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

Tourism Potential & Challenges for Islamic Monastery Heritage Sites in Ethiopia: Tiru Sina Mosque

The main intent of this study is to investigate unusual Islamic monastery heritage sites by focusing on the potential resources and challenges for religious tourism development at Tiru Sina Mosque. To meet this objective a qualitative approach was utilised and data were collected through interviews with elderly religious fathers in addition to culture and tourism officers. Additional focus groups, discussions and deep personal observations were conducted. As the findings reveal, Tiru Sina Mosque is a unique Islamic monastic site with great potential for religious tourism development. This unique Islamic monastery heritage site has socio-cultural, economic, historical, religious and aesthetic values. The study also confirmed, even though the area is rich in cultural heritage, there are serious challenges that affect its development. The major problems are lack of awareness, poor handling systems for heritage, lack of infrastructural development, absence of coordination among stakeholders, shortage of skilled professionals, lack of cooperation and partnership among different stakeholders, heritage destruction and lack of conservation, and lack of risk management

Integrating Family Planning Training into Medical Education: A Case Study of St. Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa

https://deepblue.lib.umich.edu/bitstream/2027.42/148156/1/integrating-family-planning-into-medical-education-a-case.pdf-1Description of integrating-family-planning-into-medical-education-a-case.pdf : Case Study (PDF

The status of hygiene and sanitation practice among rural model families of the Health Extension Program (HEP) in Wolayta and Kembata Tembaro Zones of Southern Nations, Nationalities and Peoples’ Region of Ethiopia

Background: Since the Health Extension Program (HEP) started the training and graduation of model families, little is known about the status and maintenance of hygiene and sanitation practice to inform future directions and decisions.Objective: to assess the status and maintenance of hygiene and sanitation practices among rural model families of the Health Extension Program.Method: A cross-sectional comparative study was conducted from Dec.-June 2010/11 in Wolayta and Kembata Tembaro Zones of Southern Nations, Nationalities and Peoples Regional State of Ethiopia. Two types of comparisons were involved in the study; comparison of hygiene and sanitation practices of a randomly selected 690 model families and 686 non-model families, and comparison of similar practices among model families at the time of graduation, assessed in retrospective interview, versus at the time of survey. Quantitative data were collected from the two zones from Dec- Jan. 2010/11. Qualitative data were also collected in June 2011 to complement the findings of the quantitative data from a purposively selected group of women and men among model families in the study areas. Descriptive and analytics statistics were used to analyse the quantitative data using STATA version 10 while the qualitative data were analysed using Open Code version 3.6.2.0Results: The study showed that among model families, 82% of them had pit latrine, 23.1 % had solid and liquid waste disposal pits, 19.0% had shelves for storing utensils and 34.1 % had separate dwelling for people and cattle as compared to 55.6 %, 9.1%, 6% and 18.5 % of similar practices among non-model families respectively (p<0.001). Latrine availability, storage of water in a narrow necked covered container, possession of shelves for storage of utensils and fuel saving stoves declined from 96.6% to 82.3%, 92.7% to 78.6%, 33.6% to 19.1% and from 6.1% to 3%, respectively among model families after graduation (p<0.01). During FGDs and in-depth interviews, socio-economic and cultural reasons were mentioned as factors that hindered the maintenance of the practices.Conclusion: Generally, model families performed better in most of the hygiene and sanitation practices than nonmodel families. The study also indicated a decline in the maintenance of certain practices among some model families

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

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

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In vivo efficacy of artemether-lumefantrine against uncomplicated Plasmodium falciparum malaria in Central Ethiopia

