scholarly journals Appropriateness and affordability of prescriptions to diabetic patients attending a tertiary hospital in Eastern Uganda: A retrospective cross-sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245036
Author(s):  
Samuel Baker Obakiro ◽  
Kenedy Kiyimba ◽  
Agnes Napyo ◽  
Andrew Marvin Kanyike ◽  
Wilberforce John Mayoka ◽  
...  
Keyword(s):  
Health Management ◽  
Drug Prescription ◽  
Essential Medicine ◽  
Secondary Data ◽  
Essential Medicines ◽  
Health Management Information System ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
The Government ◽  
Eastern Uganda

Background Irrational prescription of drugs can lead to high cost of treatment thus limiting access to essential medicines. We assessed the affordability and appropriateness of prescriptions written for diabetic patients in Eastern Uganda. Methods We collected secondary data from the health management information system registers of patients who attended the outpatient medical clinic at Mbale regional referral hospital from January 2019 to December 2019. The average cost of the prescriptions was calculated and adjusted odds ratios for predictors for unaffordability estimated using logistic regression. Computed scores for indicators of rational drug prescription were used to assess the extent of rational prescribing. Results The median cost per prescription was USD 11.34 (IQR 8.1, 20.2). Majority of the diabetic patients (n = 2462; 94.3%, 95% CI: 93.3–95.1%) could not afford the prescribed drugs. Predictors for unaffordability were if a prescription contained: ≥ 4 medicines (AOR = 12.45; 95% CI: 3.9–39.7); an injectable (AOR = 5.47; 95%CI: 1.47–20.32) and a diagnosis of diabetes mellitus with other comorbidities (AOR = 3.36; 95%CI: 1.95–5.78). Having no antidiabetic drug prescribed was protective for non-affordability (AOR = 0.38; 95%CI: 0.24–0.61). The average number of drugs per prescription was 2.8. The percentage prescription of drugs by generic name and from the essential medicine and health supplies list of Uganda were (6160/7461; 82.6%, 96% CI: 81.7%-83.4%) and (6092/7461; 81.7%, 95% CI: 80.8%-82.5%) respectively against WHO standard of 100%. Conclusion The majority of diabetic patients (94.3%) in Eastern Uganda cannot afford to buy prescribed medicines. The government should therefore ensure that essential medicines are readily accessible in public health facilities.

scholarly journals Self-injected Depot–Medroxyprogesterone Acetate Subcutaneous (DMPA-SC) Uptake in Nigeria: A Paradigm Shift

2021 ◽  
Vol 8 (3) ◽  
pp. 80-101
Author(s):  
Kehinde Osinowo
Keyword(s):  
Family Planning ◽  
Health Management ◽  
Unmet Need ◽  
Secondary Data ◽  
Planning Method ◽  
Family Planning Method ◽  
Health Management Information System ◽  
Modern Contraceptive ◽  
National Family Planning ◽  
The Government

Self-injection of DMPA-SC method is one of the Government of Nigeria’s (GON) national family planning goals to address the unmet need for contraception. Some studies on DMPA-SC/SI have demonstrated its feasibility to improve modern contraceptive uptake. However, there is a gap in the predictors of method uptake and continuation across self-injecting and provider-administered in Nigeria. This study explored the uptake of self-injection DMPA-SC contraceptives among women in two geopolitical zones of Nigeria. The study employed 20 focused group discussions (FGDs) and 40 In-depth interviews (IDIs). Self-structured pretested questionnaire to elicit information from 844 women registered for Family Planning in selected health facilities. Descriptive statistics were calculated and multivariate logistic regression was used to model determinants of DMPA-SC/SI family planning uptake. Six months of Secondary Data from the Health Management Information system (HMIS) was used to triangulate the trends in uptake. About 97.6% reported ever heard DMPA-SC/SI family planning method; 78.4% reported its uptake; while 88.5% reported ever heard of self-injection as an option of family planning method. Data for each State showed a remarkable increase in uptake of DMPA-SC/SI. The motivations to use DMPA-SC/Self Injection were ease of accessibility, convenience, and self-administer/care. Factors that encourage the uptake of DMPA-SC/SI were; health benefits, the prevailing economic situation and its effectiveness. Findings from the study showed that interventions that deploy health education, awareness, social mobilization, advocacy, policy implementation, and public sensitization, making contraceptive services available for free, will increase the uptake of Keywords: Determinants, DMPA-SC/SI, Practice, Self-injection, Uptake. DMPA-SC/SI in the study areas.

