AVAILABILITY OF ESSENTIAL MEDICINES IN PUBLIC HEALTH FACILITIES OF JIMMA ZONE, SOUTHWEST ETHIOPIA

Background: Availability is the relationship between the type and quantity of product or services needed and the type and quantity of product or services provided. Availability of essential medicines at facility level is an important factor to address patients' satisfaction and increase their health seeking behavior. The objective of this study is to determine the availability and associated factors of essential medicines in public health facilities of Jimma zone, South West Ethiopia. Methods: Facility-based cross-sectional study design was employed. Based on WHO recommendation, thirty health facilities were selected from five districts and six health facilities were chosen from each district of the zone. Availability of 29 key essential medicines that were selected from 2014 Ethiopian national essential medicine list were checked in stores and dispensaries as well as the store keepers, head of health facilities and dispensaries were selected for interview. The data were checked for completeness, edited, and coded then entered and analyzed using excels 2016 and SPSS version 23. Descriptive statistics were computed and tables, graphs and numerical summary presented results. Result: Average availability of selected core essential medicines (n=29) was 78.6% in surveyed health facilities. With regard to stock level, 8% of the surveyed medicines were in critical level, 55.2% were in safe level and 36.8% were in over stock level. Six hundred six patients were participated in the study with a response rate of 97%. Among total respondents, 77.7% left the facility with all of their prescribed medicines while 22.3% received only part of their prescribed medicines. Conclusion: The availability of essential medicines was fairly high in surveyed health facilities during the study period. In this study, many patients seeking treatment in public health facilities failed to obtain significant proportion of prescribed medicines. Peer Review History: Received: 4 November 2021; Revised: 10 December; Accepted: 22 December, Available online: 15 January 2022 Academic Editor: Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, [email protected] UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file: Reviewer's Comments: Average Peer review marks at initial stage: 5.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, [email protected] Dr. George Zhu, Tehran University of Medical Sciences, Tehran, Iran, [email protected] Similar Articles: ACCESS TO MEDICINES STRATEGIES OF THE NATIONAL CANCER CONTROL PROGRAMME IN CAMEROON THE EFFICIENCY OF INEFFICIENCY: MEDICINE DISTRIBUTION IN SUDAN

Professional Commitment and Its Associated Factors among Institutional Delivery Services Providers in Public Health Facilities, In Shone District, Southern Ethiopia

Background: There is paucity of information on level of commitment among health professionals attending delivery service in public health facilities of low-income countries including Ethiopia. Hence, the aim of this study is to assess the level and factors associated with professional commitment among institutional delivery services providers at public health facilities in Shone District, Southern Ethiopia. Methods: A facility-based cross-sectional study design was conducted at primary level public health facilities in Shone District. All health facilities (one primary hospital and 7 health centers) were included in the study. Five hundred three study participants who fulfilled inclusion criteria in proportion to obstetric care providers in each public health facilities were selected by applying simple random sampling method. Self-administered Likert scale type of questionnaire was used. Data were analyzed using SPSS version 20. Bivariate and multivariable logistic regression analyses were done to see the association between dependent and explanatory variables. Results: The magnitude of professional commitment for obstetric care providers working in public health facilities of Shone district was 69.4%. In this study, those who worked at hospital, those who had positive attitude toward organizational commitment, and those who had positive attitude toward personal characteristics were 2.4, 2.3 and 1.76 times more likely committed to profession compared with their counterparts respectively. Conclusion: The professional commitment among institutional delivery service provision was medium as compared to other study finding. All health professional should manage their own personal characteristics to behave in good way to be committed for their profession. Organizational commitment had great influence on professional commitment.

Enhancing Public Participation in Public Health Offerings: Patient Preferences for Facilities in the Western Cape Province Using a Discrete Choice Experiment

Understanding patients’ preferences for health facilities could help decision makers in designing patient-centered services. Therefore, this study aims to understand how patients’ willingness to trade for certain attributes affects the choice of public health facilities in the Western Cape province of Cape Town, South Africa. A discrete choice experiment was conducted in two community day centers (CDCs). Patients repetitively chose between two hypothetical health facilities that differed in six attributes: distance to facility, treatment by doctors vs. nurses, confidentiality during treatment, availability of medication, first visit (drop-in) waiting times, and appointment waiting times. The sample consisted of 463 participants. The findings showed that availability of medication (50.5%), appointment waiting times (19.5%), and first visit waiting times (10.2%) were the most important factors for patients when choosing a health facility. In addition, respondents preferred shorter appointment and first visit waiting times (<2 h). These results identified important characteristics in choosing public health facilities in Cape Town. These public health facilities could be improved by including patient voices to inform operational and policy decisions in a low-income setting.