<p>Abstract</p> <p>Background</p> <p><it>In vivo </it>efficacy assessments of the first-line treatments for <it>Plasmodium falciparum </it>malaria are essential for ensuring effective case management. In Ethiopia, artemether-lumefantrine (AL) has been the first-line treatment for uncomplicated <it>P. falciparum </it>malaria since 2004.</p> <p>Methods</p> <p>Between October and November 2009, we conducted a 42-day, single arm, open label study of AL for <it>P. falciparum </it>in individuals >6 months of age at two sites in Oromia State, Ethiopia. Eligible patients who had documented <it>P. falciparum </it>mono-infection were enrolled and followed according to the standard 2009 World Health Organization <it>in vivo </it>drug efficacy monitoring protocol. The primary and secondary endpoints were PCR uncorrected and corrected cure rates, as measured by adequate clinical and parasitological response on days 28 and 42, respectively.</p> <p>Results</p> <p>Of 4426 patients tested, 120 with confirmed falciparum malaria were enrolled and treated with AL. Follow-up was completed for 112 patients at day 28 and 104 patients at day 42. There was one late parasitological failure, which was classified as undetermined after genotyping. Uncorrected cure rates at both day 28 and 42 for the per protocol analysis were 99.1% (95% CI 95.1-100.0); corrected cure rates at both day 28 and 42 were 100.0%. Uncorrected cure rates at day 28 and 42 for the intention to treat analysis were 93.3% (95% CI 87.2-97.1) and 86.6% (95% CI 79.1-92.1), respectively, while the corrected cure rates at day 28 and 42 were 94.1% (95% CI 88.2-97.6) and 87.3% (95% CI 79.9-92.7), respectively. Using survival analysis, the unadjusted cure rate was 99.1% and 100.0% adjusted by genotyping for day 28 and 42, respectively. Eight <it>P. falciparum </it>patients (6.7%) presented with <it>Plasmodium vivax </it>infection during follow-up and were excluded from the per protocol analysis. Only one patient had persistent parasitaemia at day 3. No serious adverse events were reported, with cough and nausea/vomiting being the most common adverse events.</p> <p>Conclusions</p> <p>AL remains a highly effective and well-tolerated treatment for uncomplicated falciparum malaria in the study setting after several years of universal access to AL. A high rate of parasitaemia with <it>P. vivax </it>possibly from relapse or new infection was observed.</p> <p>Trial Registration</p> <p><a href="http://www.clinicaltrials.gov/ct2/show/NCT01052584">NCT01052584</a></p

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

Low physical activity is associated with adverse health outcome and higher costs in Indonesia: A national panel study

AimsTo assess the association between low physical activity, cardiovascular disease (CVD) and risk factors, health service utilization, risk of catastrophic health expenditure, and work productivity in Indonesia.MethodsIn this population-based, panel data analysis, we used data from two waves of the Indonesian Family Life Survey (IFLS) for 2007/2008 and 2014/2015. Respondents aged 40–80 years who participated in both waves were included in this study (n = 5,936). Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ-SF). Multinomial logistic regression model was used to examine factors associated with physical activity levels (low, moderate, and high). We applied a series of multilevel mixed-effect panel regression to examine the associations between physical activity and outcome variables.ResultsThe prevalence of low physical activity increased from 18.2% in 2007 to 39.6% in 2014. Compared with those with high physical activity, respondents with low physical activity were more likely to have a 10-year high CVD risk (AOR: 2.11, 95% CI: 1.51–2.95), use outpatient care (AOR: 1.26, 95% CI: 1.07–1.96) and inpatient care (AOR 1.45, 95% CI: 1.07–1.96), experience catastrophic health expenditure of 10% of total household expenditure (AOR: 1.66, 95% CI: 1.21–2.28), and have lower labor participation (AOR: 0.24, 95% 0.20–0.28).ConclusionsLow physical activity is associated with adverse health outcomes and considerable costs to the health system and wider society. Accelerated implementation of public health policies to reduce physical inactivity is likely to result in substantial population health and economic benefits

Reducing stigma and increasing workplace productivity due to mental health difficulties in a large government organization in the UK: a protocol for a randomised control treatment trial (RCT) of a low intensity psychological intervention and stigma reduction programme for common mental disorder (Prevail)

Background Common mental disorders are the leading cause of workplace absences. While the reasons for this are multifarious, there is little doubt that stigma related to common mental disorder plays a large role in sickness absence and in poor help-seeking. Frequently both managers and staff are unsure of how to approach and intervene with mental health related problems. We have therefore devised a mental health intervention programme (Prevail) that aims to reduce stigma and to educate staff about evidence-based low intensity psychological interventions. These can be used by the individual, as well as in collaboration with managers via co-production of problem-focussed solutions, with the aim of improving mental health, reducing sickness absence, and increasing workplace productivity. Methods This two-armed cluster randomised control trial (RCT) will evaluate the effectiveness of Prevail. Eighty managers at a large UK government institution (the DVLA) and their teams (approximately 960 employees) will be randomised into the active intervention group or control (employment as usual) arms of the study. All participants will be invited to complete a series of questionnaires related to mental health stigma, their current and past mental health, and their recent workplace productivity (absenteeism and presenteeism). All employees in the active arm will receive the Prevail Staff intervention, which covers stigma reduction and includes psychoeducation about evidence-based low intensity psychological interventions for common mental disorder. The managers in the active arm will also receive the Prevail Managers programme which covers communication skills, problem formulation, and problem-solving skills. The questionnaire battery will then be given to both groups again 4 weeks post training, and 12 months post-training. Official records of absenteeism from Human Resources will also be gathered from both active and control groups at 12 months post-training