scholarly journals Factors influencing availability of tracer essential medicines in selected health facilities in Nyeri County, Kenya

2021 ◽  
Vol 8 (3) ◽  
pp. 1013
Author(s):  
Minai Samuel Munga ◽  
Tabither Muthoni Gitau ◽  
Lawrence Mirie Kimani ◽  
Peterson Kariuki ◽  
Enoch Ng'etich
Keyword(s):  
Inventory Management ◽  
Health Management ◽  
Policy Formulation ◽  
Emerging Diseases ◽  
Health Facilities ◽  
Essential Medicines ◽  
Supply Chain System ◽  
Cross Sectional ◽  
The Government ◽  
Roll Out

Background: Tracer essential medicines are drugs which fully fulfil a population’s health requirements and ought to be always available allowing for a properly functioning health system all the time. They should be available in the appropriate dosage, adequate amounts and at assured quality at a price that many people and the community can easily afford.Methods: Analytical cross-sectional study design was used. This study utilized a mixed method approach (qualitative, observation and quantitative).Results: The study found out that artemether lumefantrine was the least available drug at 50% in all the sampled facilities with KEMSA cited as the main supplier of tracer essential medicines in these facilities. Policy formulation was done without any involvement of pharmacy in-charges and policies passed at the county management team merely passed onto the staff at the health facilities without their engagement.Conclusions: With the roll out of UHC program, majority of the participants indicated an increase in the availability of essential drugs in Nyeri County hence the government should roll out the program countrywide. Health management and leadership teams in the county needs to engage the pharmacy in-charges during policy making and changes, provide efficient communication in the supply chain system, including proper inventory management systems and to enhance research of drugs and emerging diseases in the county.

scholarly journals Empty shelves: selected essential medicines stockouts in South Africa

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Wolvaardt ◽  
R Nemuntandani ◽  
I Kamungoma-Dada
Keyword(s):  
South Africa ◽  
Urban Areas ◽  
Descriptive Analysis ◽  
Secondary Data ◽  
Treatment Interruption ◽  
Cross Sectional Study ◽  
Essential Medicines ◽  
Chi Square ◽  
Cross Sectional ◽  
Antiretroviral Medication

Abstract Background Access to essential medicines in South Africa has been compromised by stockouts in health facilities. This study describes the occurrence of stockouts for a selection of essential medicines. Methods This cross-sectional study used secondary data retrieved from the Stop Stock Outs Project (SSP). A descriptive analysis was conducted on data from the 2013-2015 SSP case management database of routinely reported stockouts. Chi square tests of independence was conducted on data from the SSP 2015 annual telephonic survey to investigate associations between the occurrence of stockouts, the level of health facility and the type of health professional. Results 231 facilities reported 609 stockouts. Antiretroviral medication had the most stockout reports (78%; n = 475/609), followed by anti-infectives (17.1%; n = 104/609) and tuberculosis medication (4.9%; n = 30/609). The highest number of stockout reports were received from Gauteng province and the majority (71.09%; n = 150/211) of facilities reporting stockouts were in urban areas. There were more stockouts at ambulatory, rather than inpatient care, facilities however, this was not statistically significant. Conclusions This study confirms that South Africa experiences medicine stockouts for many of the essential medicines, with antiretroviral medication being the category most affected. The stockouts vary between provinces and the urban-rural divide but are an equal threat to both ambulatory and inpatient facilities. Key messages The pattern of stockouts experienced over a three-year period suggest that stockouts are ‘normal’ despite the substantive effects of treatment interruption – especially patients with HIV and/or TB. Antiretroviral therapy is at risk as a result of stockouts.

