BackgroundClinical pharmacy service has evolved steadily over the past few decades and is contributing to the ‘patient care journey’ at all stages. The service improves safety and effectiveness of medicines, thereby avoiding medication errors. As part of this global shift in pharmacy education and practice, Ethiopian Universities revamped the undergraduate pharmacy curriculum and the first graduates came out in July 2013. These graduates were immediately deployed in public hospital settings, with the ultimate aim of providing clinical pharmacy services. As such an initiative is new to the Ethiopian pharmacy sector, there is a need to do assessment of the health care providers’ perception and satisfaction towards the service.MethodsA cross-sectional survey using self-administered questionnaire was conducted in six regions and one-city administration of the country. Physicians, Health officers and Nurses working along with the new pharmacy graduates formed the study population. A total of 650 healthcare professionals participated in the study. Data were entered, cleaned and analyzed using appropriate statistical tools.ResultsMajority of the health care providers agreed that clinical pharmacy service could have a significant contribution to the patient care. A large proportion of them (70–90 %) had a positive attitude, although there appeared to be some differences across professions. About 50 % of the professionals were of the opinion that patient care should be left to the health care providers and pharmacists should concentrate on drug products. In addition, the same proportion of respondents said that the setup in their respective hospital was appropriate for provision of clinical pharmacy service. Multivariable analysis indicated that attitude of the health care providers was significantly associated with year of experience.ConclusionsA large proportion of the health care providers had positive attitude towards the service, although the extent of the service was below their expectation. Hence, efforts should be in place to organize continuous professional training for pharmacists and awareness creation forums for other healthcare professionals.

BackgroundA wide range of pharmaceutical products are needed for diagnosis, treatment, and prevention of HIV/AIDS. However, interrupted supplies and stock-outs are the major challenges in the supply chain of ARV medicines and related commodities. The aim of this study was to assess the supply chain management of HIV/AIDS related commodities in public health facilities of Addis Ababa, Ethiopia.MethodsA descriptive cross-sectional survey complemented by qualitative method was conducted in 24 public health facilities (4 hospitals and 20 health centers). A semi-structured questionnaire and observation check list were used to collect data on HIV/AIDS related service, reporting and ordering; receiving, transportation and storage condition of ARV medicines and test kits; and supportive supervision and logistics management information system. In addition, in-depth interview with flexible probing techniques was used to complement the quantitative data with emphasis to the storage condition of ARV medicines and test kits. Quantitative data was analyzed using SPSS version-20. Analysis of qualitative data involved rigorous reading of transcripts in order to identify key themes and data was analyzed using thematic approach.ResultsThe study revealed that 16 health centers and one hospital had recorded and reported patient medication record. Six months prior to the study, 14 health centers and 2 hospitals had stopped VCT services for one time or more. Three hospitals and 18 health centers claimed to have been able to submit the requisition and report concerning ARV medicines to Pharmaceutical Fund and Supply Agency according to the specific reporting period. More than three-fourth of the health centers had one or more emergency order of ARV medicines on the day of visit, while all of hospitals had emergency order more than 3 times within 6 months prior to the study. All of the hospitals and nearly half of the health centers had an emergency order of test kits more than 3 times in the past 6 months. Overall, nearly 3/4th of the health facilities faced stock-out of one or more ARV medicines and test kits on the day of visit.ConclusionThere was no adequate data on patient medication record and stock status of HIV/AIDS related commodities. Moreover there were frequent stock-outs of ARV medicines and HIV test kits, which was an indicator of the weak supply chain management. Hospitals and health centers, therefore, should devise a system to capture and make use of patient medication record and stock status information so as to ensure continuous supply of the commodities.

