Exploring the role of ICT in pharmaceutical supply chain practices and operational performance in Ethiopia: a structural equation modeling approach.

BACKGROUND: A well-coordinated supply chain ensures the sustainable availability of life-saving medicines that improve public health outcomes. Information Communication Technology (ICT) is one of the strategies for optimizing supply chain coordination. However, there is a paucity of data on how it affects supply chain practice and performance at the Ethiopian Pharmaceutical Supply Agency (EPSA). OBJECTIVE: This study aimed to explore the relationships between information and communication technology, supply chain practice, and pharmaceutical supply chain operational performance using a structural equation modeling approach. METHODS: We conducted an analytical cross-sectional study between April and June 2021. Three hundred twenty EPSA employees participated in the survey. We used a pretested, self-administered five-point Likert scale questionnaire to collect the intended data. A structural equation modeling confirmed the relationship between the constructs (information communication technology, supply chain practices, and performance). Thus, the measurement models were first validated using exploratory and confirmatory factor analysis in SPSS/AMOS software. A p-value of less than 5% indicated statistical significance. RESULTS: Of the 320 questionnaires distributed, 300 participants (202 males and 98 females) duly responded. In this survey, supply chain practices (mainly customer relationship management and information sharing) and ICT had significant positive direct effects on operational performance with standardized regression weights (ß) of 0.65 (p < .001) and 0.29 (p < .001), respectively. On the other hand, 73% of the variations in operational performance were explained by ICT and supply chain practices, wherein ICT played moderate mediation effects between supply chain practice and performance (VAF = 0.24, p < .001). Despite the significant positive influence of ICT, the agency still faced data visibility problems with customers and other supply chain partners. CONCLUSION: The findings revealed that supply chain practices and ICT implementation impacted the agency's supply chain performance positively and significantly. The ICT implementation practice in the agency posited a significant positive partial mediating role between supply chain practice and operational performance. Thus, if the agency focuses on the automation and integration of customer relationship management and the practice of information exchange, the essential supply chain practices, it can further improve operational performance.

Development of constructs to measure client satisfaction with pharmacy services in resource-limited settings. A multicenter cross-sectional study.

BACKGROUND: Satisfaction with pharmacy services has many implications, including the degree of interaction with health care providers, the type and quality of service provided, and the extent to which needs and desires are met. This study aimed to identify the dimensions of pharmacy services and quantify client satisfaction with them. METHODS: A quantitative cross-sectional study was employed to guide this study. Data were entered into Epi Data, exported to SPSS 26.0, and analyzed using exploratory factor analysis to identify the underlying dimensions of pharmacy service. The study was conducted between 14th August 2020 and 28th December 2020. For standardization and comparison purposes, items loaded onto each dimension were computed and rescaled, and descriptive statistics were used to summarize the results. Stepwise linear regression was performed to quantify the contribution of each dimension to overall satisfaction and to identify determinant variables for overall satisfaction. A 95% CI, and a P-value of < 0.05 were used for the declaration of statistical significance. RESULTS: The mean overall satisfaction with pharmacy service was found to be (21.62±6.74)/30. There were eight dimensions of pharmacy service identified, and poor customer satisfaction was recorded for the premises and supply dimensions, with mean satisfaction of (12.08±8.49)/30 and (13.66±10.06)/30, respectively. The highest mean satisfaction was recorded with waiting time (24.24±6.54). Of the emergent dimensions, only four (supply, compassion and care, privacy, and premises) were predictors of overall satisfaction (P<0.05). The supply component was the strongest predictor of overall satisfaction, accounting for 20% of the variance in overall satisfaction. The number of prescribed and dispensed pharmaceuticals, marital status, and gender of participants also predicted overall satisfaction (P<0.05). CONCLUSION: The survey uncovered eight underlying aspects of pharmacy services that influence client satisfaction. A significant gap was recorded with premises and supply chain-related components. These dimensions' contributions to total satisfaction were substantial in terms of practical relevance. As a result, improving the availability of pharmaceuticals and the infrastructure surrounding pharmacy services may enhance consumer satisfaction considerably. Stakeholders must work on addressing supply related and premises difficulties to increase client satisfaction.

