The Practical Approach to Care Kit (PACK)

PACK Nigeria (Adult and Child) provides a single, integrated, comprehensive, evidence-informed clinical guide to support all cadres working in primary healthcare in Nigeria: i.e. junior community health extension workers (JCHEWs), community health extension workers (CHEWs), community health officers (CHOs), nurses, midwives and medical officers. Colour-coding is used to clearly delineate the scope of practice of these different cadres and clarify referral pathways. This integration promotes a team-based approach to a patient’s care and enables patients to receive consistent and standardized care from whichever cadre treats them.

The Practical Approach to Care Kit (PACK) programme is a health systems intervention that was developed by the Knowledge Translation Unit (KTU) in South Africa 23 years ago and has since been adopted as policy by the country’s department of health to strengthen primary care initiatives. Designed to support health workers to deliver policy-aligned, comprehensive and integrated primary care, the programme comprises four pillars—the provision of clinical decision support in the form of the PACK Adult guide, a training programme, and health systems improvement and monitoring and evaluation components. In 2016, in Collaboration with KTU and BMJ, HRI Global (then known as HRIWA) localised PACK for Nigeria. So PACK Nigeria was developed in Nigeria by Nigerians for use in Nigeria, in response to poor clinical competence amongst primary health care clinicians in the country (World Bank Nigeria/FMOH Service Delivery Indicator study of PHC in 7 states, 2014).

PACK Nigeria demonstrably improves clinical competence by providing a comprehensive primary health care approach to adult and child care, covering over 500 common presenting symptoms, syndromes and chronic conditions. It is aligned with local regulations, relevant clinical protocols for all cadres of primary healthcare professional , evidence and available diagnostic tests, equipment and medications.