Assessment of laboratory logistics management information system practice for HIV/AIDS and tuberculosis laboratory commodities in selected public health facilities in Addis Ababa, Ethiopia

Introduction: Logistics management information system for health commodities remained poorly implemented in most of developing countries. To assess the status of laboratory logistics management information system for HIV/AIDS and tuberculosis laboratory commodities in public health facilities in Addis Ababa. Methods: A cross-sectional descriptive study was conducted from September 2010-January 2011 at selected public health facilities. A stratified random sampling method was used to include a total of 43 facilities which, were investigated through quantitative methods using structured questionnaires interviews. Focus group discussion with the designated supply chain managers and key informant interviews were conducted for the qualitative method. Results: There exists a well-designed logistics system for laboratory commodities with trained pharmacy personnel, distributed standard LMIS formats and established inventory control procedures. However, majority of laboratory professionals were not trained in LMIS. Majority of the facilities (60.5%) were stocked out for at least one ART monitoring and TB laboratory reagents and the highest stock out rate was for chemistry reagents. Expired ART monitoring laboratory commodities were found in 25 (73.5%) of facilities. Fifty percent (50%) of the assessed hospitals and 54% of health centers were currently using stock/bin cards for all HIV/AIDS and TB laboratory commodities in main pharmacy store, among these only 25% and 20.8% of them were updated with accurate information matching with the physical count done at the time of visit for hospitals and health centers respectively. Conclusion: Even though there exists a well designed laboratory LMIS, keeping quality stock/bin cards and LMIS reports were very low. Key ART monitoring laboratory commodities were stock out at many facilities at the day of visit and during the past six months. Based on findings, training of laboratory personnel's managing laboratory commodities and keeping accurate inventory control procedures were recommended.Key words: Logistics management information system, stock outs, laboratory commoditie

X-ray film reject rate analysis at eight selected government hospitals in Addis Ababa, Ethiopia, 2010

Background: Improper practices in radiography that lead to possible repeating of procedures predispose patients for additional cost, more waiting time, and excess dose of ionizing radiation, leading to various dose dependent and dose independent health problems including cancer. In the face of such problems and the scarcity of resources, improvingthe quality and efficiency of radiology services is imperative.Objective: The purpose of this research was to identify the main causes of film faults as well as the pattern and magnitude of film rejection.Methods: Using a prospective cross-sectional hospital based approach; eight public hospitals were selected in Addis Ababa through convenience sampling. Adult and pediatrics radiographs with film faults were reviewed using a standardized checklist of common causes of reject. The collected data were then entered into a database for analysis using descriptive statistics.Results: Reject rate was calculated in eight governmental hospitals across all plain film examinations. The overall reject rate was 374 (3.1 %) in 12,165 x-ray exposures. Total reject rate by hospital showed 10.5% for Zewditu and 1.53% and 1.87% for Tikur Anbessa Specialized Hospital (TASH) and the Police Hospital, respectively.Conclusions: Rejected films were found to have been caused by numerous factors including poor technical judgment, patient motion, and poor supervision of staff. Hence, strategies need to be developed within medical imaging departments to improve the situation.[Ethiop. J. Health Dev. 2012;26(1):54-59

Improvement of Grassland Through Community Participation in the Middle AwashValley of Ethiopia

The natural resources of the grassland in the middle Awash valley of Ethiopia are subjected to competing claims: development to generate revenue for the state, conservation of wildlife and wilderness areas, as well as use for local production. The combination of climatic conditions causing drought and the over use of the natural resource can be cited as the primary cause of grassland deterioration in the area. Since the problems of the grasslands are complex and multi-dimensional, they are not amenable to quick and easy fixes. Hence, if sustainable progress is to be achieved, the responsibility for change must be in the hands of the communities and household themselves. Pastoral communities, in collaboration with CARE-Ethiopia, local government and other partner NGOs embarked on grassland improvement activities that were based on traditional activities. The objective of this study was to assess the condition of the traditionally-improved grazing lands