The mediating effect of information sharing on pharmaceutical supply chain integration and operational performance in Ethiopia: an analytical cross-sectional study.

BACKGROUND: Information is crucial in enhancing partnership, reducing uncertainties and inventory costs, improving order fulfillment, and increasing customer satisfaction. However, there is a scantiness of studies on how information sharing affects pharmaceutical supply chain practices and performance. Hence, this study aimed to examine the mediating effect of information sharing between supply chain integration and operational performance. METHOD: We conducted an analytical cross-sectional study complemented with a qualitative assessment between May and July 2021. The study populations (n = 343) were selected employees working at the Ethiopian pharmaceutical supply agency's head office and selected hubs. The quantitative data were collected by self-administered five-point Likert-scale questions and analyzed using SPSS®-version 23. The mediation effect was determined using sequential linear regression based on the Baron and Kenny stepwise approach. A 95% confidence interval and a p-value less than 5% were used to determine statistical significance. We gathered the qualitative data through in-depth face-to-face interviews with nine key informants and analyzed them using a thematic analysis technique. RESULTS: Among 320 completed questionnaires returned (with a response rate of 93%), we used 288 in the analysis. Of the respondents, 97 (33.7%) disagreed that information sharing with the agency is simplified. One hundred seventeen (40.6%) disagreed that customers share information via an online system. Most respondents (76.4%) agreed that internal integration in the agency reduced total order time. Information sharing (ß = 0.270, p < 0.001), customer integration (ß = 0.265, p < 0.001), and internal integration (ß = 0.151, p < 0.001) were predictor variables that had a direct positive effect on operational performance. Information sharing posited a partially mediating role between customer integration and operational performance with ß = 0.136 at p < 0.001. Data quality problems, human-resource-related issues, and natural and human-made calamities were the major challenges affecting information sharing and the overall supply chain practices. CONCLUSION: Customer integration, internal integration, and information sharing influenced operational performance positively. Although coordination among the units in the agency is reasonable, there was a lack of communication and quick response from partners, as well as data quality problems and the absence of an automation system in most health facilities. The key informants suggested end-to-end supply systems connections with partners through Enterprise Resource Planning and other means.

Health Professionals' COVID-19 Vaccine Acceptance and Associated Factors in Tertiary Hospitals of South-West Ethiopia: A Multi-Center Cross- Sectional Study.

BACKGROUND: Acceptance of the COVID-19 vaccine by health professionals highly influences the communities' decision to receive the vaccine, because health professionals are perceived to be a reliable source of health information. Hence, this study aimed at assessing COVID-19 vaccine acceptance and associated factors among health professionals in two tertiary hospitals in southwest Ethiopia. METHODS: A cross-sectional study was conducted among 319 health professionals working in Jimma University Medical Center and Mizan-Tepi university teaching hospital, southwest Ethiopia, from June 30, 2021 to July 30, 2021. Data were collected by a structured self-administered questionnaire and analyzed by SPSS version 23. A multivariate logistic regression model was used to identify independent factors associated with health professionals' covid-19 vaccine acceptance. Variables with P-value < .25 on univariate analysis were candidates for multivariate logistic regression. Then, variables with P-value < .05 at 95% CI in multivariate logistics regression were considered statistically significant. RESULTS: Of the total participants, 232 (72.73%) received COVID-19 vaccines. Among non-vaccinated health care professionals, 82 (94.3%) of them stated, worries about the safety and side effects of the vaccines, as the reason for non-acceptance. Factors such as, friends or families diagnosed with COVID-19 (AOR = .086; CI: 95%, .041-.18; P = .001), and attitudes and beliefs about COVID-19 and its vaccine (AOR = .129; CI: 95%, .037-.449; P = .001), were significantly associated with the acceptance of COVID-19 vaccine. CONCLUSION: More than one-fourth of health professionals who did not accept COVID-19 vaccines require immediate intervention through awareness creation on the safety and adverse effects of the vaccine by the government and other stakeholders. Otherwise, the community may in large reject the vaccine as they trust health professionals.

