Ethiopia's commitment towards achieving sustainable development goal on reduction of maternal mortality: There is a long way to go.

Maternal mortality reduction has been recognized as a key healthcare problem that requires prioritizing in addressing. In 2015, the United Nations has set Sustainable Development Goals to reduce global maternal mortality ratio to 70 per 100,000 live births by 2030. Ethiopia as a member country has been working to achieve this Sustainable Development Goals target for the last decades. In this article, we discussed Ethiopia's commitment towards achieving Sustainable Development Goals in maternal mortality. Furthermore, the trends of maternal mortality rate in Ethiopia during Millennium Development Goals and Sustainable Development Goals are also highlighted. Although maternal mortality has been declining in Ethiopia from 2000 to 2016, the rate of death is still unacceptably high. This requires many efforts now and in future to achieve the Sustainable Development Goals target by 2030.

Newborns and Under-5 Mortality in Ethiopia: The Necessity to Revitalize Partnership in Post-COVID-19 Era to Meet the SDG Targets.

The Sustainable Development Goals (SDGs) were adopted during the United Nations meeting in 2015 to succeed Millennium Development Goals. Among the health targets, SDG 3.2 is to end preventable deaths of newborns and children under 5 years of age by 2030. These 2 targets aim to reduce neonatal mortality to at least as low as 12 per 1000 live births and under-5 mortality to at least as low as 25 per 1000 live births. Ethiopia is demonstrating a great reduction in child mortality since 2000. In the 2019 child mortality estimation which is nearly 5 years after SDGs adoption, Ethiopia's progress toward reducing the newborns and under-5 mortality lie at 27 and 50.7 per 1000 live births, respectively. The generous financial and technical support from the global partners have helped to achieve such a significant reduction. Nevertheless, the SDG targets for newborns and under-5 mortality reduction are neither attained yet nor met the national plan to achieve by the end of 2019/2020. The partnership dynamics during COVID-19 crisis and the pandemic itself may also be taken as an opportunity to draw lessons and spur efforts to achieve SDG targets. This urges the need to reaffirm a comprehensive partnership and realignment with other interconnected development goals. Therefore, collective efforts with strong partnerships are required to improve the determinants of child health and achieving SDG target reduction until 2030.

Unmet supportive care needs and determinants among cancer patients treated at University of Gondar Specialized Hospital, Northwest Ethiopia: A prospective cross-sectional study.

BACKGROUND: Assessment of supportive care needs is an important requirement to plan supportive care intervention. This study aimed to assess the unmet supportive care needs of cancer patients treated at the University of Gondar Specialized Hospital, Ethiopia. METHODS: A prospective cross-sectional study was conducted from January 1, 2017 to August 30, 2017. Adult (18 years and greater) cancer patients and those who were receiving therapy were included. The 34-Item short-form Supportive Care Needs Survey(SCNS-SF34) tool was used to assess unmet needs. The data collected were analyzed using SPSS version-21. RESULTS: A total of 150 interview guides were included in the analysis (97.4% of response rate). In the majority of 65(43.3%) the participants, the disease was metastasized even though they have undergone surgery 78 (52%). The overall mean score level of unmet need for cancer care was 3.49. The highest unmet need mean score was reported from the health system and information need domain. A significant unmet need difference concerning different need domain was found in sex, age, residence, occupation status, and monthly income. Sex and residence were found to be independent predicting factors for unmet supportive care needs. CONCLUSION: The overall level of unmet need was high. A significant unmet need difference was found in sex, age, residence, occupation status, and monthly income. Sex and residence were found to be independent predicting factors. Hence, professionals working in the oncology unit should be aware of unmet needs and expect changes over time. Certain programs and services to address the identified unmet needs should be urgently provided.

Medication regimen complexity and its impact on medication adherence and glycemic control among patients with type 2 diabetes mellitus in an Ethiopian general hospital.