scholarly journals Perspectives of pharmaceutical stakeholders on determinants of medicines accessibility at the primary care level

2021 ◽  
Vol 96 (1) ◽  
Author(s):  
Hoda Ibrahim Rizk ◽  
Monira Mahmoud Elkholy ◽  
Abeer Abdou Barakat ◽  
Raghda Mostafa Mostafa Elsayed ◽  
Shaimaa A. M. Abd El Fatah
Keyword(s):  
Health System ◽  
Access To Medicines ◽  
Generic Medicine ◽  
Essential Medicines ◽  
Cross Sectional ◽  
Urban Group ◽  
Rural And Urban ◽  
External Stakeholders ◽  
Assessment Approach ◽  
The Government

Abstract Background Equitable access to essential medicines of maintained efficacy, safety, quality, and cost-effectiveness must be ensured by a well-functioning health system. This study aims to identify the determinants of patients’ access to medicines at the primary health care (PHC) level from the perspectives of various (internal and external) stakeholders of the pharmaceutical system. Methods The study employed both quantitative and qualitative components. Quantitative component applied a descriptive a cross-sectional design and qualitative component applied an in-depth interview design. It was a health system research conducted at two (PHC) facilities (one urban and the other rural) in Egypt. It inquired upon political, economic, and managerial aspects of the pharmaceutical system utilizing the “Health System Assessment Approach: a How-To Manual” and the “WHO operational package for assessing, monitoring and evaluating country pharmaceutical situations.” Results Analysis of the quantitative data extracted from the cross-sectional component with external stakeholders (patients) revealed that about one-third of patients in both facilities were unable to pay for the medicine. Patients in both settings took less than an hour to reach the PHC facility. The Percent of patients who believe that the private pharmacies’ medicine is better than the PHC one was significantly higher in rural than urban group (24% and 10% respectively) and the percent of medicines dispensed was 50% and 66.7% in rural and urban groups respectively. Analysis of the qualitative data extracted from in-depth interviews with internal stakeholders (key informants from regulatory agencies, pharmaceutical industry, academia, pharmacists, and physicians) were summarized utilizing Strengths-Weaknesses-Opportunities-Challenges (SWOC) analysis approach. Various viewpoints toward the determinants of patients’ access to medicines were disclosed. Conclusions The Percent of medicines dispensed was insufficient in both rural and urban facilities. There is a need to invest in building trust in generic medicine quality in the government health facilities focusing on improving medicine availability and ensuring enough amounts of high-quality drugs. Although there are drug committees in the two studied PHC facilities for demonstrating the prescribing and dispensing policies, yet the system required to enforce these policies is still deficient.

scholarly journals CORRELATION BETWEEN SMOKE-FREE AREAS AND SMOKING BEHAVIOR IN INDONESIA

2020 ◽  
Vol 8 (2) ◽  
pp. 117
Author(s):  
Mohamad Anis Fahmi
Keyword(s):  
Public Awareness ◽  
Smoking Behavior ◽  
Secondary Data ◽  
Computer Application ◽  
P Value ◽  
Cross Sectional ◽  
Positive Correlation ◽  
The Government ◽  
Cross Sectional Design ◽  
The Impact

