Objective. To describe the development, implementation, and initial outcomes of a pharmaceutical care training-of-trainers course developed to assist Ethiopian pharmacy faculty members and graduate students in the development of curriculum and provision of pharmaceutical care services of relevance to this low-income country. Design. In this collaboration, US and Ethiopian faculty members worked together in a week-long seminar and in hospital ward rounds to develop and offer a course to facilitate faculty members, curricular, and service development in pharmaceutical care in Ethiopia. Assessment. Assessments were conducted during the seminar, immediately post-seminar, at 3 months post-seminar, and at 1 year post-seminar. An examination was administered at the conclusion of the course to assess immediate learning outcomes for the graduate students. Post-course assessments of short-term (3-month) and longer-term (12-month) impact were conducted to identify pharmaceutical care services that had been implemented to assess knowledge and skill gained during the seminar. Correspondence between seminar participants and the US faculty members as well as graduate student thesis projects provided further evidence of changes at 3 and 12 months post-course. Conclusion. Pharmaceutical care training was developed for Ethiopian faculty members through a seminar and hospital ward rounds. Enhancements have been added to curricula for bachelor in pharmacy students and select pharmaceutical care services have been implemented through master's thesis projects.
Objectives
Mandatory employer-based insurance coverage of contraception in the U.S. has been a controversial component of the Affordable Care Act (ACA). Prior research has examined the cost effectiveness of contraception in general; however, no studies have developed a formal decision-model in the context of the new ACA provisions. As such, this study aims to estimate the relative cost effectiveness of insurance coverage of contraception under employer-sponsored insurance coverage taking into consideration newer regulations allowing for religious exemptions.
Study Design
A decision-tree was developed from the employer perspective to simulate pregnancy costs and outcomes associated with insurance coverage. Method-specific estimates of contraception failure rates, outcomes, and costs were derived from the literature. Uptake by marital status and age was drawn from a nationally-representative database
Results
Providing no contraception coverage resulted in 33 more unintended pregnancies per 1000 women (95% Confidence Range: 22.4; 44.0). This subsequently significantly increased the number of unintended births and terminations. Total costs were higher among uninsured women owing to higher costs of pregnancy outcomes. The effect of no insurance was greatest on unmarried women 20–29 years old.
Conclusions
Denying female employees full coverage of contraceptives increases total costs from the employer perspective, as well as the total number of terminations.
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