Quality analysis of selected Pediatric HIV/AIDS/TB Medicines in Livingstone District, Zambia

Introduction :Counterfeiting affects all medical products, from medicines and pharmaceutical ingredients to medical devices and diagnostics. Counterfeit drugs including overt forgeries, pharmaceutically-sound close imitations, substandard generic medications, gray pharmaceuticals, and repackaged expired drugs are not only a problem of the developing world. It is therefore important to know or ascertain the quality of medicines or drugs being consumed by the population for public health protection. This study was designed to evaluate the quality of selected pediatric HIV/AIDS and TB drugs in Livingstone district health facilities of Zambia. Methodology :The study was a cross sectional study that involved the collection of samples of different brands/lots of pediatric Nevirapine (NVP) suspension as well as Rifampicin-Isoniazid (RH) tablets in Livingstone District health facilities. A total of 400 RH tablets and 50 bottles of NVP suspension of different brands and batches were collected, kept and transported to Lusaka for analysis at ambient temperature. The analysis involved assessing for presence of Active Pharmaceutical Ingredients, percentage content, packaging, appearance and labeling standards with reference to the official monographs in this case the International Pharmacopoeia 2011 (IP) and the United State Pharmacopeia 36 (USP). Results :A total of 450 drug samples were included in the study and 100% were correctly identified, had the active pharmaceutical ingredient in the right quantities, appeared, labeled and packaged in conformity with the official monographs of the USP 36 and IP 2011. Conclusion :This study provided objective evidence that the selected pediatric medicines available in Livingstone District Health facilities of the Republic of Zambia are of good quality and meet the requirements as stipulated in the official monographs of the USP and IP

Predictive validity of continuous assessment score on the final examination score and assessment outcomes for pharmacy students examined between 2013 and 2017 at the University of Zambia