Background: Low public awareness of the impact of smoking makes the implementation of smoke-free areas (KTR) difficult. Smoke-free areas aim to protect the public from the direct and indirect effects of smoking. Purpose: This study aimed to analyze the correlation between the application of smoke-free areas and the prevalence of active and ex-smokers in Indonesia. Method: This study implemented a cross-sectional design, using secondary data from the Riskesdas 2018 on active and ex-smokers. KTR application data were obtained from the Profile of Non-Communicable Diseases in 2016. A Pearson product-moment test was conducted by a computer application to determine the correlation coefficient (r). This coefficient was used to describe the level of correlation between the two variables; significance was determined as a p value of 5%. Results: This study showed that the average application of KTR throughout Indonesia was 50.83%, active smokers comprised 23.49% of the population, and ex-smokers comprised 4.94%. Most active smokers were in Java and Sumatra, while the majority of ex-smokers were in Java and Sulawesi and the majority of KTR was in Java. This study shows that there is a positive correlation between KTR application and the percentage of ex-smokers (r = 0.46; p value = 0.01). Conclusion: There is a positive correlation between the application of KTR and an increase in ex-smokers. The government needs to increase the application of KTR policies.

scholarly journals Factors Related to Symptoms in Patients Suspect Covid-19 in The Public Health Center Kebayoran Baru in March – June 2020

2021 ◽  
Vol 1 (1) ◽  
pp. 907-922
Author(s):  
Tri Wahyuni ◽  
Suherman Suherman ◽  
Nazarwin Saputra ◽  
Istianah Surury
Keyword(s):  
Diabetes Mellitus ◽  
Heart Disease ◽  
Health Center ◽  
Community Health Center ◽  
High Mobility ◽  
Secondary Data ◽  
Chi Square ◽  
Cross Sectional ◽  
The World ◽  
The Government

The world is undergoing the new pandemic named COVID-19 of early 2020 announced in China and all over the world and infect more than 10 million people in the world (incidence rate 1.3). Indonesia has the number of cases 28.818 per June 04, 2020, with a CFR of 6%, the highest in Southeast Asia. Besides confirming the case, the suspect like ODP, PDP, and OTG should also be monitored. Although the number of cases and suspects in the Kebayoran Baru district is not the highest in South Jakarta, as the center of South Jakarta where many offices and high mobility, and the population is not as much as another district, so the possible transmission of COVID-19 in Kebayoran Baru still high. To find out the relationship between age, sex, comorbid hypertension, diabetes mellitus, and heart disease with the severity of symptoms in COVID-19 suspect of Kebayoran Baru district March – June 2020. The design of this study used cross-sectional secondary data of COVID-19 suspect monitoring in Community Health Center Kebayoran Baru. Analysis with chi-square 0.005. Statistical results of COVID-19 suspects in the Kebayoran Baru district are 44% having symptoms. The research suggests that a significant relationship between age, hypertension comorbid, diabetes mellitus comorbid, and heart disease with the symptoms. While sex has no significant relation with symptoms. The government should have more attention to protect people that having comorbid such as hypertension, diabetes mellitus, or heart disease.

scholarly journals Essential Medicine and Equipment for Emergency Obstetric and Newborn Care in Zanzibar: Situation at a Glance

2019 ◽  
pp. 1-7
Author(s):  
Andrea B. Pembe ◽  
Bruno Sunguya ◽  
Stella Mushy ◽  
Sebalda Leshabari ◽  
George Kiwango ◽  
...  
Keyword(s):  
Neonatal Mortality ◽  
Essential Medicine ◽  
Newborn Care ◽  
Newborn Health ◽  
Structure Interview ◽  
Essential Medicines ◽  
Maternal And Newborn Health ◽  
Cross Sectional ◽  
Live Births ◽  
Delivery Services

Background:Maternal and neonatal mortality are unacceptably high in Zanzibar. Maternal mortality and neonatal mortality ratio stand at 350 per 100,000 live births and 29 per 1,000 live births respectively as of 2018. Addressing challenges facing maternal and newborn health requires among others, the assurance of essential medicine and equipment to deliver evidence based interventions. This paper reports evidence gathered on the availability of essential medicines and equipment in providing Emergency Obstetric and Newborn Care (EmoNC) services in Zanzibar. Methods:A cross-sectional mixed methods study design was used to collect information on the availability of drugs and equipment from all health facilities providing delivery services in Zanzibar. Semi-structure interview guide was used to carry in-depth interviews (IDIs) with health facility in-charges while observation on availability of essential medicine and equipment for EmONC was carried using standard observation guide as adopted from Averting Maternal Death and Disability program.