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Background: HIV/AIDS is a major public health, social and economic problem in Ethiopia. However, little has been done on assessment of the quality of the services given to patients in this country. Objective: To assess the quality of HIV/AIDS services in health centers of East Shoa Zone, Oromia region, Ethiopia. Method: Cross sectional survey was undertaken in selected health centers of East Shoa Zone between February and May, 2017. Data was collected using researcher administered structured questionnaire, logistics indicators assessment tool and observation check list. SPSS for windows version 20 was utilized in the analysis of the collected data. Results: The study facilities were providing various services to HIV/AIDS patients. All (100%) and 6(75%) facilities respectively had shortage of trained human power required to give ART and TB services. Regarding ARV medicines availability, majority of the study facilities, 5 (62.50%) reported that they had the stockout of AZT300/3TC150/NVP200 in six months prior to study while 4 (66.7%) of the facilities had the stockout of NVP 240ml (50mg/5ml) syrup on day of visit. Among anti-TB medicines, E100 was out of stock in three facilities (37.5%) on day of visit and INH100 had been out of stock in 4 (50%) of the facilities in six months prior to the study. From OIs medicines, Cotrimoxazole 960mg tablet stockedout in 4 (66.70%) on day of visit and in5 (83.30%) health centers in six months prior to the study. Considerable number of study facilities, 4 (66.70%) had the stockout of tramadol 50mg tablet on day of visit and ibuprofen 400mg tablet in six months prior to the study, 5 (71.40%). Conclusion: The studied facilities were challenged by different factors including, scarcity of human power, stockout of various HIV/AIDS related medicines and inability to make patients adhere to the services given by the facilities. The consequences of these factors can be dangerous to the patients as well as to the wider public and hence making available the appropriate human resource and HIV/AIDS related commodities including medicines should be the priority for the health facilities and the region to improve the quality of HIV/AIDS services in the study area. Keywords: HIV/AIDS; Services quality; Health center; East Shoa Zone.

primary healthcare (as defined by WHO). RESULTS: Overall, 52.7% of the sample had high adherence and 47.3% medium/low adherence. Statistical significance was found for the following variables: age (p-value¼0.016), urbanization (p-val-ue¼0.024), self-rated health status (p-value¼0.049) and responsiveness of primary healthcare (p-value¼0.014). Specifically, respondents residing in rural areas (OR¼1.578) and those of higher self-rated health status (OR¼1.009) were more likely to have medium/low adherence. On the other hand, age (OR¼0.985) and perceived responsiveness of primary healthcare (OR¼0.771) were negatively associated with medium/low adherence and hence, as age and perceived responsiveness of primary healthcare increased, the probability to have medium/low adherence decreased. CONCLUSIONS: Based on the results, adherence to medication is associated with a number of factors. Since adherence of chronic patients is crucial for their overall health and for the healthcare system, it is important for health professionals to have in mind these factors in order to apply interventions that aim to increase adherence in specific groups of the population. OBJECTIVES:Our aim was to demonstrate the complexity of health tourism and how the preventive branch of health tourism appears in culture. The study focuses on the three different segments of preventive and recreational tourism (wellness, fitness and spas). METHODS: 4000 questionnaires had been sent in the West-Hungarian Region. Closed questions were applied and giving opinions was also possible in the form of open questions. Distribution rates, variance analysis (ANOVA), and, p values on the basis of Chi-square and F-test have been calculated. RESULTS: 3501 questionnaires have been filled in, from which 37.9% of the respondents used wellness, 18.3% fitness and 43.8% spa services. Healthcare services are mainly utilized by those aged between 40-60 (34.2), and while preventive services are used by the 25-39 age group (36.7%), the under 25 and over 60, age groups are less characterized by focusing on prevention. Regarding the levels of education 96.7% of the poll responded. The rate of graduates is 43%. From those paying attention to prevention 32.6% come from towns, 41.1% from county towns, 10.7% from the capital and 16.3% from villages. 2.1% of respondents with lower level of qualification, 35.8% with medium level of qualification and 39.5% with higher qualification take use of health maintenance services. Typically, those belonging to higher income category (47.3%) choose wellness hotels and spas to spend their free time. Regarding massage services, there is a significant difference between those visiting for the first time and recurring guests (p¼0.03), 31% of the first group and 26.7% of recurring guests took use of massage. CONCLUSIONS: The number of family members and the promotion of extra services (massage) must be taken into consideration. Discounted services influence the use of the services. The use of steam rooms, children's play and massage services shows s...