ThesisBackground: The University of Zambia, School of Medicine/ Health Sciences has an examination policy that puts significant emphasis on the contribution of the learners’ continuous assessment scores towards their final examination scores. While there is evidence of the predictive nature of continuous assessment on academic performance in some educational setups, there exists locally, insufficient evidence on the predictive validity of continuous assessment scores on the final examination scores and assessment outcomes of pass or fail and the grade point average in health professions education such as pharmacy. Realizing that the ultimate key determinants of course specific pass or fail and grade point average are the quality of the assessment practices and decisions, in the context of their validity, the current study proposes that the predictive validity of continuous assessment scores on the final examination scores and assessment outcomes of pass or fail and grade point average in promoting quality in health professions education be established. Therefore, this study set out to establish the predictive validity of the continuous assessment score on the final examination score and assessment outcomes of pass or fail and grade point average for pharmacy students examined between 2013 and 2017 while exploring the experiences and perceptions of examinees and examiners regarding the assessment policy and practice at the University of Zambia. Methods: The current study utilised a mixed-method approach using the convergent parallel study design. The quantitative arm was a non-interventional cross-sectional study, while the qualitative arm was a case study design. The study was conducted at the University of Zambia, School of Medicine, Department of Medical Education Development and Evelyn Hone College of Health Sciences located within Lusaka District, Zambia. The study sample comprised of the fourth- and fifth-year pharmacy students’ examination results at the University of Zambia and third-year pharmacy student’s examination results at Evelyn Hone College examined between 2013 and 2017. A total of 855 examination results were retrieved and analysed in the quantitative arm. In the qualitative arm, three (3) focus group discussions were conducted comprising of the third-year pharmacy students from Evelyn Hone College and a combined fourth- and fifth-year pharmacy students from the University of Zambia. Another focus group discussion was conduct on the examiners from both institutions. Correlations of the continous assessment score on the final examination score and the grade point average were carried out. Chi-square was used to establish the relationship between the continous assessment score and the course-specific pass or fail. Furthermore, Multiple linear and logistic regressions were conducted to establish the predictive validity of the continous assessment score on the final examination score, pass or fail and the grade point average while adjusting for demographic characteristics. In the focus group discussions, the data were transcribed and then compared and further regrouped and recoded to come up with broader themes based on the interview guide. The broader themes were then linked to the six core categories for the examinees focus group discussions while only three core categories were identified for the examiners focus group discussions. Results: There was a statistically significant positive correlation between course-specific continous assessment scores and the final examination scores as well as the grade point average scores across all the courses examined. The surprising finding after further analysis was that the median grade point average scores observed in the study were below the University of Zambia School of Medicine acceptable grade point average score of 2.5. There was a statistically significant difference observed between the course-specific mean continous viii assessment scores and the respective final examination scores. Multiple linear and logistic regression revealed that the continous assessment score had predictive validity on the final examination score, grade point average and pass or fail assessment outcomes. Additionally, examinees, whose continous assessment score was Less than 20 demonstrated capabilities of passing in all the courses examined, who in this context, would not have ordinarily been allowed to sit for the final examination . The main themes identified in the focus group discussions include: Awareness of the policy; Strengths and weaknesses; Feedback mechanism on assessments; and Factors affecting academic performance. Among the highlighted factors affecting students’ academic performance include: Poor communication among faculty; Inadequate time allocation for the study break; and High student to lecturer ratio resulting in poor individual student attention. Conclusion: There is predictive validity of the continous assessment score on the final examination score and examination outcomes of course-specific pass or fail and grade point average. However, it was observed that the median grade point average score obtained was lower compared to the University of Zambia acceptable grade point average score of 2.5. This could be indicative of poor mastery of expected competencies based on the definition of grade point average. Additionally, examinees whose continous assessment score was less than 20 demonstrated capabilities of passing in all the courses examined. The results suggest that there may be no justification to deny a student to sit the final examination based on the failed continous assessment score realising that a course is graded on a performance continuum of scores ranging from 0 to 100%. The current study has provided valuable frameworks and evidence for designing interventions to improve learning and performance in assessments leading to better pedagogical delivery of curriculum objectives and better decisions on the assessment of competencies. This will ultimately lead to better educational outcomes that will translate into competent health professionals to deliver quality health care services for the benefit of patients. Key Words: Predictive Validity, Continous Assessment, Final Examination, Summative Assessment, Grade Point Averag

Expanding the scales and domains of (in)security: youth employment in urban Zambia

Most research on issues of (in)security has tended to have a military/safety angle and focus on global/national scales linked to spectacular events. This paper addresses the overlooked insecurity realities of urban dwellers in the global South through a focus on more persistent and enduring forms of employment insecurities among young people. Building on both quantitative and qualitative data collected in a low-income settlement in Lusaka, Zambia, we explore how young people perceive their employment situation and examine the practices they engage in when seeking ways of making a living. Through analysing their views and experiences we show how employment insecurity is influenced by processes operating at the body, local, national and global scales, and how employment insecurity is closely interconnected with insecurity in other domains of young people's lives including the household, housing and education. Although the youth unemployment situation is often viewed as a serious threat to human security, we show how the lack of stable employment in itself is a manifestation of insecurity

A Comparison of the Arbitrary Set Fifty Percent Pass Mark Standard and Grade Point Average Attainment for Pharmacy Students at the University of Zambia: Implications for High-stakes decisions in Assessments

