Introduction: Rational use of Drugs is the prescription and dispensation of drugs to the appropriate patients in appropriate doses, for required period and at lowest cost to them and their community. Irrational use refers to inappropriate use of drugs which include prescription and dispensation of too many drugs (polypharmacy), unnecessary and overuse of antibiotics and use of injection where oral drug suffices. A step towards preventing irrational drug use is to document it in a study such as this, so that appropriate corrective steps can be taken. Methods: This was a cross sectional cohort analysis of the prescribing records of primary health care workers from eight primary health care facilities. Result & Discussion: There were 513 prescriptions of 2, 590 drugs from the eight facilities;206 (40%) from a cohort of two comprehensive health centres and 307(60%) from a cohort of six basic health clinics. 206(40%) was diagnosis-based prescriptions, while 307(60%) was not based on diagnosis. About 426(83%) contain antibiotics prescriptions, while 87(17%) had no antibiotic prescriptions. About 395(77%) prescriptions contained injectable drugs while 118(23%) did not contain any injectable drug. Conclusion: The average of number drugs per prescription and the proportions of antibiotics and injectables prescriptions in this study were higher than the WHO recommendations. These values were equally higher than values in many studies. Healthcare workers at the basic health clinics did more diagnosis-based prescriptions, prescribed more antibiotics and more injectable than their counterparts at the comprehensive health centers.

Engagement and training of community health extension workers was the strategy adopted by Nigeria to solve the problem of the dearth of skilled health workers at the primary health care level. This group of health workers were trained to use standing orders in the management of the patient at this level of care. The purpose of this study is to investigate the extent of utilization of standing order among community health extension workers. The research was cross-sectional in nature, and it used a self-applied structured questionnaire. The questionnaire was distributed between March and April 2022. There were 265 respondents with age ranges between 23 and 58 years, and the majority (86.7%) were females. 98.1% possessed a copy of the standing order, and 88.5% and 9.9% kept their standing orders in health facilities and home, respectively. 62.3% used it regularly, 19.6% occasionally, 8.3% sometimes and 9.8% rarely used it. Reasons given for not using standing orders included- waste of time, patients who think I am not competent, and not containing new drugs. Regular utilization of standing order is low, and there is a need to educate the community extension workers on the importance of standing order at the primary health care level. Keywords: Standing order, Standardization, Utilization.

Diagnosis is the establishment of a disease condition affecting an individual by a clinician. It is the end result of a process in which a clinician synthesis various combinations of symptoms and signs exhibited by a patient to make a list of possible disease conditions afflicting the patient. This study aimed to ascertain whether Primary Health Care Workers In the Ikere Local Government of Ekiti State were making diagnoses or classifications of diseases before giving treatments. The purpose of this study was to ascertain whether Primary Health Care Workers In the Ikere Local Government of Ekiti State were making diagnoses or classifications of diseases before giving treatments. The study was a retrospective cross-sectional in nature and used secondary data from eight (8) primary health centers within the Local Government, comprising of two (2) Comprehensive and six (6) Basic Health Centers. A total of 513 out-patient cards were examined in the eight selected health facilities. Data was collected and analysed using SPSS version 2.0. Attempt at making a diagnosis were made in 206(40.2%), while no diagnosis were made in 307 (59.6%). 40 different diagnoses were made with malaria alone, 113 (54%) been the most diagnosed. Other diagnoses included wound 17 (8.1%), road traffic accident 10 (4.8%), malaria in combination with typhoid 8 (3.8%), malaria with peptic ulcer and malaria with infection at 2 (1%) each, dysentery, and typhoid 4 (1.9%) each. The uses of physical examination and laboratory investigation as well as diagnosis/ classification before treatment, were low. Keywords: Classification, Diagnosis, Primary health care, Primary health care workers.