Determinants of Early Mortality Among Deaths at Adult Emergency Departments in Southern Ethiopia.

BACKGROUND: In Ethiopia, the first 3 days (72 h) after admission to the emergency department (ED) account for more than half (59.8%) of all deaths. However, little is known about the prevalence of early mortality and its associated factors in southern Ethiopia. OBJECTIVE: The main objective of this study is to assess the prevalence and associated factors of early mortality among deaths in adult EDs at selected public hospitals in Hawassa, southern Ethiopia. METHODS: An institutional-based retrospective cross-sectional study design was applied. A systematic random sampling technique was used to select 369 charts of patients who died in the adult EDs of selected public hospitals in the past 2 years. The data were collected using a standardized and pretested data abstraction tool using the Kobo Toolbox data collection tool. Logistic regression analyses were carried out to assess the strength of the association. Statistical significance was declared at p-value < 0.05, and an adjusted odds ratio (AOR) with a 95% confidence interval was used to report the strength of the association. RESULT: According to the results of the current study, 288 patients, or 78% of the total, passed away within 72 h of admission to the ED. The following variables were significantly associated with early mortality: delayed initial intervention (AOR 2.338), red triage categories (AOR 3.9), lack of investigation (AOR 3.4), comorbid illness (AOR 3.2), absence of prehospital treatment (AOR 4.2), and road traffic accidents (AOR 4.1). CONCLUSION: There was an increased early mortality rate seen in this investigation. The following factors were significantly associated with an early death in the ED: comorbidity, delayed intervention, red warning score, road traffic accidents, absence of prehospital treatment, and lack of diagnostic testing. By addressing the variables that are strongly linked to an early mortality, every intervention should be undertaken to reduce the risk of an early death.

Utilization of emergency medical service and its associated factors among patients visited public hospitals at Hawassa City, Sidama Region, Ethiopia, 2023.

Background: The burden of emergency medical conditions is borne mostly by poorer nations, with a 6 % increase in deaths of adults and children due to emergency conditions between 1990 and 2015. Emergency medical service is crucial to improve outcomes of those injuries and other time-sensitive illnesses. However, access to emergency medical services in Hawassa City is still limited and its' utilization is influenced by different factors. Methods: A facility-based cross-sectional study was conducted among 422 randomly selected clients who visited the emergency service in public hospitals of Hawassa City. A structured interviewer-administered questionnaire adapted by reviewing previous literature was used. The collected data by using the Kobo toolbox was exported into a statical package for social science software for analysis. Descriptive statistics such as frequency, percentage, mean, and standard deviation were used. A binary logistic regression model at a 95 % confidence interval was used to declare an association between dependent and independent variables using the odds ratio. Results: All 422 participants completed the interview with a response rate of 100 %. The mean age of the study participants was 33.73 years with a 14.67 standard deviation. One quarter (24.9 % (95 % CI: 21.1-29.4)) of the study participants have utilized emergency medical services. Urban residence (AOR = 3.48, 95 % CI: 1.69-7.16), ever utilized ambulance service (AOR = 2.37, 95%CI: 1.21-4.67), having Red Cross Association ambulance number (AOR = 2.64, 95%CI: 1.20-5.83) and awareness on presence of free government ambulance (AOR = 3.74, 95%CI: 1.46-9.59) were the predictors of the outcome variable. Conclusion: utilization of emergency medical services in the study area was relatively low when compared with other studies. urban residence, ever utilization of ambulance service, awareness of the presence of free government ambulances, and having a Red Cross Association ambulance number were predictors of utilization of emergency medical service.

Global Health Commodities Supply Chain in the Era of COVID-19 Pandemic: Challenges, Impacts, and Prospects: A Systematic Review.

