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

The Impact of Rural Livelihood Diversification on Household Poverty: Evidence from Jimma Zone, Oromia National Regional State, Southwest Ethiopia

In Ethiopia, agriculture is the principal source of food and livelihood for many rural households, making it a central component of programs that seek to reduce poverty and achieve food security. Since the sector is faced with many challenges, rural households are compelled to develop strategies through diversification to cope with the increasing vulnerability associated with agricultural production. As a result, the purpose of this research is to assess the impact of livelihood diversification on household poverty in the Jimma zone of Ethiopia’s Oromia regional state. A multistage sampling procedure was employed to select 385 sample household heads. The study utilized data obtained from a cross-sectional survey using an interview schedule, focus group discussion, key informant interview, and personal observations. Both descriptive and econometric data analysis techniques were applied. The result of the FGT poverty measure revealed that the incidence of poverty among rural households was 37.14%, implying that 62.86% were non-poor. The descriptive statistics revealed that age of household, dependency ratio, year of schooling, sex of household, livestock ownership, landholding, non-farm income, market distance, and extension contact were found to have a significant influence on the poverty status of a household at different probability levels. Based on the cost of basic needs approach, it was applied to measure poverty status. The results of the logit model indicate that family size, landholding, livestock ownership, year of schooling, access to credit services, and off-farm income of the households were found to have significantly determined livelihood diversification. Moreover, the results of the propensity score matching indicate that household participation in livelihood diversification has a positive and significant impact on household poverty. Accordingly, households with diversified livelihoods were found to be 9% better off than those that were not diversified in terms of poverty. Policies aimed at increasing the income generation ability of the household should be strongly considered. Therefore, to ensure the capacity of rural households to practice farming along with a wide range of income-generating activities to improve the well-being of the rural poor and have a significant impact on poverty reduction, participating in livelihood diversification should be given emphasis in development planning.

Descriptive Analysis of Typhoid Fever Surveillance Data in the Jimma Zone, Southwest Ethiopia (2015–2019)

Introduction. Typhoid fever is a major cause of morbidity and mortality around the globe, and it is a serious illness in developing countries. Typhoid fever is prevalent in Ethiopia, and the burden differs with diverse demography, environment, and climate. The study aimed to determine the incidence of typhoid fever cases by person, place, and time. Method. A descriptive cross-sectional study was conducted among the five years (2015–2019) of surveillance data of typhoid fever in the Jimma Zone, Oromia Region, Ethiopia. The data were extracted from the zonal health management information system database from May to June 2020. SPSS version 21 was used to enter and analyze the data. Descriptive analysis was used to assess the distribution of typhoid fever incidence in time, place, and personal groups. Result. A total of 36,641 individuals suffered from typhoid fever during the five years. Among these, 18,972 (51.8%) were females and 17,669 (48.2%) were males. Incidence of typhoid fever was found as follows: 216, 198, 203, 264, and 299 cases per 100,000 persons were reported during 2015, 2016, 2017, 2018, and 2019, respectively. Typhoid fever cases were increased by 1.4 from 2015–2019. A high incidence of cases was observed at the start of wet months. The majority of the investigated cases were identified in Kersa, 4,476 (12.2%), Gomma, 4,075 (11.1%), and Mana, 3,267 (8.9%), woredas. Of the total, 151 (0.4%) of the reported cases were admitted for inpatient care. During the five years of surveillance data, death was not reported from all woredas. Conclusion and Recommendation. Typhoid fever was a major public health problem in the Jimma Zone for the last 5 years, and it was increased through the years. Zonal health departments should strengthen the interventions focused on the woredas that had a high burden of typhoid fever at the start of the wet months.

Financial risks of care seeking for malaria by rural households in Jimma Zone, Oromia Region, Southwest Ethiopia: a cross-sectional study

