risk factors for severe disease are present, such aEML (Adult)→
- CholeraSee: Gastrointestinal conditions. 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_10.3 CholeraPrimary Care→
- CholeraDescription General Measures Medicine Treatment Referral ICD-10 code: A00.0-1/A00.9 Note: This is a notifiable condition. DESCRIPTION Very acute severe watery diarrhoea due to infection with Vibrio cholerae . Clinical features include: Rice water appearance of stools: no blood in stools no pus in stools no faecal odour possible vomiting rapid severe dehydration GENERAL MEASURES Rehydrate aggressiPrimary Care→
- CholeraDescription General Measures Medicine Treatment ICD-10 code: A00.0-1/A00.9 *Notifiable medical condition. DESCRIPTION Diarrhoea due to Vibrio cholerae , often in outbreaks. GENERAL MEASURES Rehydration is the cornerstone of management. Oral rehydration is preferred. MEDICINE TREATMENT Oral rehydration solution (ORS) by mouth or nasogastric tube. If enteral administration not possible, e.g., patieEML (Adult)→
- CholeraDefinition Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: A00.9 * Notifiable condition. DEFINITION An acute diarrhoeal disease caused by V. cholerae . DIAGNOSTIC CRITERIA Clinical Sudden onset of severe, watery diarrhoea, i.e. ‘rice water’ diarrhoea. Low-grade or no fever. Persistent vomiting not associated with nausea. Rapid fluid and electrolyPEML (Paeds)→
- 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.Other→
- Chronic AsthmaConditions with Predominant WheezePrimary Care→
- Chronic AsthmaPaediatrics - Chronic AsthmaOther→
- Chronic Bullous Disease Of ChildhoodICD-10 code: L12.2 DESCRIPTION Tense blisters that lead to ulceration involving the groin, face and trunk. DIAGNOSTIC CRITERIA Skin biopsy with immunofluorescence. GENERAL AND SUPPORTIVE MEASURES Appropriate wound care. REFERRAL All cases. Standard Treatment Guidelines And Essential Medicines List For South Africa, Hospital Level, Paediatrics, 2023 Edition Chapter 5: Dermatology, &nbsPEML (Paeds)→
- Chronic Cancer PainPainPrimary Care→
- Chronic CholestasisDescription General and supportive measures Medicine treatment DESCRIPTION Impairment of bile formation and/or bile flow which may present with pruritis and/or jaundice. It is classified as intrahepatic (e.g. chronic hepatitis, paucity of bile ducts) or extrahepatic (e.g. biliary atresia). GENERAL AND SUPPORTIVE MEASURES Diet supplemented with medium-chain triglycerides. MEDICINE TREATMENT For prPEML (Paeds)→
- Chronic Cough - Paediatric Palliative CareDescription General and supportive measures Medicine treatment ICD-10 code: R05 DESCRIPTION Involuntary cough lasting more than 3 weeks caused by chronic stimulation of cough receptors impairing sleep, communication and feeding. GENERAL AND SUPPORTIVE MEASURES Determine and treat the underlying cause where possible. Exclude undiagnosed GORD and bronchospasm. If caused by ACE inhibitor, consPEML (Paeds)→
- Chronic HypertensionMedicine treatment Referral O10.0 Stop oral antihypertensive medicines when pregnancy is planned or as soon as pregnancy is diagnosed, change to methyldopa and refer for assessment and management. MEDICINE TREATMENT Methyldopa, oral, 250 mg 8 hourly. Titrate to a maximum dose: 750 mg 8 hourly. When using iron together with methyldopa, ensure that iron and methyldopa are not taken concurrently. LoPrimary Care→
- Chronic HypertensionChronic HypertensionOther→
- Chronic HypertensionStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults, Updated for the 2023 EditionEML (Adult)→
- Chronic Kidney Disease (CKD)Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→
- Chronic Kidney Disease (CKD)Structural or functional kidney damagePrimary Care→
- Chronic Kidney Disease (Renal Failure, Chronic)Description Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: N18.9 DESCRIPTION Chronic kidney disease (CKD) is defined as: "evidence of structural or functional kidney abnormalities (abnormal urinalysis, imaging studies or histology) that persist for at least 3 months, with or without a decreased glomerular filtration rate (GFR), as defined by a GPEML (Paeds)→
- Chronic Lower Leg UlcersBacterial Infections of the SkinPrimary Care→
- Chronic Non-Cancer PainPainPrimary Care→
- Chronic Obstructive Pulmonary Disease (COPD)Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→
- Chronic Obstructive Pulmonary Disease (COPD)Conditions with Predominant WheezePrimary Care→
- Ciprofloxacin (Age 2 months up to 5 years)IMCI - Child (Age 2 months up to 5 years)IMCI→
- 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.Other→
- 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 indicatOther→
- 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 paOther→
- 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"Other→
- 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 JOther→
- 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 . Other→
- 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 iOther→
- 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 hOther→
- 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 .Other→
- 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.Other→
- 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 usedOther→
- 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-childrOther→
- 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 ethionamideOther→
- 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 diOther→
- 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. PHCOther→
- 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 toOther→