Background: The COVID-19 pandemic led to the most substantial health crisis in the 21st Century. This pandemic interrupted the supply of essential commodities for human beings. Among the essential commodities for human survival, disruption of the supply of essential health commodities has become a global concern. Objective: The study aimed to systematically analyze published articles on the challenges, impacts, and prospects of the global health commodities' supply chain in the era of the COVID-19 pandemic. Methods: A standard searching strategy was conducted in seven research databases to retrieve pertinent articles. Finally, 459 articles were retrieved for further screening, and only 13 articles were selected for final synthesis. Results: Almost 38.5% of the studies targeted the supply chain of health commodities used to treat HIV, TB, and malaria. Lockdown policies, travel restrictions, lack of transportation, low manufacturing capacity, and rising costs were the significant challenges indicated for the supply interruption of essential health commodities and COVID-19 vaccines. Findings indicated that the supply interruption of essential health commodities leads to a devastating impact on global health. Conclusion: Global medicine shortages due to the pandemic crisis can have a devastatingly harmful impact on patient outcomes and might result in a devastatingly long-lasting effect on the health of the world community. Supply-related challenges of the COVID-19 vaccine affect countries' ambitions for achieving herd immunity quickly. Monitoring the pandemic's effect on the health commodities' supply system and designing a short-term and long-term resilient health supply chain system that can cope with current and future health catastrophes is pivotal.

National Continuing Professional Development (CPD) training needs of pharmacists in Ethiopia.

BACKGROUND: Continuing Professional Development (CPD) in pharmacy is a lifelong learning approach whereby individual pharmacists are responsible for updating and broadening their knowledge, skills, and attitudes. This is vital to ensure the delivery of high-quality patient care services. However, there is a lack of available data revealing the CPD needs of Ethiopian pharmacists. Thus, the objective of this study was to identify CPD training needs of pharmacists practicing in Ethiopia. METHODS: An institution-based cross-sectional study design with a quantitative approach was employed in this study. This assessment involved 640 pharmacists representing various sectors of the profession. Data were collected through a combination of an online platform and a face-to-face questionnaire administered in person. RESULT: A total of 634 participants completed and returned the questionnaires, resulting in an impressive response rate of 99.1%. A significant majority (74.1%) of the participants possessed bachelor's degree in pharmacy (B. Pharm). Pharmaceutical Logistics and Pharmacy administration was preferentially selected as a prior CPD course by 36% of participants, of them while Pharmacotherapy (17%), Leadership/Governance (13%), Community Pharmacy (12%), Research and Development (11%) were also the subsequent top choices by participants. Off-site face-to-face lectures (59.2%), Hybrid (face-to-face + e-learning) (54.8%), and on-site on-the-job training (45.5%) were the most convenient means of CPD course delivery. On the other hand, the participants least favored print-based or correspondence programs for CPD course delivery. CONCLUSIONS: CPD holds great importance in the professional lives of pharmacists. It is critical for pharmacists, CPD providers, and those responsible for accrediting CPD programs to recognize the specific CPD requirements, preferred methods of delivery, and obstacles involved. This understanding is vital for establishing priorities and effectively planning CPD activities. In light of this, our study identified the most preferred CPD training courses and convenient delivery methods for pharmacists in Ethiopia. We recommend that CPD providers and accrediting bodies in Ethiopia refer to our findings when approving CPD courses.

Pharmacy professionals' knowledge, attitude and practice towards doping in sports: A Cross-sectional study in Ethiopia.

Background: Doping is appearing as a major problem in Ethiopia, a country decorated with medium and long-distance runners. To protect athletes from doping, pharmacists can be the first port of call for advising athletes on drug treatment. Hence, to fuel the anti-doping movement, it is crucial to explore the knowledge, attitude, and practice of community pharmacy professionals. Therefore, this study aimed to assess the community pharmacy professionals' knowledge, attitude, and practices towards doping in sports in Addis Ababa, Ethiopia. Materials and methods: A cross-sectional survey, involving 336 study participants, was conducted in selected community pharmacies of Addis Ababa, Ethiopia from April to May 2018. Results: Of 336 study participants, most of them knew the word "doping" and out of these, 51.9 % of them wrote the definition of doping correctly. Most respondents classified narcotics, hormone modulators, growth factors, and ß-2 agonists correctly. Almost one-third of the professionals agreed that they have adequate information about doping and that doping is a public health problem. Among the participants, only 33.4 % were confronted with "suspicious of doping substance" without a prescription over the last 12 months. Conclusions: Although most pharmacy professionals lack doping-specific knowledge and adequate training required to be operative in doping prevention, most of them perceive doping as a public health problem although the curriculum does not have good coverage about doping.