Procurement Practice of Program Drugs and Its Challenges at the Ethiopian Pharmaceuticals Supply Agency: A Mixed Methods Study.

BACKGROUND: Effective drug procurement guarantees the sustainable supply of products for health and eliminates excessive costs. However, there is limited information on the area of pharmaceutical procurement practice in Ethiopia. Thus, this study aimed at assessing the procurement practices of program drugs and its challenges at the Ethiopian Pharmaceuticals Supply Agency. METHODS: A cross-sectional study accompanied by qualitative assessment was conducted between February 21 and April 20/2020 to examine the procurement practice of the Ethiopian pharmaceutical supply agency. The quantitative data were gathered by reviewing documents and electronic records. Mean forecast error, price paid to international price reference, number of emergency orders placed, and lead time variability were the measurements used to assess the procurement practice. A statistical package for the social sciences version 23 was used to analyze the data. The results were then summarized using tables and texts. The qualitative data were collated through face-to-face in-depth interviews to explore the challenges behind the procurement practice. And the data were analyzed manually using the thematic analysis technique. RESULTS: The agency had its own procurement list which defines the items to be procured. The overall mean forecast error in the 2018/19 budget year was 27.8%. Of the 70 program commodities included in the study, 52 (74.3%) items had a mean price less than the international price reference. Three of the 14 orders (21.4%) placed in the aforementioned year were emergency purchases made through direct procurement. The mean lead time for the suppliers of the agency was 137.3 days. Poor data quality from service delivery points, staff capacity constraints, communication problems, and policy issues became the major challenges to implement an effective procurement system in the agency. CONCLUSION: The procurement practice at the agency has strong side. However, it was not without weaknesses. Using a procurement list is a worthwhile practice. Despite this, much remains to improve lead times and forecasting accuracy.

Matrix analyses of pharmaceutical products for the years 2017 to 2019 among public health facilities in Hadiya zone, Ethiopia: a cross-sectional descriptive study.

BACKGROUND: To date, global healthcare spending becomes a primary concern, and pharmaceutical costs are the main drivers. The issue is more pressing in developing countries like Ethiopia. However, there is a scantiness of comprehensive data on inventory control practices in health facilities. This study, therefore, aimed to assess the criticality, financial value, and consumption patterns of pharmaceuticals using inventory matrix analyses and explore the related challenges. METHODS: A cross-sectional study supplemented with qualitative assessments was carried out from December 2020 to January 2021 in public health facilities. Three hospitals and 14 health centers were proportionally selected using a simple random sampling technique. Self-administered questionnaires and review of logistics documents and databases like Dagu-Facility were used to obtain the quantitative data. The data were analyzed using excel spreadsheets and SPSS version 23. We gathered the qualitative data through face-to-face in-depth interviews. RESULTS: The facilities spent 66,312,277.0 Ethiopian birrs to procure 518 pharmaceuticals between 2017 and 2019. Of the total products, 68 (13.1%) belonged to class A and 353 (68.1%) belonged to class C. Among 427 items identified by VEN analysis, 202 (47.3%) were vitals, and 201 (47.1%) were essential products making the highest proportions. Cross-tabulations of ABC and VEN showed that 230 (53.9%) items formed category I, representing 84.3% of total expenditures. Sterile surgical gloves #7.5, amoxicillin capsules, examination gloves, and 40% dextrose injection were among the top-ten high-value closing inventories, accounting for 21% of class X items. The fast-moving items were the most prevalent in all years, accounting for more than 45%, and shared the maximum expenditure, up to 90%. Scarcity of infrastructure and skilled human resources, shortage of pharmaceuticals and problems with suppliers, and management issues were the major challenges in the health facilities. CONCLUSION: Most of the items identified by ABC-VEN and FSN-XYZ were Category one, i.e., mainly vital costly products and a few fast-moving items with high closing inventory values, respectively, suggesting close supervision. However, several issues became impediments. Hence, facilities should alleviate the bottlenecks and monitor the stock status to prevent theft and stock out.

Tracer Pharmaceuticals Availability and Distribution Trends Prior to and During the Covid-19 Pandemic: A Comparative Study.

