Background. The increased morbidity and mortality rates in children under five in developing countries are mostly attributed to poor availability and failure of prescribing lifesaving medicines. This study was aimed at evaluating the availability and utilization of the WHO-recommended priority lifesaving medicines for children under five in public health facilities. Method. A cross-sectional survey complemented with a qualitative method was conducted in 14 health centers and four hospitals in the Jimma Zone, Ethiopia. In the facilities, we assessed the availability within the last half year and on the day of the visit. Utilization of the medicines was assessed through a review of patient records of the last one year. Twelve in-depth interviews were carried out to collect the qualitative data, and the analysis was executed using thematic analysis. Results. For treatment of pneumonia, amoxicillin dispersible tablets and gentamycin injection were available in 94.4% of the facilities. For treatment of malaria, artemether/lumefantrine was available in 61.1% of the facilities. For pain management, paracetamol tablets were available in 94.4% of the facilities. AZT+3TC+NEV for HIV/AIDS management was available in all facilities. At least one essential medicine was out of stock in the past six months with the average duration of 33.6 days in health centers and 28.25 days in hospitals. Oral rehydration salt and zinc (84.7%) and AZT+3TC+NEV (100%) had better utilization. However, for almost all cases, other nonpriority medicines were highly prescribed. Lack of administrative commitment, supply of near expiry products, complexity of diseases, and lack of customized child formulations were among the challenges of availability and utilization of those medicines. Conclusions. The overall availability of lifesaving medicines on the day of the visit was fairly good but with poor utilization in almost all facilities. Some products were not available for considerable length of time in the past six months.
Background: Maintaining an adequate level of inventory is critical since an enormous amount of capital tied up with it. Having excess inventory leads to wastage. On the contrary, insufficient commodity leads to stock out. Hence, this study aimed to assess inventory management practices of program commodities at Ethiopian Pharmaceutical Supply Agency. Methods: A descriptive cross-sectional study complemented with a qualitative method was conducted from February 21 to April 20/2019. Order fill rate, wastage rate, frequency of emergency order, acceptable storage condition met, and stock out were the metrics we used to measure the inventory management practices of the agency. Quantitative data were collected through physical observation of the warehouses and review of logistics management tools. Seventeen in-depth interviews were conducted to explore the challenges of inventory management. Results: From the total 70 program commodities managed by the agency, 2.1% wasted due to expiration and damage. These resulted in a loss of over US $2 million. The highest wastage was recorded for antimalarials which accounted for 13.1% of the malaria commodities' total inventory value. Only 14.8% of the orders were fulfilled above 80%. Thirty-seven items were stock out on average for 8.5 average days. Longer duration of stock out (260 days) was recorded for TB commodities. Seventeen items from different programs were purchased through emergency orders with a higher frequency of levonorgestrel purchase. Only 6 (60%) warehouses met acceptable storage conditions. Space deficit, outdated warehouse designs, shortage of warehouse equipment, lack of precise data, and capacity building gaps were the inventory management challenges identified. Conclusion: Though the wastage rate was near to the acceptable range, there were lesser order fill rates, storage condition inadequacy, and significant stock-outs of program commodities. The finding implies the need for an improvement in inventory management practice of the agency.
Background Euthanasia is the last resort for those living with untreatable and terminable diseases which cause pain and suffering. However, the concept of euthanasia resulted in many dilemmas and controversy around life extension and death. Objective The aim of this study was to evaluate the knowledge and attitudes of final year pharmacy and law students concerning euthanasia. Methods A descriptive cross-sectional study was carried out among all final year law and pharmacy undergraduate students. The data were collected using self-administered structured questionnaire and analyzed by SPSS version 22. Multivariate logistic regression was used to assess the influence of socio-demographic characteristics of participant’s on acceptance of euthanasia. Result 72 (61.5%) of the students were declared that euthanasia is administration of lethal drugs to a patient at the explicit request of that patient. Majority 87 (74.4%) of the students knew that euthanasia is active shortening of the dying process. Most participants 95(81.2%) awared that there is no legalized euthanasia in Ethiopia. On the other hand, 47(40.2%) believed the patient has the right to choose to end his/her own life. Around 45% had the view that euthanasia should be legalized in some circumstances. Only 27.3% (n = 32) of the respondents endorsed legalization of euthanasia in Ethiopia. 35 (29.9%) said euthanasia should be performed. The acceptance of euthanasia was greater for pharmacy students compared to law students [adjusted odds ratio (AOR) = 3.490; 95% CI 1.346–9.049; p = 0.010] and lower for Muslim students compared to Orthodox students (AOR = 0.186; 95% CI 0.044–0.783; p = 0.022). Conclusion The final year law and pharmacy students were aware of euthanasia. However, majority of students did not reveal favorable attitude toward euthanasia and its acceptance was low. Participants’ field of study and religion were significantly affect acceptance of euthanasia As the current study limited to pharmacy and law students, the authors suggest that future studies should involve various segments of societies to investigate more about euthanasia in Ethiopia.
