Rational use of medicines (RUM) for children in the developing world: Current status, key challenges and potential solutions

Abstract

With Rational and Responsible Use of Medicines (RUM) patients receive medicines appropriate to their needs at lowest cost to them and their community. Activities, capabilities and existing health resources are aligned to these goals. Achieving RUM in the paediatric population is associated with special challenges, many of which are amplified in LMICs. This chapter provides examples of multiple contributing factors and outlines key challenges for delivering RUM. Many countries lack national medicines policies and the absence of child-specific policies in particular is a fundamental problem. Key obstacles include the lack of paediatric-specific information to inform decisions and to guide evaluation of medicines use and outcomes in this population; lack of paediatric-specific skills and knowledge amongst health care workers; lack of practical tools; and the presence of perverse financial incentives. The authors discuss potential solutions, with national policy recommendations specific to child healthcare, consistent with WHO’s general framework of core interventions.