BACKGROUND: Coronavirus disease 2019 (Covid-19) has had an unprecedented impact on the health products delivery system. To maintain routine health services, tracer pharmaceuticals (TPs) should always be available and accessible in healthcare institutions. Thus, this study aimed to explore the influence of the Covid-19 on TPs availability and distribution trends in the context of the Covid-19 pandemic in Ethiopia. METHODS: An institution-based comparative study was undertaken on 25 TPs in the pharmaceutical supply agency. From the agency's logistical data, we collated the amount of TPs ordered, received, and distributed, as well as the stock status, by using an observation checklist. The collated data were recorded in Microsoft Excel and transferred to SPSS for analysis. A frequency and percentage analysis were performed to evaluate the fill rate, product availability, and stock-out duration. A dependent t-test was used to compare if there was a significant mean difference in TPs distribution before and after the Covid-19 at a p-value less than 5%. RESULTS: Before Covid-19, 18 (72%) of the TPs were refilled above 80% of amount ordered. After the pandemic, however, the fill rate dropped to 48%. The availability of TPs during the Covid-19 was 60%. During the six months of Covid-19, the average stock-out duration for all TPs was 34.68 days, with Cimetidine 200mg/mL injectable (line-item fill rate = 0, days out of stock = 180 days) being the most stocked-out item. Tracer pharmaceuticals distribution before Covid-19 (M = 81,317, SD = 139,274) were significantly different after the pandemic (M = 60,212, SD = 94,966) at the 5% significance level (t (24) = 2.289, p = 0.031). CONCLUSION: This survey reveals how Covid-19 has influenced service providers' logistics systems. Following the pandemic, the line fill rate fell below half with a three-fifths availability of products. To effectively manage supply chain disruptions experienced in Covid-19 and beyond, the agency in collaboration with stakeholders should make an effort to enhance end-to-end inventory visibility, establish a resilient logistics system, strengthen domestic manufacturers' capabilities, and develop contingency plans with supplying partners.

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.

Investigating the effect of pharmaceutical logistics service performance on customer satisfaction: a two-step approach with structural equation modeling.

BACKGROUND: These days, pharmaceutical customers are the utmost stakeholders in the healthcare supply chain, and ensuring their satisfaction with the logistics services has become worthwhile. This study aimed to investigate the effect of perceived logistics service performance on customer satisfaction in the public health facilities served under the Ethiopian Pharmaceutical Supply Agency of the western cluster. METHODS: An analytical cross-sectional study was conducted between January and February 2020. We selected 269 respondents using a multistage sampling technique. A pretested semi-structured questionnaire was used to collect the intended data. We employed SPSS version 26 and AMOS 22 software to analyze the quantitative data. The findings obtained from the open-ended questions were summarized in word document manually and used to discuss the quantitative data. We tested the hypotheses using structural equation modeling. RESULTS: Of the 269 questionnaires, 247 were duly completed and returned, making a 92% response rate. The findings indicated that the pre-transaction logistics service components (ß = 0.31, p < .001), the transaction logistics service components (ß = 0.54, p < .001), and the post-transaction logistics service components (ß = 0.62, p < .001) influenced customer satisfaction positively and significantly explaining 77.1% of variations. The respondents indicated that the right person with appropriate qualifications, adequate knowledge, and experience should be employed to provide specific logistics services to please clients. CONCLUSION: It is worth pointing out that the higher logistics services performances are likely to enhance customer satisfaction. Therefore, logistics managers should strive to ensure customers get the desired products and services reliably to increase their satisfaction even better than the current performance.

Health professionals' perception of pharmaceuticals procurement performance in public health facilities in Southwestern Ethiopia.

