Project description:BackgroundThe problem of medicine expiration presents a notable obstacle, resulting in considerable financial losses. Nevertheless, there is currently limited data indicating that certain medications do not experience a significant decrease in effectiveness after their expiration date. Therefore, the aim of the study was to assess the physico-chemical quality of expired fluoroquinolone antibiotics.MethodsThe expired samples of fluoroquinolone antibiotics were purposively collected from public hospitals in the Jimma zone of the Oromia regional state, Ethiopia. A World Health Organization quality evaluation sampling strategy was employed. Then, simple random sampling techniques were utilized for the selection of tablets for the laboratory quality control test. The assay, identification, and dissolution were performed in accordance with the United States Pharmacopeia (USP) guidelines, as well as failure mode and effect analysis (FMEA) techniques.ResultsThe finding revealed that about 100% (7/7) expired samples passed pharmacopeia quality specifications for identity and assay tests. However, of the seven expired brands, about 14.3% (1/7) of the sample (Code-002) was unable to release its API content within the USP criteria of 30 min. The risk-based quality evaluation revealed that assay was the most critical quality attributed to ciprofloxacin tablets (RPN = 189), followed by identity (RPN = 100). Assay was also the most critical quality attribute (RPN = 378), followed by identity (RPN = 100) for Norfloxacin tablets. The risk-based desirability function approach showed that 75% (3/4) of ciprofloxacin products were of good quality, and 25% (1) were found to be of acceptable quality, while the desirability function of norfloxacin tablets was found to be excellent 1 (33.3%), good 1 (33.3%), and acceptable 1 (33.3%).ConclusionThe study revealed that medications can maintain their quality beyond their labeled expiration date. By combining pharmacopeial standards with risk-based approaches like failure mode and effect analysis (FMEA), the study provides a comprehensive evaluation framework. This approach not only confirms the continued effectiveness of expired fluoroquinolone antibiotics but also underscores the potential waste reduction and cost-saving benefits. This could significantly contribute to addressing healthcare challenges in low-resource settings, promoting more efficient pharmaceutical resource utilization.

Project description:BackgroundThe community-based health insurance (CBHI) scheme is a growing initiative aimed at enhancing healthcare access for the most impoverished members of the community. The Ethiopian CBHI scheme aims to enhance access to essential healthcare services, including medical laboratory services, for the poorest members of the community, but there is limited evidence on satisfaction levels. The aim of this study was to assess the satisfaction level of CBHI beneficiaries with laboratory services and their associated factors among selected public hospitals in Jimma Zone, Oromia Region, Ethiopia.MethodsA facility-based cross-sectional study was conducted on selected public hospitals in the Jimma Zone from September to October 2023. A total of 421 CBHI beneficiaries were enrolled in the study using a convenient sampling technique, and interviewers administered structured questionnaires to collect data. Data were entered into Epi-data and analyzed using the Statistical Package of Social Sciences version 25. Descriptive analysis was used to summarize independent variables; bivariate and multivariable logistic regression analyses were done to test the association between independent and dependent variables; and statistical significance was declared at P<0.05.ResultsMore than half (55.8%) of the 419 study participants were female. Above half, 57.5% of the respondents were satisfied by the clinical laboratory services at public hospitals in Jimma Zone. Components with a higher satisfaction rate were providers' professional appearances (98.3%), procedures for specimen collection (87.6%), and availability of entertainment facilities at the waiting area (67.8%). On the contrary, longer waiting times to receive the test results (76.6%), inefficiency of the reception area (74.7%), and the inability of professionals to explain diagnostic procedures (58.0%) were associated with higher rates of dissatisfaction. Educational status and the number of hospital visits were found to have a statistically significant association with level of satisfaction with laboratory services.ConclusionsCBHI beneficiaries' satisfaction with laboratory service was at a moderate level in Jimma Zone public hospitals. Therefore, attention should be given to continuous monitoring of patients' satisfaction with services, improving reception areas, and practicing routine explanations about the purposes and procedures during specimen collection to improve the beneficiaries' satisfaction level with clinical laboratory services.