Assessment of Knowledge, Practices, and Challenges of Pharmaceuticals Inventory Control Among Pharmacy Professionals Working in Selected Public Health Facilities of West Arsi Zone, Oromia, Ethiopia

Background: Good pharmaceutical inventory control enables health facilities (HFs) to provide complete health care by ensuring the availability of safe, effective, and affordable pharmaceuticals and related supplies of the required quality, inadequate quantity, at the required place and at all times. It boosts patients’ trust in the HFs and motivates working staff. However, it needs well-trained and skilled professionals. The aim of the current study was, therefore, assessing knowledge, practice, and challenges of pharmacy professionals conducting inventory control in selected public health facilities of West Arsi Zone, Oromia regional state for the year 2016 to 2018. Method: A mixed-methods study design was used to assess pharmacy professionals’ knowledge, skills, and challenges in applying inventory management methods. A semi-structured questionnaire was implemented for quantitative, whereas an open-ended question was employed for key informants (KIs) to explore qualitative data. Result: Ninety percent of pharmacy professionals knew about VEN analysis concepts and 70% about ABC analysis. However, none of them had a concept of FSN and XYZ analysis. Among the respondents who knew the concept, 75% had gained knowledge through formal training and 10% of them learned from on-job training. When they asked about the methods of inventory control, 60% responded as they did not hear about it. Of those who said “Yes” on being asked to mention at least 1 method of it, 80% could not able to correctly mention the methods used in inventory control. However, 44%, 62.5%, and 75% of respondents had practiced ABC, VED, and ABC-VED matrix analysis respectively. The challenges that prevented these professionals from practicing pharmaceutical inventory control in their HFs were grouped into price-related, training-related, human resource-related, and managerial-related factors. Conclusion: Inventory control is the heart of the pharmaceutical supply system. Without its healthy action, HFs’ goal attainment will not be viable. Problems of sick pharmaceutical inventory control are directly related to a lack of knowledge and appreciation of it by the concerned bodies. The current finding revealed almost all pharmacy professionals included in the study had little knowledge about how to manage their inventories. Managers’ unwillingness to cooperate and facilitate necessary resources prevented the professionals from doing inventory control.

Disability-Friendly Healthcare at Public Health Facilities in Bangladesh: A Mixed-Method Study To Explore the Existing Situation

Background Several strategies and policies are being implemented in Bangladesh to address the healthcare needs of people with disabilities, who comprise about 10% of the country’s total population. However, these measures are not adequate to provide accessible or friendly healthcare to the people with disabilities. This study aimed to explore the disability-friendliness of healthcare facilities, and the challenges of people with disabilities in terms of access to 1) information and communication, 2) access to infrastructure, and 3) providers’ capacity in Bangladesh. Methods A mixed-method study was conducted, including a cross-sectional survey of healthcare facilities, followed by structured-interview with people with disabilities and healthcare managers, and qualitative interviews among people with disabilities or their caregivers, healthcare providers (HCPs), policymakers, and community leaders. Data were collected from 150 public healthcare (primary-to-tertiary) facilities and from 300 people with disabilities in 16 districts across Bangladesh between January-December 2019. An observational checklist and structured questionnaires were used to assess the situation of healthcare facilities, and literature-guided guidelines were used for qualitative interviews. During analysis, the disability-friendliness of healthcare facilities were quantified through a scoring system, and thematic analysis of qualitative data was performed to identify the challenges of implementing disability-friendly healthcare (DFHC). Results The score for providing DFHC was low across all the four objectives in the healthcare facilities. The highest score (mean percentage) was observed in the infrastructure domain: 29.3±20.5, followed by communication: 18.2±4.8, and information: 14.6±6.22, and the lowest (0.93±7.1) score was for capacity of the HCPs to provide DFHC. Mean percentage scores for access to 13 infrastructure points were low, and extremely low scores were found in areas such as access to elevators (5.6±5.0), ticket counters (7.3±17.7) and toilets (10.6±9.3). Furthermore, about 59.1% of people with disabilities expressed dissatisfaction regarding access to information and communication. The majority (98.2%) recommended that training of HCPs can improve the situation. Conclusion This study revealed that most of the public health facilities in Bangladesh were not disability-friendly. Findings can inform development of a national disability-friendly policy with implementation guidelines.