BACKGROUND: Pharmaceutical's procurement is a core component of logistics management, and has a significant influence on product availability, and total supply chain costs. In Ethiopia, there are few studies on this topic where almost all of them were from suppliers' perspectives and entirely quantitative. This study, therefore, aimed to assess health professionals' perceptions about pharmaceuticals procurement performance in public health facilities in southwest Ethiopia. METHODS: A facility-based cross-sectional study complemented with a qualitative method was conducted from March 20 and April 30, 2019. We collected the quantitative data through self-administered structured questionnaires from pharmacy staff and document review using checklists. EpiData version 3.1 and SPSS version 20 were used for data entry and analysis, respectively. Descriptive statistics were done for quantitative data. Qualitative data were gathered through face-to-face in-depth interviews and analyzed using thematic analysis technique. RESULTS: Regarding respondents' perception of accountability in pharmaceutical procurement, 110 (57.9%) agreed or strongly agreed that their facilities adopt and use standard treatment guidelines and facility-specific medicine lists. Concerning competitiveness, 139 (62.6%) of the participants either disagreed or strongly disagreed that their facilities used formal suppliers' qualifications based on service reliability and financial capacity. Regarding efficiency, 146 (76.8%) disagreed or strongly disagreed that their facilities develop a mechanism for prompt, reliable payment to lower medicine prices. The qualitative analysis identified staff workforce and competency, budget shortages, suppliers' uncertainty, and pharmaceutical non-availability as challenges for procurement management performance. CONCLUSION: The results indicated that participants perceived procurement performance of their facilities as poor. Therefore, staff development, fundraising options, monitoring and evaluation, coordination and collaboration can improve procurement practice and performance.

Evaluation of Pharmaceuticals Inventory Management in Selected Health Facilities of West Arsi Zone, Oromia, Ethiopia.

BACKGROUND: Effective inventory management ensures an uninterrupted supply of safe, effective, and affordable pharmaceuticals which could be achieved through developing ABC-VEN (Always, Better, Control-Vital, Essential, Desirable) and FSN-XYZ (Fast, Slow, Non-moving-High, Medium, Low Value) matrix analysis. ABC-VEN matrix analysis is used to control inventory according to their annual consumption and on their functional importance whereas, FSN-XYZ matrix analysis is applied to control inventory by identifying the items to be discarded and the amount saved during the closing of annual accounts. OBJECTIVE: To evaluate inventory management in selected health facilities of West Arsi zone, Oromia regional state for the year 2016-2018. METHODS: Facility-based cross-sectional descriptive study complemented with a qualitative study was conducted in fourteen health facilities. Data were collected from goods issuing vouchers for the year 2016-2018 to perform ABC-VEN matrix analysis. The frequency of issue was collected to perform FSN analysis and the value of each closing stock was taken to get XYZ analysis. RESULTS: From the ABC-VEN matrix analysis, 26.6% of items were Category I of which the highest proportion were taken by class A and V items consuming 84.7% of annual drug expenditure (ADE). The remaining 49.2% and 24.2% of the drugs accounted for only 13.2% and 2.1% of the ADE being category II and III, respectively. Based on FSN-XYZ matrix analysis findings, category I with 41.% item share account for the highest budget (average 86.5% of values). Of this category, the XN group-non-moving and high-cost drugs had the high value (20%) which need managerial measure. In category III, the ZN group items, being 25% of drugs, only had 2.2% of value-that may increase wastage, inventory holding cost, and shortage of storage space. CONCLUSION: The matrix analysis for inventory control is a strong tool that enables one to identify items requiring close monitoring. The coupled ABC-VEN matrix analysis, combining their individual advantages - inventory's cost and its functional importance help in achieving a meaningful inventory management. However, to control the stock at an appropriate level with minimum shortage and oversupply, it has to be supported by XYZ-FSN matrix analysis. The XYZ-FSN matrix benefits the health facilities to determine the level of inventory with high value in dead-stock, and to take measures like transferring to others, discarding, or saving.

Assessment of Inventory Management Practices at the Ethiopian Pharmaceuticals Supply Agency, Addis Ababa, Ethiopia.