Consumer drivers and barriers of WASH products use in rural Ethiopia

In Ethiopia, the coverage of basic WASH facilities is very low. In response, government of Ethiopia and its development partners have been using sanitation marketing to promote and sell WASH products. Qualitative in-depth interview with households, supply chain actors, and stakeholders were conducted in four regions of Ethiopia to learn about current product use behaviours. The result showed presence of any latrine was related to greater awareness about importance to health. Financial constraints, unavailability of construction materials were major barriers to possession of latrines. Word of mouth was the dominant source of information on WASH products, with health extension workers being a respected source. The major challenges of supply chain actors at district level were finance, inadequate working space, and lack of business development skills. Lack of regular WASH products supply system at community level and lack of profound awareness about health benefit were the priority constrains to access latrines

Hydrological Foundation as a Basis for a Holistic Environmental Flow Assessment of Tropical Highland Rivers in Ethiopia

The sustainable development of water resources includes retaining some amount of the natural flow regime in water bodies to protect and maintain aquatic ecosystem health and the human livelihoods and wellbeing dependent upon them. Although assessment of environmental flows is now occurring globally, limited studies have been carried out in the Ethiopian highlands, especially studies to understand flow-ecological response relationships. This paper establishes a hydrological foundation of Gumara River from an ecological perspective. The data analysis followed three steps: first, determination of the current flow regime flow indices and ecologically relevant flow regime; second, naturalization of the current flow regime looking at how flow regime is changing; and, finally, an initial exploration of flow linkages with ecological processes. Flow data of Gumara River from 1973 to 2018 are used for the analysis. Monthly low flow occurred from December to June; the lowest being in March, with a median flow of 4.0 m(3) s(-1). Monthly high flow occurred from July to November; the highest being in August, with a median flow of 236 m(3) s(-1). 1-Day low flows decreased from 1.55 m(3) s(-1) in 1973 to 0.16 m(3) s(-1) in 2018, and 90-Day (seasonal) low flow decreased from 4.9 m(3) s(-1) in 1973 to 2.04 m(3) s(-1) in 2018. The Mann-Kendall trend test indicated that the decrease in low flow was significant for both durations at alpha = 0.05. A similar trend is indicated for both durations of high flow. The decrease in both low flows and high flows is attributed to the expansion of pump irrigation by 29 km(2) and expansion of plantations, which resulted in an increase of NDVI from 0.25 in 2000 to 0.29 in 2019. In addition, an analysis of environmental flow components revealed that only four "large floods" appeared in the last 46 years; no "large flood" occurred after 1988. Lacking "large floods" which inundate floodplain wetlands has resulted in early disconnection of floodplain wetlands from the river and the lake; which has impacts on breeding and nursery habitat shrinkage for migratory fish species in Lake Tana. On the other hand, the extreme decrease in "low flow" components has impacts on pin smaller pools. These results serve as the hydrological foundation for continued studies in the Gumara catchment, with the eventual goal of quantifying environmental flow requirements.redators, reducing their mobility and ability to access prey concentrate

Assessment of routine surveillance data as a tool to investigate measles outbreaks in Mozambique

BACKGROUND: Measles remains a major public health problem in Mozambique despite significant efforts to control the disease. Currently, health authorities base their outbreak control on data from the routine surveillance system while vaccine coverage and efficacy are calculated based on mathematical projections of the target population. The aim of this work was to assess the quality of the measles reporting system during two outbreaks that occurred in Maputo City (1998) and in Manica Province (2002). METHODS: Retrospectively, we collected data from the routine surveillance system, i.e. register books at health facilities and weekly provincial and national epidemiological reports. To test whether the provinces registered an outbreak, the distribution of measles cases was compared to an endemic level established based on cases reported in previous years. RESULTS: There was a significant under-notification of measles cases from the health facilities to the province and national level. Register books, the primary sources of information for the measles surveillance system, were found to be incomplete for two main variables: "age" and "vaccination status". CONCLUSION: The Mozambican surveillance system is based on poor quality records, receives the notification of only a fraction of the total number of measles in the country and may result in failures do detect epidemics. The measles reporting system does not provide the data needed by Expanded Program on Immunisation managers to make evidence-based decisions, nor does it allow in-depth analysis to monitor measles epidemiology in the country. The progress of Mozambique to the next stage of measles elimination will require an improvement of the routine surveillance system and a stronger Health Information System