Background: Different studies reported that higher diabetes-specific Medication Regimen Complexity Index (MRCI) has a negative impact on glycemic control potentially by decreasing medication adherence. However, information about regimen complexity and its association with adherence and glycemic control in Ethiopian patients with diabetes is unknown. Aim: To evaluate medication regimen complexity and to assess its impact on medication adherence and glycemic control among patients with type 2 diabetes Mellitus (T2DM). Methods: A hospital-based cross-sectional design was conducted at Debre Tabor General Hospital from 1 May 2018 to 30 June 2018. Medication regimen complexity was evaluated using the 65-item validated tool called Medication Complexity Index (MRCI). Adherence was measured using Morisky Medication Adherence Scale while patients were classified as having poor or good glycemic control based on the recent record of their fasting blood glucose. Multivariable logistic regression analysis was applied to determine the association between predictive variables and outcome variables. Results: A total of 275 patients with T2DM who meet the inclusion criteria were included in the final analysis. About 22.2% of the participants were classified as having high diabetes-specific MRCI, whereas 35.6% of the participants were classified as having high patient-level MRCI. The majority (70.5%) of the respondents were adherent to their medications, and 42.9% of the total population were categorized as having good glycemic control. According to the result of the multivariate analysis, patients with low-level and moderate-level MRCI of both diabetes-specific and patient-level MRCI were more adherent to their medication compared with patients with high MRCI. High diabetes medication regimen complexity was associated with poor glycemic control in the adjusted analyses (adjusted OR = 0.276; 95% CI = 0.100 o 0.759). Conclusion: The prevalence of high MRCImedication regimen complexity index is high among patients with T2DM. Patients with low and moderate regimen complexity had improved adherence. High diabetes-specific medication regimen complexity was associated with poor glycemic control. Simplification of a complex medication regimen for patients with diabetes should be sought by physicians and pharmacists to improve medication adherence and subsequent improvement in glycemic control.

Older patients' perception of deprescribing in resource-limited settings: a cross-sectional study in an Ethiopia university hospital.

OBJECTIVE: To assess older patients' attitude towards deprescribing of inappropriate medications. DESIGN: This was an institutional-based, quantitative, cross-sectional survey. SETTING: Outpatient clinics of the University of Gondar Referral and Teaching Hospital in Ethiopia. PARTICIPANTS: Patients aged 65 or older with at least one medication were enrolled in the study from 1 March to 30 June 2017. Excluded patients were those who had severe physical or psychological problems and who refused to participate. MAIN OUTCOME MEASURES: Older patients' attitude towards deprescribing was measured using a validated instrument, 'the revised Patients' Attitudes towards Deprescribing' (rPATD) tool for older patients. Data were collected on sociodemographic characteristics and clinical data such as comorbidity and polypharmacy, and the main outcome was older patients' willingness to deprescribe inappropriate medications. RESULTS: Of the 351 eligible participants, 316 patients completed the survey. Of the 316 patients, 54.7% were men and were taking a median of 3 (IQR: 2-4) medications daily. Overall, most of the participants (92.1%; 95% CI 89% to 95%) were satisfied with the medications they were taking; however, still a significant number of participants (81.6%; 95% CI 77% to 86%) were willing to stop one or more of their medications if possible and agreed by their doctors. This willingness was correlated with seven items of the rPATD, including a strong correlation with the overall satisfaction of patients with the medications taken. CONCLUSION: Many older patients have shown their willingness to reduce one or more of their medications if their doctors said it was possible. Healthcare providers should be proactive in discussing and evaluating potentially inappropriate medications for better clinical decision making.

Prospective evaluation of Ceftriaxone use in medical and emergency wards of Gondar university referral hospital, Ethiopia.

Ceftriaxone is among the most commonly utilized antibiotics owing to its high potency, wide spectrum of activity, and low risk of toxicity. It is used to treat different types of bacterial infections including pneumonia, bone infections, abdominal infections, Skin and soft tissue infections, urinary tract infections. However, evidence around the globe shows the misuse of Ceftriaxone. This study aimed at evaluating the appropriateness of ceftriaxone use in medical and emergency wards of Gondar university referral hospital (GURH), Northwest Ethiopia. A prospective, cross-sectional study design was employed to evaluate the use of ceftriaxone. The medical records of patients who received ceftriaxone were reviewed prospectively between January 1 and March 30, 2017. Appropriateness of ceftriaxone use was evaluated as per the protocol developed from current treatment guidelines. A total of 390 patients' medical records were reviewed. The utilization rate of ceftriaxone was found to be high with a point prevalence of 59%. Ceftriaxone was empirically used in 79.5% of cases. The most common indications of Ceftriaxone were respiratory tract infections (29.3%), central nervous system infections (24.1%), and prophylactic indications (16.4%). The mean duration of ceftriaxone therapy in our study was 11.47 days, with a range of 1-52 days. More than two-thirds (80.2%) of ceftriaxone use were found to be inappropriate and majority of unjustified ceftriaxone use emanated from inappropriate frequency of administration (78.3%), absence of culture and sensitivity test (68.7%), and duration of therapy (47%). Empiric treatment with ceftriaxone and the presence of coadministered drugs was significantly associated with its inappropriate use. The present study revealed a very high rate of inappropriate use of ceftriaxone which may potentially lead to emergence of drug-resistant microorganisms and ultimately exposes the patient to treatment failure and increased cost of therapy.