BACKGROUND: Maintaining an adequate level of inventory is critical since an enormous amount of capital tied up with it. Having excess inventory leads to wastage. On the contrary, insufficient commodity leads to stock out. Hence, this study aimed to assess inventory management practices of program commodities at Ethiopian Pharmaceutical Supply Agency. METHODS: A descriptive cross-sectional study complemented with a qualitative method was conducted from February 21 to April 20/2019. Order fill rate, wastage rate, frequency of emergency order, acceptable storage condition met, and stock out were the metrics we used to measure the inventory management practices of the agency. Quantitative data were collected through physical observation of the warehouses and review of logistics management tools. Seventeen in-depth interviews were conducted to explore the challenges of inventory management. RESULTS: From the total 70 program commodities managed by the agency, 2.1% wasted due to expiration and damage. These resulted in a loss of over US $2 million. The highest wastage was recorded for antimalarials which accounted for 13.1% of the malaria commodities' total inventory value. Only 14.8% of the orders were fulfilled above 80%. Thirty-seven items were stock out on average for 8.5 average days. Longer duration of stock out (260 days) was recorded for TB commodities. Seventeen items from different programs were purchased through emergency orders with a higher frequency of levonorgestrel purchase. Only 6 (60%) warehouses met acceptable storage conditions. Space deficit, outdated warehouse designs, shortage of warehouse equipment, lack of precise data, and capacity building gaps were the inventory management challenges identified. CONCLUSION: Though the wastage rate was near to the acceptable range, there were lesser order fill rates, storage condition inadequacy, and significant stock-outs of program commodities. The finding implies the need for an improvement in inventory management practice of the agency.

Inventory management performance for laboratory commodities in public hospitals of Jimma zone, Southwest Ethiopia.

BACKGROUND: Maintaining an efficient and effective inventory management system ensures a reliable supply of laboratory commodities. The aim of this study was, therefore, to assess the performance of inventory management for laboratory commodities in public hospitals in the Jimma zone. METHODS: A facility-based cross-sectional descriptive study, accompanied by a qualitative method, was conducted in seven public hospitals between April 30 and May 29, 2019. We collected data through document reviews (225 bin-cards), physical observation, self-administered questionnaires, and in-depth interviews. The quantitative data were analyzed using Excel spreadsheets and SPSS version 24. Fifteen key informants of different backgrounds took part in the qualitative study. The data were then analyzed using thematic analysis techniques. RESULTS: All the public hospitals in the zone were included in the study, making a response rate of 100%. Of the total estimated bin-cards, 225 (69.9%) of them held along with the items, and only 30.4% of them filled accurately. In four of the hospitals, pharmacists determined how much to order. Five of the hospitals used average monthly consumption data to calculate purchase quantity. Over the past 6 months, four of the hospitals had placed at least one or two emergency orders. The wastage rate of the commodities in the hospitals was 27.2% and resulted in a loss of about 10,248.5 US dollars. The hospitals had met 70.6% of the criteria for proper storage conditions. Budget constraints, absence of prompt administrative support, lack of staff commitment, and frequent shortages of commodities on the part of suppliers were major bottlenecks of inventory management. CONCLUSIONS: The hospitals had weak inventory management practices, showed by inaccurate records, stock-outs (frequent emergency orders), a high wastage rate compared to national baseline statistics, and the storage conditions below the standard.

Assessment of Pharmaceuticals Waste Practices Among Private Drug Retail Outlets in Ethiopia.

Background: Pharmaceuticals waste is a public safety concern, resulting in a possible accidental poisoning, misuse, and environmental pollution. Thus, appropriate disposal of the damaged and expired medicines would save lives and protect the ecological system. Objective: The study was aimed to assess knowledge, attitudes, and disposal practices of pharmaceuticals waste among practitioners in private retail outlets. Method: A facility-based descriptive cross-sectional study was conducted among private practitioners in retail outlets of Jimma city from November 20 to December 19, 2018. All private drug retail outlets and the respective staffs that fulfilled the eligibility criteria were included in the study. The data were collected using self-administrated questionnaires. Results: Of 106 questionnaires distributed to practitioners, 87 completed questionnaires returned, making a response rate of 82.1%. Fifty-nine (67.8%) of the participants reported that at least one type of damaged or expired medicines was present in their store. The main reasons for the damage or expiration include inappropriate storage practices, 32 (29.1%), and receiving medicines with a near expiration date, 42 (38.2%). Concerning knowledge about disposal practices, 70 (41.7%) and 47 (38.2%) of the participants, respectively, reported that safe disposal of damaged or expired medicines would prevent environmental pollution and illegal use. Regarding disposal practice, 47 (38.2%) of the respondents reported burning separately, and 24 (19.5%) of them reported burying underground. Fifty-two (59.8%) of the total participants strongly agreed that they had a responsibility to protect environmental pollution. Conclusions: The majority of the participants knew that the appropriate disposal of pharmaceuticals waste could protect human beings and ecological systems. However, a majority of the respondents disposed of the pharmaceuticals waste at the retail pharmacy.

