Assessment of Clients' Satisfaction with Health Service Deliveries at Jimma University Specialized Hospital

BACKGROUND: Client satisfaction is considered as one of the desired outcomes of health care and it is directly related with utilization of health services. Nonetheless, there is no adequate information on users’ perception about the service provided in the hospital after the implementation of Business process re-engineering reform. Hence, the objective of this study was to assess the perceived levels of clients’ satisfaction with health services rendered at Jimma University Specialized Hospital. METHODS: A cross sectional study was conducted from March 1-8, 2010 on a sample of 422 service users of the hospital using systematic random sampling technique. Data was collected using structured questionnaire and analyzed by SPSS for windows version 16.0. Statistical tests were employed where necessary at 0.05 level of significance. RESULT: The questionnaire was administered to a total of 422 clients , of which, 51.7 % were male, about 33.4% of the respondents were between the age group 25-34, 41.% of the clients were illiterates, 60% were from the rural areas and 57.8 % received the service free of charge. The findings of the study showed that the overall client satisfaction level with the health services rendered at the hospital was 77%. Satisfaction was reported to be highest (82.7%) with the way the doctors examined them and on the other hand dissatisfaction was reported to be highest (46.9%) by respondents with the time spent to see a doctor. Furthermore, satisfaction with the health care was found to have a significant association with the age of the respondents (p=0.034) and educational level of the respondents (p=0.003). CONCLUSION: This study showed higher clients’ satisfaction level in the University Specialized Hospital when compared to previous studies in the same hospital as well as other similar studies in the country. Lack of drugs and supplies, poor information provision, long waiting time, poor cleanliness, lack of privacy and inadequate visiting hours, were found to be the major causes of dissatisfaction. Therefore, the Hospital management should understand these weak service areas and plan for a better service delivery. KEYWORDS: Hospital, Outpatient Department, inpatient, satisfaction

Factors and misperceptions of routine childhood immunization service uptake in Ethiopia: findings from a nationwide qualitative study

Introduction: While the routine childhood immunization program might be affected by several factors, its identification using qualitative evidence of caretakers is generally minimal. This article explores the various factors and misperceptions of routine childhood immunization service uptake in Ethiopia and provides possible recommendations to mitigate them. Methods: In this study, we used a qualitative multiple case study design collecting primary data from 63 focus group discussions (FGDs) conducted with a purposefully selected sample of children's caretakers (n = 630). Results: According to the results of this study, the use of routine childhood immunization is dependent on four major factors: caretakers' behavior, family characteristics, information and communication and immunization service system. In addition, the participants had some misperceptions about routine childhood immunization. For example, immunization should be taken when the child gets sick and a single dose vaccine is enough for a child. These factors and misperceptions are complex and sometimes context-specific and vary between categories of caretakers. Conclusion: Our interpretations suggest that no single factor affects immunization service uptake alone in a unique way. Rather, it is the synergy among the factors that has a collective influence on the childhood immunization system. Therefore, intervention efforts should target these multiple factors simultaneously. Importantly, this study recommends improving the quality of existing childhood immunization services and building awareness among caretakers as crucial components

Designing of Accounting Information System for Small and Medium Enterprises: Application of PLS-SEM

Accounting information system is a complex and subjective concept that lacks a comprehensive conceptual framework. Previous AIS studies focused on the context of information system and its benefit. Moreover, the existing studies have revealed contradictory results. Some authors argue that full AIS adoption is necessary for all organizations, regardless their size. Others proposed a reduced level. Nevertheless, they are not precisly  confirmed a subsystems of AIS that  proclaimed as less important for SMEs. In response to this gap, the present study has attempted to design AIS framework for SMEs. As such, this research aims to decompose and identify the important  sub-systems that constitute AIS. To fulfil this purposes, the research employed an exploratory research design that used Partial List Squire-Structural Equation Model. Primary data were collected from eighty SMEs. The study result confirmed that transaction-processing subsystem has the largest importance index followed by reporting subsystem. Even though, internal control is the least important, it was statistically significant in designing of AIS for SME. In the context of reporting, managerial reports (Budget preparation, variance analysis) are more important that financial accounting reports (FSEU). Regarding technology, whether IT is designed as simple as manual system or as complex as EP, its effect on management decision is minimum. Likewise, internal auditing practice of SMEs has very small impact in AIS alignment with accounting information users’ satisfaction. Collectively, the study revailed that all subsystems of AIS are significantly important in the designing of AIS conceptual frame work for SMEs

Lactic acid production from Brewer’s Spent Grain by Lactobacillus plantarum ATCC 8014