Project description:BackgroundNurse-physician communication has been shown to have a significant impact on the job satisfaction and retention of staff. In areas where it has been studied, communication failure between nurses and physicians was found to be one of the leading causes of preventable patient injuries, complications, death and medical malpractice claims.ObjectiveThe objective of this study is to determine perception of nurses and physicians towards nurse-physician communication in patient care and associated factors in public hospitals of Jimma zone, southwest Ethiopia.MethodsInstitution based cross-sectional survey was conducted from March 10 to April 16, 2014 among 341 nurses and 168 physicians working in public hospitals in Jimma zone. Data was collected using a pre-tested self-administered questionnaire; entered into EpiData version 3.1 and exported to Statistical Package for Social Sciences (SPSS) version 16.0 for analysis. Factor analysis was carried out. Descriptive statistics, independent sample t-test, linear regression and one way analysis of variance were used. Variables with P-value < 0.05 were considered as statistically significant.ResultsThe response rate of the study was 91.55%. The mean perceived nurse-physician communication scores were 50.88±19.7% for perceived professional respect and satisfaction, and 48.52±19.7% for perceived openness and sharing of patient information on nurse-physician communication. Age, salary and organizational factors were statistically significant predictors for perceived respect and satisfaction. Whereas sex, working hospital, work attitude individual factors and organizational factors were significant predictors of perceived openness and sharing of patient information in nurse-physician communication during patient care.ConclusionPerceived level of nurse-physician communication mean score was low among nurses than physicians and it is attention seeking gap. Hence, the finding of our study suggests the need for developing and implementing nurse-physician communication improvement strategies to solve communication mishaps in patient care.

Project description:BackgroundThe overall time refers to the amount of time a patient spends in a health care facility, from the time he or she enters to the time he or she leaves. As a result of the imbalance between supply and demand, waiting times occur. Ethiopian hospitals are being reformed to improve the quality of care they provide. The time a patient spends in the hospital is one of the most important indicators of quality of care, as it provides insight into customer satisfaction and provider success. However, the overall time patients spend in hospitals was not studied.ObjectiveThe study aimed to assess the overall time spent by clients from entry to exit and associated factors in the outpatient departments of Jimma zone hospitals.MethodsAn institution-based cross-sectional study was conducted. Patients from outpatient units at Jimma zone public hospitals participated in the study from March 15 to May 17, 2018. Data were collected using a time and motion tool coupled with an interviewer-administered structured questionnaire on 249 samples. Participants in the study were selected using the consecutive sampling method. Overall time, in terms of waiting and service times at each section unit, and the relationship of socio-demographic and clinical factors with overall time was the main outcome variables. Data were analyzed using descriptive and linear regression analysis. Simple linear regression analysis was used to determine the relationship between the dependent and explanatory variables. Variables were considered significantly associated with the overall time if they had a p-value of less than 0.05 at the 95% confidence interval (CI).ResultThe overall response rate was 94.8%. Overall, patients spent a median time of 342.5 minutes. Patients spent 12.7% of the total time as service time and 86% of the time waiting for care. The longest overall times were spent in the laboratory (170 minutes), imaging (95 minutes), other diagnostic units (84 minutes) and examination (83 minutes). The average overall time was increased by 52.03 minutes (95%CI 21.65, 82.412), 4.65 minutes (95%CI 3.983, 5.324), and 96.43 minutes (95%CI 52.076, 140.787) when the patient was referred, the number of patients at the queue was increased by one unit, and patients who had other diagnostic tests performed respectively with P <0.005 &adjusted R2 = 0.522.Conclusion and recommendationsThe majority of patients stayed for a longer period. Most time was spent waiting for services, particularly in the examination, laboratory, and imaging units. This is strongly related to high patient load, an absence of some services, being referred patients, and patients who had other diagnostic tests. To reduce the number of patients in the queues, hospitals should work hand in hand with the Ministry of Health to enforce policies that are understood and adopted by all workers in the lower healthcare facilities. And hospital administrators are working to strengthen the triaging system to screen patients with minor illnesses. This is because most patients with minor illnesses queue with those with more complicated illnesses. Finally, we recommend that researchers conduct further research on service quality.

Project description:BackgroundNeonates with severe complications at birth or during the neonatal period who nearly died but survived constitute neonatal near miss (NNM) cases. Identifying NNM cases and correcting contributing factors are of the utmost importance to get relevant controls for neonatal deaths. However, limited studies are assessing the prevalence of NNM and associated factors with NNM cases in Ethiopia. So, this study is aimed at assessing the magnitude of neonatal near miss and associated factors among live births in public hospitals of Jimma zone, southwest Ethiopia, 2020.MethodsA facility-based cross-sectional study was conducted among 260 neonates from April 1-30 / 2020. Face to face interviewer-administered structured questionnaire was used to collect data from the mothers and a standard checklist was used for their neonates. The data was encoded and entered into Epi-Data version 4.2 and exported to SPSS version 23 for analysis. Independent variables with marginal associations (p-value <0.25) in the bivariable analysis were eligible for multivariable logistic regression analysis to detect an association with outcome variables. Finally, adjusted odds ratios (AOR) with 95% CI were used to estimate the strength of associations, and statistical significance was declared at a p-value < 0.05.ResultThe magnitude of NNM was 26.7% with [95%CI: 21.6-32.5]. Hypertension during pregnancy [AOR: 3.4; 95%CI: 1.32-8.88], mode of delivery [AOR: 3.32; 95%CI: 1.48-7.45], Obstructed labor [AOR: 2.95; 95%CI: 1.32-6.45] and non-vertex fetal presentation during delivery [AOR: 4.61; 95%CI: 2.16-9.84] were identified as significantly predictors of NNM.Conclusion and recommendationOver a quarter of the neonates were with NNM cases, which is relatively higher than the report of studies done in other countries. Hypertension during pregnancy, cesarean delivery, prolonged labor, and non-vertex fetal presentation were all found to increase the likelihood of NNM. Therefore, concerted efforts are needed from local health planners and health care providers to improve maternal health care services especially in early identification of the complications and taking appropriate management.