Background Effective drug procurement guarantees the sustainable supply of products for health and eliminates excessive costs. However, there is limited information on the area of pharmaceutical procurement practice in Ethiopia. Thus, this study aimed at assessing the procurement practices of program drugs and its challenges at the Ethiopian Pharmaceuticals Supply Agency. Methods A cross-sectional study accompanied by qualitative assessment was conducted between February 21 and April 20/2020 to examine the procurement practice of the Ethiopian pharmaceutical supply agency. The quantitative data were gathered by reviewing documents and electronic records. Mean forecast error, price paid to international price reference, number of emergency orders placed, and lead time variability were the measurements used to assess the procurement practice. A statistical package for the social sciences version 23 was used to analyze the data. The results were then summarized using tables and texts. The qualitative data were collated through face-to-face in-depth interviews to explore the challenges behind the procurement practice. And the data were analyzed manually using the thematic analysis technique. Results The agency had its own procurement list which defines the items to be procured. The overall mean forecast error in the 2018/19 budget year was 27.8%. Of the 70 program commodities included in the study, 52 (74.3%) items had a mean price less than the international price reference. Three of the 14 orders (21.4%) placed in the aforementioned year were emergency purchases made through direct procurement. The mean lead time for the suppliers of the agency was 137.3 days. Poor data quality from service delivery points, staff capacity constraints, communication problems, and policy issues became the major challenges to implement an effective procurement system in the agency. Conclusion The procurement practice at the agency has strong side. However, it was not without weaknesses. Using a procurement list is a worthwhile practice. Despite this, much remains to improve lead times and forecasting accuracy.
Background Satisfaction with pharmacy services has many implications, including the degree of interaction with health care providers, the type and quality of service provided, and the extent to which needs and desires are met. This study aimed to identify the dimensions of pharmacy services and quantify client satisfaction with them. Methods A quantitative cross-sectional study was employed to guide this study. Data were entered into Epi Data, exported to SPSS 26.0, and analyzed using exploratory factor analysis to identify the underlying dimensions of pharmacy service. The study was conducted between 14th August 2020 and 28th December 2020. For standardization and comparison purposes, items loaded onto each dimension were computed and rescaled, and descriptive statistics were used to summarize the results. Stepwise linear regression was performed to quantify the contribution of each dimension to overall satisfaction and to identify determinant variables for overall satisfaction. A 95% CI, and a P-value of < 0.05 were used for the declaration of statistical significance. Results The mean overall satisfaction with pharmacy service was found to be (21.62±6.74)/30. There were eight dimensions of pharmacy service identified, and poor customer satisfaction was recorded for the premises and supply dimensions, with mean satisfaction of (12.08±8.49)/30 and (13.66±10.06)/30, respectively. The highest mean satisfaction was recorded with waiting time (24.24±6.54). Of the emergent dimensions, only four (supply, compassion and care, privacy, and premises) were predictors of overall satisfaction (P<0.05). The supply component was the strongest predictor of overall satisfaction, accounting for 20% of the variance in overall satisfaction. The number of prescribed and dispensed pharmaceuticals, marital status, and gender of participants also predicted overall satisfaction (P<0.05). Conclusion The survey uncovered eight underlying aspects of pharmacy services that influence client satisfaction. A significant gap was recorded with premises and supply chain-related components. These dimensions’ contributions to total satisfaction were substantial in terms of practical relevance. As a result, improving the availability of pharmaceuticals and the infrastructure surrounding pharmacy services may enhance consumer satisfaction considerably. Stakeholders must work on addressing supply related and premises difficulties to increase client satisfaction.
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