610-613The objective of this research was to produce lactic acid from Brewery Spent Grain using Lactobacillus plantarum ATCC 8014. The production was carried out in four main stages, including the pretreatment, hydrolysis, fermentation and recovery of lactic acid. Box Behnken Design (BBD) (Design expert® 7 software) was used to investigate the effect of temperature (115–130°C), reaction time (25–35 min) and acid concentration (1.5–2.0 M) during the hydrolysis. Fermentation of the hydrolyzate was performed at 35°C, pH 5.0–5.5 and 200 rpm for 72 h. Optimization results proved the suitability of BSG to be used as a feedstock for the lactic acid production

Enhancing the Synthesis of Biolubricant from Used Chicken Fat: Optimization of Operating Parameters Using Magnesium Oxide Nanoparticles as a Catalyst and Response Surface Methodology

In light of the growing concerns regarding the environmental impact and sustainability of mineral oil-based lubricants, the use of biolubricants has been advocated as a renewable alternative. The double transesterification of used chicken fat oil involves two steps of converting the triglycerides into methyl esters (UCFME) using methanol and Magnesium oxide Nano Particles (MgO NPs) as catalyst, and utilizing Trimethylolpropane (TMP) and MgO NPs to produce the final biolubricant (UCFBL). This research aimed to optimize the reaction parameters for the transesterification process involving used chicken fat methyl ester (UCFME) and TMP using response surface methodology. A series of 20 individual experiments were conducted, focusing on the variables of reaction temperature, time, and UCFME-to-TMP molar ratio. Through statistical modeling, it was predicted that the transesterification process would yield a maximum conversion rate of 97.5% under the optimized conditions of a reaction temperature 114 °C, a reaction time 227 minutes, and a UCFME-to-TMP molar ratio 10.5:1. Experimental results, obtained from three independent replicates conducted under these optimal conditions, demonstrated an average yield of 98.3 % for the production of UCFBL, which aligned closely with the model's predicted range of 98.35%. The resultant biolubricant has remarkable lubrication qualities, such as a pour point of -5 °C, flash point of 289°C, viscosity index of 213, and kinematic viscosities (KV) of 38.5 and 9.2 cSt at 40 and 100 °C, respectively. These qualities revealed that the biolubricant generated fulfilled the ISO VG-32 criteria, making it an acceptable replacement for petroleum-based lubricants in industrial machine applications

Isolation and Antimicrobial Sensitivity Testing of Escherichia coli from Fish Meat Retailing Shops of Mekelle City, Ethiopia

The present study was conducted for the period of six months, September, 2016 to February, 2017 so as to isolate and identify Escherichia (E.coli) from fresh fish samples collected from four different retailing shops in Mekelle city and determine the antibiotic resistance pattern of isolated bacteria. Isolation and identification of E.coli and antibiotic sensitivity test were performed following the standard microbiological techniques. The antibiotic resistance patterns of the E.coli isolates were tested against 6 different antibiotics, namely Ampicillin, Amoxicillin, Ciprofloxacin, Norfloxacin, Gentamicin and Streptomycin. Accordingly, out of the total 96 fish samples collected and analyzed, 9(9.4%) were positive for E.coli following the primary and secondary biochemical test results. Out of the four fish meat retailing shops, the highest and statistically significant prevalence (P=0.001) of E.coli was recorded in shop III as 5(20.8%) followed by shop II as 4(16.7%).Furthermore, results of the antimicrobial sensitivity test have shown that all of the isolates were completely significantly (P=0.001) resistant to two antibiotics (Ampicillin and Amoxicillin) and 100% significantly susceptible (P=0.001) to three of the antibiotics (Ciprofloxacin, Norfloxacin, and Gentamicin). Whereas, out of the 9 isolates, 2 isolates (22.2%) were intermediate and 7 isolates (77.8%) were susceptible to Streptomycin. Hence, it can be concluded that fishes from Mekelle shops do contain antimicrobial resistant pathogenic E.coli where the proportion of these isolates significantly (P<0.001) varies from shop to shop. In spite of the lesser practice of their utilization, Ciprofloxacin, Norfloxacin, and Gentamicin were found to be the best antimicrobials to treat E.coli associated infections in the study area. However, it is suggested that post-harvest hygienic management practices are to be practiced along the fish production-marketing chain.Antibiotic sensitivity test, Escherichia coli, Fish, Mekelle, Retailing shops

Photoelectrochemical cells based on emeraldine base form of polyaniline

Photoelectrochemical cells (PECs) have been fabricated using the emeraldine base form of polyaniline (EB) as a photoactive material and Eu2+/Eu3+ redox couple in methanol as an electrolyte. A PEC with a structure: Glass/ITO/EB/electrolyte/Pt produces an open-circuit voltage (V OC) of -0.132 V and a short-circuit current (I SC) of 0.64 µA cm-2 under 50 mW cm-2 white light illumination from Xe lamp. In an effort to increase the photoresponse, a PEC with a structure: Glass/ITO/EB:Nc-TiO2/Electrolyte/Pt has been devised in which a composite film of EB and nanocrystalline TiO2 (Nc-TiO2) is used as a photoactive material. The cell shows a V OC of -0.205 V and an I SC of 105 µA cm-2 when illuminated under the same conditions