In many higher learning institutions and Health Professions Education (HPE) programmes in particular, there exists varying standard setting methods for assessment, certification and graduation of students’ academic performance. In Zambia, the historic arbitrary set 50% pass-fail standard is predominant in most health professions’ training programmes. Scientific validation of this practice, however, remains scarce. The aim of this study was to compare the academic performance on the historic arbitrary set 50% pass-fail standard to the Grade Point Average (GPA) score attainment for pharmacy students examined between 2013 and 2017 at the University of Zambia. A cross-sectional study was conducted with a total of 445 randomly selected final examination results for undergraduate pharmacy students examined between 2013 and 2017 at the University of Zambia. The data was analysed using Stata 13 and GraphPad Prism 5.  For all the statistical tests conducted, normality of the data was checked using the Shapiro-Wilk test. There was statistically significant difference between the historic arbitrary set 50% pass-fail standard and the course-specific examination composite score attainment in all the courses (P<0.0001). Additionally, there was a statistically significant difference between the examinees’ GPA score attained and the acceptable GPA score of 3.0 (Median GPA 1.75; IQR: 0.75-2.25 and 1.67; IQR: 1.0-2.0) for the fourth and fifth-year examinees respectively). The comparison of the academic performance on the arbitrary 50% pass-fail standard and GPA score attainment for pharmacy students revealed that despite students demonstrating ability to attain high course-specific composite scores using the arbitrary set 50% pass-fail standard, the attained median GPA score was statistically significantly less than the minimum acceptable GPA score of 3.0. While the 50% pass-fail standards’ precision to detect academic performance maybe questioned, the findings suggests that the incorporation of a credit point and GPA system for making assessment decisions to rate students, certification and graduation requirements in Health Professions Education may offer better precision and prediction to detect academic performance and competency attainment

Addressing Radiography Workforce Competence Gaps in Zambia: Insights into the Radiography Diploma Training Programme Using a Curriculum Mapping Approach

In Zambia, the radiography diploma programme has been offered since 1970 and has undergone only five reviews against an estimated ten [10] over 40 years. Such a situation can call into question the quality of radiography training. Curriculum evaluation is a key factor in ensuring quality standards of an educational training programme. The timely review ensures that curricula are in keeping with contemporary practice requirements. We analysed the 2014 radiography curriculum using a curriculum mapping approach to evaluate the stated objectives and their alignment to the educational domains and contemporary radiography practice requirements. Method: A case study design was used to explore the 2014 TEVETA radiography curriculum. Content analysis was used to identify curriculum learning objectives. A framework based on Harden’s curriculum mapping approach was developed. The first phase involved analysis of the curriculum content against the educational domains [i.e. cognitive, psychomotor, and affective domains, respectively]. The second phase involved comparing the stated learning outcomes with contemporary radiography practices. Results: A total of 90 learning outcomes were identified. The analysis revealed that 80% [N=72] of all the stated objectives were cognitive, while only 13% and 7% were psychomotor and affective, respectively. Furthermore, over 70% were pitched at the lower-order skills level of Dave’s taxonomy. In terms of radiographer competence, 55% [N=40] were attributed to technical skills. However, more than 90% of the technical competences were knowledge components and 10% actual psychomotor skills. Conclusion: A curriculum mapping approach was useful in analysing the current Zambian radiography diploma curriculum. The overemphasis on lower-order cognitive and psychomotor competence in the curriculum calls into question the technical readiness of new graduates to effectively perform at the expected level of proficiency in the workplace. Findings of this study provide valuable information that can be used for reviewing the curriculum to make the training more responsive to contemporary radiography practice demands

Multitasking, but for what benefit? The dilemma facing Nigerian university students regarding part-time working.

Students working part-time while studying for a full-time university degree are commonplace in many Western countries. This paper however, examines the historically uncommon part-time working activities and career aspirations among Nigerian university students. In particular, how working is perceived to contribute to developing employability skills, and whether it is influenced by their self-efficacy. Survey data from 324 questionnaires was collected from a federal university, although the data analysis used a mixed-method. The findings indicate that despite low levels of part-time working generally among students, older, more experienced, higher level and female students, place a premium on the skills that part-time work can develop. Moreover, self-efficacy and being female, is a significant predictor in understanding part-time work and career aspirations. This study offers originality by focusing on students’ part-time work, the value working provides, and its link with career aspirations, within a relatively unexplored context of Nigeria