Assessment of Inventory Management Practice and Associated Challenges of Maternal, Newborn, and Child Health Life-Saving Drugs in Public Hospitals of Southwest Ethiopia: A Mixed-Method Approach.

Introduction: Maternal, newborn, and child health is a global priority, while most countries in sub-Saharan Africa have a poor implementation of maternal, newborn, and child health programs. Objective: To assess inventory management practice and associated challenges of maternal, newborn, and child health life-saving drugs in public hospitals of Jimma zone and Jimma city. Methods: Hospital-based mixed-method cross-sectional study was conducted from October 1 to 30, 2020. The quantitative data was collected using physical inventory and document reviews. Thus, seventy-eight bin cards and annual report and resupply forms were reviewed, and the collected data was analyzed using SPSS |Version 24| software. Statistical significance was determined at p < 0.05. Twelve semi-structured in-depth interviews were conducted to collect qualitative data and analysed manually using a thematic analysis technique. Results: About half of the evaluated drugs experienced 22 stock-outs per year with a stock-out rate and mean stock-out duration of 83.3% and 1.69 months, respectively. All hospitals placed at least one emergency order. The wastage rate of products was 13.1%. The data quality of report and resupply forms such as the average data accuracy of 396 (84.61%) had a significant association with the increasing level of education, X 2 (16, N = 13) = 297.7, p = 0.019. Thirty-five (97.22%) reports and resupply forms were complete, while 24 (66.67%) of them were submitted to suppliers as per the predetermined timeline with an annual reporting rate of 94.44%. Conclusion: Data quality of bin card records was more promising than report and resupply form reports. All hospitals encountered at least one stock-out and one emergency order per year. The wastage rate was twice more than the national normal. Storage management, human asset, and capacity building challenges were identified as inventory management challenges.

Antimalarial activity of solvent fractions of a leaf of Eucalyptus globulus labill against Plasmodium berghei infected mice.

INTRODUCTION: The leaf of Eucalyptus globulus is commonly used in the traditional management of malaria. However, the efficacy of solvent fractions are didn't study yet scientifically. Thus, this study aimed to investigate the antimalarial efficacy of the solvent fractions of the leaf of Eucalyptus globulus in mice against P.berghei. METHODS: The antimalarial activity of the fractions was tested in a 4-day suppressive test, Rane's test, and prophylactic test models within P.berghei infected mice. The results were analyzed using a one-way analysis of variance (ANOVA) followed by a post hoc Tukey's test in version 20 SPSS. RESULTS: All fractions at all test doses in the three test models suppressed parasitemia (p < 0.001) compared to the negative controls. In addition, the CF and EA at all three test doses and the AF at 400 mg/kg in three antimalarial test models showed 50% and above parasitemia suppression. In compliance with this, all fractions at all test doses in all test models prolonged the mean survival time of the mice greater than 12 days, except the AF at a lower dose. All fractions at 400 mg/kg in the three test models prevented (p < 0.001) loss of body weight and rectal temperature compared to the negative controls. Furthermore, all fractions in all test models and doses prevented packed cell volume reduction (p < 0.05 to p < 0.001) compared to the negative controls.. CONCLUSION: The findings of this study showed that CF and EAF had greater antimalarial activity compared to AF. This could be attributed to the presence of few phytochemicals in the AF in contrast to the CF and EAF. Overall, the results of this study further support the in vitro antimalarial activity study and the traditional use of the leaf in the management of malaria.

Assessment of HIV Rapid Test Kits Inventory Management Practice and Challenges in Public Health Facilities of Addis Ababa, Ethiopia.

Background: Many people with undiagnosed HIV live in sub-Saharan Africa and vulnerable laboratory systems undermine testing services. Methods: A facility-based mixed-approach cross-sectional study was conducted from January 1 to February 1, 2020. A total of 23 health facilities were included in the study which stratified into hospitals and health centers. Six months of bin card records and request and resupply forms (RRFs) were reviewed. Data were collected through physical inventory, observation, and document review. After the data was imported into the MS Excel 2016 spreadsheet, it was analyzed using SPSS | Version 20 | Software. In addition, 12 semi-structured in-depth interviews were conducted and responses were analysed using a thematic approach. Results: The entire health facility had RRF reports and bin card records while the availability of HIV rapid test kits was 75%. More than half, 38 (55.1%) of the bin card records were updated and the average data accuracy of bin cards was 84.1%. The data quality of the RRF reports was determined accurate 18 (78.3%), complete 15 (65.22%), and on-time 7 (30.3%). Sixteen (69.6%) health facilities experienced at least one stock out with an average daily stock out of 4%. The wastage rate was 0.0083%. Only 9 (39.1%) health facilities have fulfilled acceptable storage conditions. Conclusion: Most of the health facilities did no longer fulfilled acceptable storage conditions. Similarly, the data quality of most bin card records and RRF reports was poor. This deprived inventory management practice was likely related to supply, staff, and documentation challenges.

Evaluation of the antidiarrheal activity of 80% methanol extract and solvent fractions of the leaf of Bersama abyssinica fresen (Melianthaceae) in mice.