Establishing a multicenter longitudinal clinical cohort Study in Ethiopia: Advanced Clinical Monitoring of Antiretroviral Treatment Project

Background: The purpose of this paper is to describe the establishment of the  Advanced Clinical Monitoring of ART Project in Ethiopia for monitoring and  evaluation of the longitudinal effectiveness of the ART program and to show the opportunities it presents. This cohort was established in response to the 2005 call by WHO for establishing additional mechanisms for stronger monitoring of ART and the need for creating the platform to generate evidence to guide the care given for the ever increasing number of patients on ART in Ethiopia.Method: A participatory and multi-stage process which started from a consensus building workshop and steered by a mother protocol as well as guiding documents which dictated the degree of engagement and expectations was followed. The primary and secondary aims of the study were agreed upon. A multi-site longitudinal observational clinical cohort was established by a consortium of stakeholders including seven Ethiopian medical schools and their affiliated referral hospitals, John Hopkins University, Ethiopian Public Health Institute, Ministry of Science and Technology, US Centers for Disease Prevention and Control - CDC-Ethiopia, and the Federal Ministry of Health. Adult and adolescent cohorts covering the age range of 14+ years) and pediatric cohorts covering those below age 14 years were the two main cohorts. During the initial recruitment of these cohorts information was extracted from existing documents for a total of 2,100 adult participants. In parallel, a prospective cohort of 1,400 adult and adolescent patients were enrolled for ART initiation and follow-up. Using similar recruitment procedures, a total of 120 children were enrolled in each of retrospective and prospective cohorts. Replacement of participants were made in subsequent years based on lost follow up and death rates to maintain adequacy of the sample to be followed-up.Achievements: Between January 2005 and August 2013 a total of 4,339 patients were followed for a median of 41.6 months and data on demographic characteristics, baseline and ongoing clinical features, hospitalization history, medication and laboratory information were collected. 39,762 aliquots and 25,515 specimens of plasma and dry-blood-spots respectively were obtained and stored longitudinally from October 2009 to August 2013. The project created a research platform for researchers, policy and decision makers. Moreover, it encouraged local and international investigators to identify and answer clinically and programmatically relevant research questions using the available data and specimens. Calls for concept notes paired with multiple trainings to stimulate investigators to conduct analyses further boosted the potential for doing research.Conclusions: A comprehensive and resourceful mechanism for scientific inquiry was established to support the national HIV/ART program. With meaningful involvement and defined roles, establishment of a study, which involved multiple institutions and investigators, was possible. Since ACM is the largest multi-site clinical cohort of patients on antiretroviral treatment in Ethiopia---which can be used for research and for improving clinical management---considering options to sustain the project is crucial. Key Words: Ethiopia, HIV clinical cohort, Antiretroviral therapy, Establishing Longitudinal Cohort Study, ART Monitoring and Evaluatio

The burden of HIV/AIDS in Ethiopia from 1990 to 2016: evidence from the Global Burden of Diseases 2016 Study

BACKGROUND: The burden of HIV/AIDS in Ethiopia has not been comprehensively assessed over the last two decades. In this study, we used the 2016 Global Burden of Diseases, Injuries and Risk factors (GBD) data to analyze the incidence, prevalence, mortality and Disability-adjusted Life Years Lost (DALY) rates of Human Immunodeficiency Virus / Acquired Immune Deficiency Syndrome (HIV/AIDS) in Ethiopia over the last 26 years. METHODS: The GBD 2016 used a wide range of data source for Ethiopia such as verbal autopsy (VA), surveys, reports of the Federal Ministry of Health and the United Nations (UN) and published scientific articles. The modified United Nations Programme on HIV/AIDS (UNAIDS) Spectrum model was used to estimate the incidence and mortality rates for HIV/AIDS. RESULTS: In 2016, an estimated 36,990 new HIV infections (95% uncertainty interval [UI]: 8775-80262), 670,906 prevalent HIV cases (95% UI: 568,268-798,970) and 19,999 HIV deaths (95% UI: 16426-24412) occurred in Ethiopia. The HIV/AIDS incidence rate peaked in 1995 and declined by 6.3% annually for both sexes with a total reduction of 77% between 1990 and 2016. The annualized HIV/AIDS mortality rate reduction during 1990 to 2016 for both sexes was 0.4%