The combined effects of obesity, abdominal obesity and major depression/anxiety on health-related quality of life: The lifelines cohort study

Copyrigh

Continuum of care in maternal, newborn and child health in Pakistan: analysis of trends and determinants from 2006 to 2012

Iqbal S, Maqsood S, Zakar R, Zakria Zakar M, Fischer F. Continuum of care in maternal, newborn and child health in Pakistan: analysis of trends and determinants from 2006 to 2012. BMC Health Services Research. 2017;17(1): 189.Background Pakistan, being a developing country, presents the dismal picture of maternal and neonatal mortality and morbidity. The majority of maternal and neonatal deaths could be avoided if Continuum of Care (CoC) is provided in a structured pathway from pregnancy to birth and to the first week of life of the newborn child. This study aimed to analyse the trends of CoC at all three levels (antenatal care, skilled delivery and postpartum care) and to identify various factors affecting the continuation in receiving CoC in Pakistan during 2006 to 2012. Methods Secondary data analysis was performed on nationally representative data from the last two iterations of Pakistan Demographic and Health Survey (PDHS), conducted during 2006/07 to 2012/13. The analysis is limited to women of the reproductive age group (15–49 years) who gave birth during the last five years preceding both surveys. This leads to a sample size of 5,724 and 7,461 respondents from PDHS 2006/07 and 2012/13 respectively. The association between CoC and several factors, including individual attributes (reproductive status), family influences, community context, as well as cultural and social values was assessed in bivariate analyses in a first step. Furthermore, odds ratios and adjusted odds ratios with 95% confidence intervals using a binary and multivariable logistic regression were calculated. Results Our research presents the trends of a composite measure of CoC including antenatal care, delivery assistance and postpartum care. The largest gap in CoC was observed at antenatal care followed by delivery and postnatal care within 48 h after delivery. Results show that CoC completion rate has increased from 15% to 27% amongst women in Pakistan over time from 2006 to 2012. Women with high age at first birth, having less number of children, with higher education, belonging to richest quintile, living in Sindh province and urban areas, having high autonomy and exposure to mass media were most likely to avail complete CoC. Conclusions The findings show that women in Pakistan still lack the CoC. This calls for attention to develop and implement tailored interventions, focusing on the needs of women in Pakistan to provide CoC in an integrated manner, involving both public and private sectors by appropriately addressing the factors hindering CoC completion rates

A systematic review of primary care models for non-communicable disease interventions in Sub-Saharan Africa

Background Chronic diseases, primarily cardiovascular disease, respiratory disease, diabetes and cancer, are the leading cause of death and disability worldwide. In sub-Saharan Africa (SSA), where communicable disease prevalence still outweighs that of non-communicable disease (NCDs), rates of NCDs are rapidly rising and evidence for primary healthcare approaches for these emerging NCDs is needed. Methods A systematic review and evidence synthesis of primary care approaches for chronic disease in SSA. Quantitative and qualitative primary research studies were included that focused on priority NCDs interventions. The method used was best-fit framework synthesis. Results Three conceptual models of care for NCDs in low- and middle-income countries were identified and used to develop an a priori framework for the synthesis. The literature search for relevant primary research studies generated 3759 unique citations of which 12 satisfied the inclusion criteria. Eleven studies were quantitative and one used mixed methods. Three higher-level themes of screening, prevention and management of disease were derived. This synthesis permitted the development of a new evidence-based conceptual model of care for priority NCDs in SSA. Conclusions For this review there was a near-consensus that passive rather than active case-finding approaches are suitable in resource-poor settings. Modifying risk factors among existing patients through advice on diet and lifestyle was a common element of healthcare approaches. The priorities for disease management in primary care were identified as: availability of essential diagnostic tools and medications at local primary healthcare clinics and the use of standardized protocols for diagnosis, treatment, monitoring and referral to specialist care