Project description:IntroductionPostpartum sexual resumption without the use of contraception is a risk for unintended and closely spaced pregnancies. Although counseling related to the resumption of postpartum sexual intercourse is a key component of postpartum sexual health, it is not widely addressed during the postnatal period. Thus, this study aimed to assess the early resumption of postpartum sexual intercourse and its associated risk factors among married postpartum women who visited public hospitals of Jimma zone, Southwest Ethiopia, for child immunization services.MethodsThe facility-based cross-sectional study design was undertaken, and a systematic random sampling technique was carried out to select 330 participants. Data were collected using a pretested interviewer-administered questionnaire from August to September 2019. Obtained data were analyzed using descriptive statistics. A bivariate analysis was used to determine the significance of the association. Variables that showed association in the bivariate analysis at p-value <0.2 were fitted into a multivariable logistic regression model to control for confounders, and the significance of association was determined at p-value <0.05 with a 95% confidence interval (CI).ResultsApproximately 53.9% of the respondents practiced early resumption of postpartum sexual intercourse. Factors such as low income (AOR = 0.19 (95% CI = 0.10-.37)), monogamous marriage 3.78(1.32-10.79), practicing sexual intercourse during pregnancy (AOR = 4.55 (95% CI = 1.29-15.97)), a cesarean delivery (AOR = 0.06 95%CI = (0.03-0.15)) and use of contraceptives (AOR = 3.7(95%CI = 1.92-7.14)) were significantly associated with early resumption of postpartum sexual intercourse.Conclusion and recommendationThe findings of this study suggested that, most postpartum mothers resumed sexual intercourse during the early postpartum period and its associated risk factors include low income, monogamous marriage, practicing sexual intercourse during pregnancy, cesarean delivery, and use of contraceptives. Discussion with couples about postpartum sexual health during the antenatal and postnatal period is crucial to prevent unwanted pregnancies and adverse health outcomes.

Project description:BackgroundRabies is a disease of warm-blooded animals that affects the central nervous system and is almost invariably fatal once clinical signs develop. It is one of the most neglected tropical diseases in several areas of the world, including Ethiopia. Additionally, the burden of the disease is estimated to be high in Ethiopia, and public awareness contributes to prevention.MethodsA community-based cross-sectional study design was conducted from June-August 2023 in the Gomma district, Jimma zone, Oromia regional state, Ethiopia, to assess the knowledge, attitudes, and practices of communities towards rabies and associated risk factors using a structured questionnaire survey. A multi-stage sampling technique was used for the selection of the sampling units and a total of 140 participants were interviewed. The questionnaire parts included socio-demographics information, knowledge, attitudes, and practices of the community's respect for rabies management and control. The data was analyzed by Statistical Package for Social Science (SPSS) Version 20. Descriptive analyses were employed and multivariable logistic regression was used to calculate the association between independent and dependent variables (Knowledge, Attitudes, and Practice scores).ResultsAbout 134 (95.7%) respondents had heard about rabies. Likewise, 75 (53.6%), 55 (39.3%), and 95 (67.9%) of the respondents had good knowledge, favorable attitudes, and good practices, respectively. Christians were more likely to have higher knowledge scores than Muslims (AOR = 6.876, CI = 1.750-27.016, p = 0.006). Respondents who knew someone's exposure had a higher knowledge score than those who did not (AOR = 6.208, CI = 2.750-14.012, p = 0.000). Moreover, Muslims were found to have a more favorable attitudes than Christians (AOR = 5.518, CI = 1.199-25.391, p = 0.028). Those who knew someone's exposure to rabies were found to have a more favorable attitudes than those who did not (AOR = 2.367, CI = 1.157-4.839, p = 0.018). Respondents who had favorable attitudes towards rabies were found to have more good practices than unfavorable attitudes (AOR = 3.267, CI = 1.391, 7.730, p = 0.005).ConclusionsThe study revealed a gap in knowledge among communities in the study area. Thus, rabies control activity and community awareness should be implemented with stakeholders.

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Assessment of the extent and monetary loss in the selected public hospitals in Jimma Zone, Ethiopia: expired medicine perspectives

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