Chemotherapy supply chain management, safe-handling and disposal in Ethiopia: the case of Tikur Anbessa specialized hospital.

Optimal chemotherapy management is substandard in low and middle-income countries. We aimed to identify major gaps to design interventional strategies for improved chemotherapy management at Tikur Anbessa Specialized Hospital (TASH), Ethiopia. This study was conducted using an observational checklist, open-ended questions, record review, and key informant interviews of department heads and focal persons at TASH. Findings were categorized into specific themes that developed. Chemotherapy represented 60.2% of the hospital medication budget. Drug utilization was quantified via monthly consumption documentation and forecasting. However, unreliable data resulted in frequent stockouts (unavailability of the item when it is needed) of chemotherapy with only 67.8% availability. Thirteen healthcare personnel (9 nurses, 2 pharmacists and 2 hospital cleaners) were interviewed: all clinical staff but neither of hospital cleaners believed that they were at risk of hazardous agents. Challenges identified included inadequate and frequent stockouts (unavailability of the item when it is needed) of personal protective equipment, lack of standardized guidelines for chemotherapy handling, admixture, and disposal, lack of designated preparation rooms, and lack of training. All nine nurses handled chemotherapy admixtures despite only two nurses previously receiving in-service training. Most of the participants had never witnessed the disposal of anticancer drugs. Prompted by the results of this study, a dialogue was initiated among members of TASH, the American Cancer Society and the University of North Carolina to implement action-oriented projects to address the gaps identified at TASH. These gaps directly and indirectly affect care and treatment outcomes of patients at a large cancer center. Collaborations with well-resourced centers are potential models for improving chemotherapy management.

A qualitative exploration of barriers in accessing community pharmacy services for persons with disability in Addis Ababa, Ethiopia: a cross sectional phenomenological study.

BACKGROUND: It was estimated that over a billion people have a disability and around 110 to 190 million experienced significant difficulties in functioning. Similarly, there were over 5 million and 32,630 individuals with disability in Ethiopia and Addis Ababa, the capital city of Ethiopia, respectively. Health care is a human right, yet access barriers to healthcare remain one of the major challenges among people with disabilities. Community pharmacists are often the health system point of entry for most patients. Therefore, the aim of this study was to explore the barriers to community pharmacy service for individuals with physical, visual and hearing disability in Addis Ababa, Ethiopia. METHODS: A cross sectional phenomenological qualitative study design was employed to explore the barriers to community pharmacy service for individuals with Physical, Visual and Hearing disability. All members from Ethiopian National Association of the Blind (ENAB), Ethiopian National Association of the Deaf (ENAD) and Ethiopian National Association of persons with Physical Disability (ENAPPD) and all community pharmacy professionals in Addis Ababa were the study populations in this study. The analysis was made using content analysis where ideas were classified into themes manually. RESULT: All informants with disability pointed out that community pharmacy services were not accessible to them. The study found transportation, physical layout, communication and medication price were the main barriers to obtain community pharmacy services among individuals with visual, physical and hearing disabilities. Respondents also witnessed that pharmacists provided proper counseling and were also cooperative and willing to help them. CONCLUSIONS: This study indicated that individuals with disability experienced different access barriers to community pharmacy services. Further studies are recommended to identify other community pharmacy disparities and access barriers to pharmacy services and propose possible solutions.