Seroprevalence of Hepatitis B Virus and Associated Factors among Pregnant Women Attending Antenatal Care Services at Public Health Facilities in Nekemte Town

Background. Viral hepatitis is an emerging global health problem. A pregnant mother infected with the hepatitis B virus has a high rate of vertical transmission, causing adverse fetal and neonatal outcomes. Understanding the magnitude of the problem and associated factors has paramount importance to avert such adverse fetal and neonatal outcomes. Therefore, the main aim of this study was to assess the seroprevalence of hepatitis B virus and associated factors among pregnant women attending antenatal care clinics at public health facilities in Nekemte town. Methods. An institutional-based cross-sectional study was conducted among 277 pregnant women attending antenatal care at public health facilities in Nekemte town from June 1 to July 30, 2020. All public health institutions in Nekemte town (two hospitals and one health center) were recruited, and study participants were selected by using a systematic sampling method. The data were collected using pretested and structured questionnaires using a face-to-face interview, and a blood sample was collected to test for hepatitis B surface antigen. Logistic regression analysis was employed to identify factors significantly associated with hepatitis B virus infection. Variables with a p value < 0.05 were considered statistically significant predictors of the outcome variable. Result. The overall seroprevalence of hepatitis B virus infection was 16 (5.8%) [95% CI: 3.2-8.7], which indicates intermediate endemicity. History of abortion (AOR =6.155; 95% CI: 1.780, 21.291), history of contact with hepatitis patient (AOR =7.178; 95% CI: 1.702, 30.279), and having multiple sexual partners (AOR =6.788; 95% CI: 1.701, 27.086) had a statistically significant association with hepatitis B surface antigen seropositivity. Conclusion. Hepatitis B virus seroprevalence among pregnant women in this study shows intermediate endemicity. Therefore, health professionals should provide health information on the risk of having multiple sexual partners, risk factors of unprotected contact with hepatitis patients, and abortion for pregnant women during their antenatal care visits.

Predictors of Healthcare-Seeking Behaviour, Health Services Access and Utilization in Ajebo Community, South-West, Nigeria

Background: Health is a fundamental requirement for living a socially and economically productive life. Poor health inflicts great hardships on households, including debilitation, substantial monetary expenditures, loss of productivity and sometimes, death. Objectives: To describe healthcare-seeking behaviour, access to health services and utilisation, and their predictors in a southwestern Nigerian community. Methods: A descriptive, cross-sectional study was conducted in Ajebo community, Obafemi/Owode Local Government Area in Ogun State. A total of 420 respondents were studied using an interviewer-administered questionnaire to collect quantitative data. Results: More than half (54.0%) of the respondents had access to public health facilities, 41.7% had access to private health facilities, while patent medicine stores were accessed by 4.3% of the respondents. Out of the 249 (59.3%) who were ill in the preceding three months, 92.4% of them sought healthcare. More males utilized government-owned health services s than females (χ² = 3.878, p = 0.049). More than half (56.4%) travelled >10 minutes to access healthcare services. Lack of formal education was not a hindrance to seeking healthcare (OR = 31.392, p = 0.003, CI = 3.323-2.347). Income earning <30,000 Naira was the strongest predictor of healthcare utilization (OR = 3.304, p =0.001, 95% CI = 2.007-5.441). Education with OR = 31.392 (p = 0.003, 95% CI = 3.323-96.570) was the strongest predictor of healthcare-seeking behaviour. Conclusion: Healthcare-seeking behaviour was not limited by lack of formal education. The utilisation of public health facilities was high among the respondents. State of employment and income were strong predictors of healthcare utilisation in Ajebo community.

Assessment of the Midwives Knowledge on Utilization of Partograph in Management of Labour in Public Health Facilities in Tharaka Nithi County

The World Health Organization (WHO) has recommended Partograph as a labor management tool due to its impact in reducing obstetric labor complications and maternal deaths over the years. This labor management tool is inexpensive and appropriate for use in low-resource settings, particularly in developing countries. Despite the fact that many African countries, including Ethiopia, Kenya, and Nigeria, have adopted the Partograph in labor management, there is little information on midwives' knowledge on the use of the tool in labor management. Understanding of how to use a Partograph is essential for reducing complications and maternal deaths. The purpose of this study was to determine midwives' knowledge on using the Partograph in labor management. The study adopted a cross sectional survey design. 45 midwives were randomly selected from 16 public health facilities in Tharaka Nithi County. Questionnaires were used to collect data. Focused Group Discussions were also conducted with 77 postnatal mothers who gave birth in the 16 health facilities. The collected data was analyzed using descriptive statistics (means, frequencies, and percentages) and Chi-Square tests. Thematic analysis was used to examine qualitative data. Results showed that 74% of midwives had used Partograph in labor monitoring, while 26% had never used the tool. 60% of the midwives had received Partograph training. Despite not having been trained, some midwives were using the Partograph. Findings revealed inconsistencies in the use of Partograph in labor management. A large proportion of midwives deviated from the WHO's recommended use of Partograph in the first stage of labor. The study recommended that the Tharaka Nithi County government, through the Ministry of Health, invest in Partograph utilization in-service training programs to provide nurses and midwives working in the maternity wing the necessary knowledge and skills for proper Partograph utilization. There is also a need for policy changes in institutions to ensure that nurses use of the Partograph as a strategy for reducing maternal mortality rates, improving motherhood, and labor management in the County. Key words: Partograph; labour management; public health facilities.