Water is widely used as a raw material, ingredient, and solvent in the processing, formulation, and manufacture of pharmaceutical products, and assessing its quality is of paramount importance. To the best of the authors' knowledge, there hasn't been any baseline assessment made with regard to the implementation status of Good Manufacturing Practices (GMP) principles in water treatment systems of pharmaceutical industries in Ethiopia. Hence, to assess the level of compliance to GMP in water treatment systems of pharmaceutical industries in Ethiopia, a national survey was conducted in all pharmaceutical industries of the country. Data were collected by employing quantitative and qualitative methods. Self-administered questionnaires were distributed to nine pharmaceutical industries and the response rate was 8 (88.5%). According to the results, none of the industries had an influent and effluent total organic carbon monitoring system. Among the available storage tanks for purified water and water for injection, 7 (87.5%) of them were of a sanitary material. However, in 4 (50%) industries pipes were not made of sanitary material, purified water was not kept circulating at 70-80 o C and there were dead legs in the water lines. The validation results were investigated and corrective action was taken only in 1 (12.5%) of the industries. The compliance of the water treatment systems of most of the industries to WHO GMP principles was found to be below the standard in many aspects. Therefore, it is recommended that the industries should exert maximum efforts to comply with GMP principles.

Background:The growing burden of antibiotic resistance (AR) is a global public health problem. Despite the threats to global efforts to combat infectious diseases, data to guide its prevention and control in sub-Saharan Africa is limited. This study aimed to assess AR and antibiotic use among adult inpatients in an urban tertiary hospital in Sierra Leone.Methods and materials: Using a cross-sectional study design, data on antibiotic use was collected from consecutive adult inpatients (≥18 years) between October 2017 and February 2018 at Connaught Hospital in Freetown, Sierra Leone. Antibiotic resistance rates of bacterial isolates from urine and sputum of adult inpatients (≥ 18 years) were assessed from February through June 2018.Results: Of the 920 patients interviewed, 753 (81.8%) were prescribed an antibiotic. Before antibiotics use, 85.1% had no leucocytes count and none had a bacterial culture. Antibiotics commonly prescribed were cephalosporins (25.0%), penicillins (23.2%) and imidazoles (20.8%). Indications for prescribing were surgical prophylaxis (15.7%), pneumonia (15.1%), and trauma (5.8%).Of the 164 samples, 90.8% was urine. The common urinary isolates were Escherichia coli (29.2%), Klebsiella pneumoniae (19.0%), Enterococcus faecalis (13.1%) and Acinetobacter baumanii (9.4%), while that of sputum were K. pneumoniae (31.3%), E. coli (18.8%), S. aureus (12.5%) and P. aeruginosa (12.5%). Penicillin resistance rate for E. faecium and S. aureus was 100%. Gram negative resistance patterns were ampicillin (93% for both E. coli and A. baumanii and 90% K. pneumoniae), ampicillin-sulbactam (67% for both E. coli and K. pneumoniae), ciprofloxacin (82% K. pneumoniae, 70%E. coli, and 50% P. aeruginosa) and ceftriaxone (70%E. coli, 68%K. pneumoniae and 67% E. cloacae). The resistance rate to carbapenems for all Enterobacteriaceae was 13%, and 32% for all Gram-negative organisms. Conclusion:We found high rates of AR, and antibiotic use, most of which were not guided by laboratory evidence. Drivers of poor prescribing practices and AR are lack of microbiological support and oversight. These are common factors in many developing countries, which lack funds and serve a sicker population. Greater investments are needed to establish antimicrobial stewardship programs and provide clinicians with diagnostic support to enable improvements in patient outcomes and rational use of antibiotics.

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