ObjectivesDespite major progress in the prevention and control of malaria in recent years, the disease remains a major cause of morbidity in Ethiopia. Malaria also imposes substantial socioeconomic costs on households. The aim of this study is to estimate the financial risk of seeking malaria service for rural households across socioeconomic statuses in the Jimma Zone, Oromia Region.DesignA facility-based cross-sectional survey.SettingJimma Zone, Oromia Region, Southwest Ethiopia.ParticipantsA total of 221 patients with malaria from 10 public health facilities were interviewed between September 2018 and December 2019.Primary and secondary outcome measuresThe main outcome measures capture the financial risks associated with malaria services, specifically catastrophic and impoverishing health expenditures. Catastrophic health expenditure (CHE) occurs when healthcare costs reach 10% of a household’s monthly income, whereas impoverishment occurs when a household’s monthly income falls below the national poverty level after paying for health service. Descriptive statistics were used to summarise the expenditure patterns associated with malaria services. All costs were gathered in Ethiopian birr and reported in 2019 US$.ResultsThe average cost of receiving malaria services was US$4.40 (bootstrap 95% CI: 3.6 to 5.3), with indirect costs accounting for 52% of total costs. Overall, at the 10% threshold, 12% (bootstrap 95% CI: 8.1% to 16.7%) of patients with malaria incurred CHE: 40% (bootstrap 95% CI: 26.7% to 55.6%) of the household in the poorest quintile experienced CHE, but none from the richest quintile did. The proportion of households living in poverty increased by more than 2-3% after spending on malaria-specific health services.ConclusionHealthcare seeking for malaria imposes a substantial financial risk on rural households, particularly for the poorest and most vulnerable. Malaria policies and interventions should therefore seek to alleviate both the direct costs and productivity losses associated with the disease, especially among the poor.

Does microcredit use helps farmers win battle against food insecurity: evidence from Jimma zone of Southwest Ethiopia

Background Lack of access to credit precludes smallholder farmers from making investment that generates greater level of income, consumption and wealth. To reverse this limit, Oromia Credit and Saving Share Company has been providing microcredit for rural households for the last two decades in the study area. Yet, there is limited knowledge on the impact of this microcredit service on rural household food security in Jimma zone. Therefore, this research aims at generating location-specific data on the impact of microcredit utilization on household food security in the study area. A multistage sampling procedure was employed to select 360 sample households. Data were generated through household survey, focus group discussion and key informant interview. Both descriptive and econometric data analysis techniques (binary logit model and Propensity score matching) were used. Results The results reveal that educational level, family size; land size and non/off-farm income of the households influenced microcredit utilization positively, whereas livestock ownership and farm income negatively influenced it. The analysis of food security status indicate that large proportion of households are food secure. The Propensity score matching result expose that microcredit utilization has generated a positive and significant impact on household food security. Conclusions Efforts towards scaling out services of microcredit institutions should target improving financial literacy of the rural poor and their current financial need on the basis of other resources such as land and livestock they owned with the ultimate goal of ensuring household food security. It is also imperative to realize the labour force capacity of the households in the process of expanding credit service.

Health care manager commitment towards implementation of citizen charter standards and associated factors in public hospitals of Jimma zone, Southwest Ethiopia

Background Managerial commitment is important for effective design and implementation of citizen charter to assure the quality of health service delivery as per the standards depicted in the document. Hence the objective of this study is to assess the level of managerial commitment towards implementation of the citizen charter standards and associated factor in Jimma zone public hospitals. Methods A Facility based cross-sectional study design was employed in Jimma zone public hospitals from March 14 to May 16, 2019 and 422 health managers who were currently working at all levels of management were participated in the study. After checking its completeness, the data was entered into EPI data version 3.1 and exported to SPSS version 20 for statistical analysis. Factor analysis was conducted. Simple and multiple linear regression were done using 95%CI and significance was declared at P < 0.05. All assumptions of linear regression and principal component analysis were checked. Results The percentages mean score of managerial commitment for health managers working in jimma zone public hospitals was 58%. Perceived value and care for managers (β = .329,95% CI,.245,.413, p-value<.001), Interaction between staff and managers’ (β = 0.077,95%CI,.032,.122, p-value< 001),involvement during implementation of citizen charter(β = 0.061,95%CI,.010,.112,p-value = 018) and positional level(β = − 122,95%CI,-.242,-.002,p-value = .046) as predictors of managerial commitment towards implementation of citizen charter standards. Conclusions In this study, the percentage mean score of managerial commitment for health care managers working in Jimma zone public hospitals was medium. Hence, all levels of managers to consider and maintain factors identified in this study in their management practice to foster a higher level of managerial commitment towards implementation of citizen charter standards in jimma zone public hospitals.

Predictors of Poor Quality of Life among People Living with HIV/AIDS on Antiretroviral therapy in Jimma zone Public Hospitals, South West Ethiopia: A Mixed-method Study.

