Level of use – each item has a specified lowest level of use within the health care system and can be prescribed and dispensed in the specified and all higher levels |
NR National referral hospital |
RL Regional laboratory |
RR Regional referral hospital |
H Hospital |
HC4 Health centre 4 (Medical Officer) |
HC3 Health centre 3 (Clinical Officer) |
HC2 Health centre 2 (Enrolled Comprehensive Nurse) |
HC1 Health centre 1 (Community level) |
Specialist list further restricts to facilities with a specific type of clinical and/or diagnostic expertise (e.g., certain ophthalmological preparations) |
VEN classification takes into account health impact |
Vital (V)—medicines used to treat life-threatening diseases and health supplies and laboratory commodities that are necessary for basic healthcare |
Essential (E)—medicines are effective to treat less severe, but nevertheless, widespread illnesses |
Necessary (N)—medicines used for diseases with less impact on the population, medicines of doubtful efficacy, or medicines with a high cost for marginal therapeutic benefit |
Items deemed vital for HC4 are assumed to be vital at all higher levels of health system but may not be ordered if other better alternatives are available to the higher level |