Patient Knowledge of Correct Dosage Regimen; The Need for Good Dispensing Practice.

Background: The inappropriate use of medicine is a widespread problem, especially in developing countries. Proper dispensing practices as part of medication therapy increase benefits and minimize risks to the consumers. Objective: The purpose of this study was to assess patient knowledge of dosage regimen and the pharmacists dispensing practice. Method: A cross-sectional study design was conducted at Jimma Medical Center from March 1, 2018 to April 29, 2018. Data were collected prospectively using checklists and structured questionnaires. Results: Of the total prescribed drugs, 689 (74.25%) were actually dispensed, and 239 (34.7%) drugs were adequately labeled. The average dispensing and consultation times were 41.45 ± 12.1 and 49.13 ± 12 seconds, respectively. Of the total participants on exit interview, 267 (74.8%) correctly reported the dosage schedule of dispensed medicines. From the multivariate logistics regression analysis, language barrier (adjusted odds ratio [AOR] = 32.6, 95% confidence interval [CI] = 12.23-87.15), severity of health condition (AOR = 7.3, 95% CI = 2.70-19.56), and the number of drugs dispensed (AOR = 0.41, 95% CI = 0.18-0.87 [1 drug], AOR = 0.16, 95% CI = 0.61-0.42 [2 drugs]) have shown significant association with patient knowledge of dosage regimen. Conclusions: Majority of the patients did not receive the prescribed medicines from the outpatient pharmacy of Jimma Medical Center. Plus, only a few of the dispensed drugs contain all the necessary information. However, a large portion of the participants correctly reported the dosage schedule of their drugs.

Logistics management information system performance for program drugs in public health facilities of East Wollega Zone, Oromia regional state, Ethiopia.

BACKGROUND: Proper logistics management information system in the supply chain improves health outcomes by maintaining accurate and timely information. The purpose of this study was to determine program drugs logistics management information system performance in public health facilities of East Wollega Zone, Oromia Regional State. METHODS: A facility-based descriptive cross-sectional study design complemented with a qualitative method was conducted from April 01 to May 30, 2017. The quantitative data were gathered through reviewing logistics tools, a physical count of the selected program drugs, and interview of the pharmacy staffs. The evaluation of data quality was done on 134 RRFs and 805 bin-cards. A statistical package for social science version 20 was used to analyze the quantitative data. A chi-square test was performed to determine the association between dependent and independent variables. For the qualitative method, 11 face to face in-depth interviews were carried out, and the data were analyzed using thematic analysis technique. RESULTS: Twenty three selected public health facilities were included in the study of which 39% of them had an automated recording system. Concerning the data quality, 65% of RRFs and 79.1% of bin-cards were accurately filled, and 97.8% of the reports were found to be complete. Sixty-nine percent of the facilities had timely submitted their report to the higher level and the reporting rate of the facilities was determined to be 97%. A significant association was observed between RRF data accuracy and type of profession, X2 (4, N = 134) =35.0, P = 0.040, trainings, X2 (2, N = 134) =37.12, P = 0.001, e-LMIS, X2 (2, N = 134) = 38.67, P = 0.03, educational status, X2 (2,N = 134) = 90.38, P = 0.012, & supervision, X2 (2, N = 134) = 94.03,P < 0.001. Shortage of skilled human resources and poor commitment of the staffs were identified to be the major bottlenecks of logistics management information system performances. CONCLUSIONS: The facilities' report submission rates were promising yet the quality of the reports need improvement. Poor data quality was more likely because of weak supportive supervision and the information system being managed by non-pharmacy professionals.