Background: Given the benefits of ART (Antiretroviral Therapy) for people living with HIV/AIDS, their quality of life continues to impair. Moreover, several studies have been investigated the magnitude of quality of life among developed countries with a paucity of behavioral and psychosocial factors. Thus, the objective of this study was to identify predictors of poor quality of life among people living with HIV on ART in Jimma Zone Public Hospitals, Southwest Ethiopia. Methods: Institution-based case-control study triangulated with a qualitative method was employed. The sample size was determined using Epi-info 7.1.1 using the ratio of 1:3 cases to controls. A simple random sampling technique was conducted to select cases and controls. Data were entered into Epi-Data and analyzed using SPSS version 20. Qualitative data were collected from purposely selected key informants and analyzed manually. The study was conducted from March 10 to April 30, 2018.Results: a total of 81(25.1%) cases and 242(75.9%) controls were included in the study. Those PLWHA who chew Khat occasionally (AOR: 4.3; 95% CI: 1.01,17.8) and at weakly intervals (AOR: 6.3, 95% CI:2.0, 20.7), Stigmatism(AOR: 9.2; 95% CI:3.5, 24.3), severe depression(AOR: 16.1; 95% CI:5.2, 49.6), fair baseline ART adherence (AOR: 10.4; 95% CI:2.4, 44.8), poor baseline ART adherence (AOR: 6.4;95% CI:2.0,20.7), baseline WHO stage III, IV(AOR4.9,95%CI:2.0,11.5), current WHO stage III,IV (AOR: 3.9; 95% CI: 1.1, 13.5), current BMI <18.5 kg/m2 (AOR 2.37 95% CI (1.00, 5.62) and recent low hemoglobin level <12.8 mg/dl (AOR: 4.1; 95% CI:1.7, 9.7) were independently associated with poor quality of life. Key informant interviews identified that financial and food insecurity, stigma and discrimination, poor adherence, and side effect were the predictors that affect the quality of life.Conclusion: Multiple predictors of poor quality of life have been identified from the quantitative and key informant interviews. Khat chewing frequency (occasionally and weekly), stigma, depression, baseline drug adherence, duration on ART(less than 36 months), baseline WHO stage III/IV, Current WHO III, IV, being underweight in the current BMI, most recent hemoglobin level below 12.8mg/dl, including financial and food insecurity, stigma and discrimination, poor adherence and side effect from key informant interview. Therefore, effective interventions should be targeted by incorporating responsible bodies towards boosting the quality of life of PLWHIV by emphasizing avoiding behavioral factors like khat chewing, alcohol, shisha. Counseling and guidance on treatment adherence and follow-up should be done. Continuous awareness creation, dietary diversity, and modifications and guide on income-generating activities.

Primary school students’ poetic malaria messages from Jimma zone, Oromia, Ethiopia: a qualitative content analysis

Background The engagement of schools in malaria control is an emerging strategy. Little is known about the involvement of students in the development of malaria messages. This study evaluated the message content of primary school students’ malaria poems. Methods A qualitative content analysis was conducted to explore malaria messages conveyed in poems produced by students. Twenty poems were purposively selected from twenty schools across rural villages in five districts of the Jimma Zone. Data were analyzed using Atlas.ti version 7.1.4 software. The message contents were quantified in terms of frequency, and including metaphors, presented using central themes, categories, and supportive quotations. Results A total of 602 malarial contents were generated, and organized into 21 categories under five central themes. 1) Malaria-related knowledge (causation and modes of transmission, mosquito breeding and biting behavior, signs and symptoms, care for insecticide-treated nets (ITNs), and prevention methods), 2) Perceived threats from malaria, 3)The effectiveness of prevention methods (i.e., related to the adaption of ITNs, environmental cleaning, indoor residual spray (IRS), treatment for fever, and drug adherence practices), 4) Misconceptions, beliefs, and malpractices regarding the cause of malaria and drug use) and 5) Direct calls to the adopt ITN, IRS, clean surroundings, treatment, and drug use. The most commonly conveyed message contents were about the severity of malaria, distinguishable signs and symptoms, calls for community participation for malaria elimination, knowledge of preventive methods, and effectiveness of ITN use. Metaphoric expressions (war and death) were used to convey messages about the severity and the need to manage the prognosis of malaria through the active ITN use, which itself was metaphorically represented as ‘a trap’ to mosquitoes. Conclusions The poetic analysis indicated that the students developed and disseminated rich malarial messages, especially on malarial knowledge, and perceptions, beliefs, norms and practices of the local community to prevent and control malaria. Therefore, primary school students can be a source of information and would effectively communicate knowledge, perceptions, and promote malaria related practices, particularly in rural settings.