scholarly journals Knowledge, attitude and practices regarding generic medicines and its usage: a community-based study

2019 ◽  
Vol 6 (5) ◽  
pp. 2182 ◽  
Author(s):  
Kirthinath Ballala ◽  
Chythra R. Rao ◽  
Aparna S. Chaudhary ◽  
Ashwini S. Bidnurmath ◽  
Akhilesh K. Pandey
Keyword(s):  
Urban Areas ◽  
Generic Drugs ◽  
Community Outreach ◽  
Essential Medicines ◽  
Generic Medicines ◽  
Online Questionnaire ◽  
Community Based ◽  
Cross Sectional ◽  
Total Study Population ◽  
The Government

Background: India is the largest provider of generic medications globally. Despite this, several essential medicines remain inaccessible to majority of the general population, due to poor awareness, unavailability of drugs, distrust about the quality of the medicines, poor policy implementation and inadequate recommendation by doctors.Methods: A community-based cross-sectional study was carried out among 1151 adults in rural and urban areas attached to the community outreach area of a University Medical College. Written informed consent was taken from the participants. Data was collected using a pre-tested semi-structured online questionnaire and analysed using SPSS 15.0.Results: Knowledge regarding generic medicines was found to be low among the surveyed population (666, 57.9%), irrespective of their socio-economic status, education, occupation, place of residence or presence of chronic illnesses. As the knowledge was poor, participants were briefed about the generic medicines and their benefits. Thereafter, the attitude was assessed and found to be favourable among more than half (633, 55.0%) of the surveyed population. The usage of Generic medicines was found to be poor among the respondents. Only 53 (4.6%) of the total study population had switched from branded to generic medicines in the past six months as generic medicines were less expensive compared to their branded counterparts.Conclusions: The awareness about generic drugs and its usage was poor in the surveyed population. A favourable attitude towards generic drugs was achieved by educating the people about their similarity to branded medications. Therefore, there is a need to educate people not only about the quality, safety and efficacy of the generic medicines but also about the government initiatives like the Jan Aushadhi scheme. 

scholarly journals THE INFLUENCE OF FINANCIAL PLANNING ON THE RELATIONSHIP BETWEEN HOUSEHOLD INCOME AND LEVEL OF SAVING IN TANZANIA

2020 ◽  
Vol 8 (12) ◽  
pp. 622-634
Author(s):  
Warren Tibesigwa ◽  
◽  
Will Kaberuka ◽  
Joanina Ayebare ◽  
Ally Ndeshiuta Morris ◽  
...  
Keyword(s):  
Financial Planning ◽  
Household Income ◽  
Secondary Data ◽  
School Curriculum ◽  
Moderating Effect ◽  
Cross Sectional ◽  
Study Results ◽  
The Government ◽  
Financial Awareness ◽  
The Relationship

There are many studies on the relationship between household income and saving though very little is known about the influence of financial planning on the relationship between household income and saving.This paper examined the moderating effect of financial planning on the relationship between household income and saving in Tanzania.Based on cross-sectional secondary data (Finscope data,2017) that was collected using multistage sampling from 9457 respondents, descriptive, correlation, regression and moderation effect were performed to analyze the data.The findings indicate that household income and interaction effects have a positive relationship with level of saving. Finally, regression results show that household income and financial planning have a positive significant effect on household saving levels and that financial planning has a positive moderating effect on the relationship between household income and level of saving. From these study results,it is recommended that the government of Tanzania through the ministry of community development, gender and children in should introduce financial awareness programs to the communities in order for the people to realize the need of financial planning and hence improve their saving.Further more the government throughthe ministry of education and vocational training should introduce financial awareness in the school curriculum so that citizens learn how to plan for financial matters at early stages.

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