INTRODUCTION: The use of traditional medicinal plants in the management of diarrhea has long been practiced in Ethiopia. B. abyssinica fresen is one of the plants traditionally used to treat diarrhea whereas an in vivo study had not yet been conducted. Thus, this study aimed to evaluate the antidiarrheal activity of crude extract and solvent fractions of the leaf of B. abyssinica in mice. METHODS: Cold maceration within 80% methanol was used to extract the leaf powder and extract of the leaf was fractionated using n-hexane, chloroform, and distilled water. The in vivo antidiarrheal activity of crude extracts and solvent fractions were tested in experimental models of castor oil-induced diarrhea, enteropooling, and antimotility test. Five groups each with 6 mice were used under the three antidiarrheal models. Positive controls were treated with loperamide 3 mg/kg and atropine 5 mg/kg and 2% tween 80 was used in the treatment of negative controls. The extract and solvent fractions were administered at doses of 100, 200, and 400 mg/kg. Time of onset of diarrhea, number and weight of total and wet feces, the percent reduction in the number of wet feces, weight and volume of intestinal contents, and percent inhibition of intestinal motility were recorded. Data were analyzed using SPSS version 20. RESULT: Defecation of castor oil-induced diarrheal or loose stools was inhibited (p < 0.01 to p < 0.001) at 200 mg/kg and 400 mg/kg of crude extract and aqueous fraction. The crude extract and the aqueous fraction at three doses (p < 0.01 to p < 0.001), the chloroform fraction at 200 mg/kg and 400 mg/kg (p < 0.01 to p < 0.001), and the n-hexane fraction at 400 mg/kg (p < 0.05) reduced intraluminal fluid accumulation compared with the negative control. Castor oil-induced intestinal motility was significantly suppressed with the three-doses of aqueous fraction (p < 0.05 to p < 0.001), 200 mg/kg and 400 mg/kg of crude extract (p < 0.05 to p < 0.01), 400 mg/kg of chloroform and n-hexane (p < 0.01 to p < 0.001) compared with negative control. CONCLUSION: The crude extract, aqueous, and chloroform fractions of B. abyyssinica leaves have promising anti-diarrheal effects, supporting the plant's traditional use to treat diarrhea.

Evaluation of the Antimalarial Activity of Crude Extract of Eucalyptus globulus Labill. Leaf against Plasmodium berghei in Mice.

INTRODUCTION: Traditional medicinal plants are used as a common source of developing new and effective antimalarial drugs. E. globulus leaf has been used in the traditional management of malaria in different countries, including Ethiopia. However, there is no in vivo study done on the antimalarial activity of the plant. Thus, this study aimed to evaluate the antimalarial activity of crude extract of E. globulus Labill. leaf in P. berghei-infected mice. METHOD: The fresh leaves of E. globulus were collected, washed, air-dried, and made as coarse powder. Either sex of mice aged 6 to 8 weeks was used in the experiment. The antimalarial activity of the crude extract was tested in four-day suppressive, curative (Rane's), and prophylactic (repository) tests. The parameters like level of parasitemia, packed cell volume, body weight, rectal temperature, and mean survival time were recorded. The analysis of the data was done with SPSS version 20 with a 95% confidence interval in one-way ANOVA followed by Tukey's post hoc test. RESULTS: In all three antimalarial test models, the extract of leaf of E. globulus at all three doses suppressed the level of parasitemia significantly (p < 0.001), increased survival time (p < 0.05 to p < 0.001), and prevented a decrease in body weight as compared to the negative control. The middle and large doses of the extract also decreased loss of body temperature (p < 0.05 to p < 0.001) compared to the negative control. Reduction of packed cell volume was prevented within the three test doses of the extract in both curative and prophylactic tests and middle and large doses in the 4-day suppressive test compared to the negative control. CONCLUSION: The crude extract of the plant showed promising antimalarial activity. This supports the traditional use and the in vitro test result of the plant.

Evaluating Inventory Management Practice of Antiretroviral Drugs in Public Health Facilities of Addis Ababa, Ethiopia.

BACKGROUND: The right to safe and effective treatment is an exclusive right that depends on the robustness of the domestic health care system. METHODS: A facility-based cross-sectional study was conducted from January 01 to February 01, 2020. Ten eligible hospitals and 12 randomly selected health centers were parts of this study. A total of 66 RRFs and 308 bin cards were reviewed. Data were collected through observation, record and report review, and physical count using an observational checklist. In addition, 44 semi structured interviews were conducted. The collected data were entered to MS Excel sheet and analysed using SPSS (version 20) software. The correlation test result was determined statistically significant at p<0.05. RESULTS: Twenty-two public health facilities were included in the study of which 16 (72.72%) health facilities had at least one stock out. Availability of ARVs had very strong positive correlation ship with bin card updating practice (r=0.9 1, P<0.01), inventory accuracy rate (r=0.912, P<0.015) and very strong negative correlation ship with wastage rate (r = -0.66, P<0.001). The wastage rate due to expiration and loss was 3.9%. The mean bin card accuracy was 90.6%. RRF reports were accurate 17 (77.3%), complete 7(32%) and reported on time 14 (63.64%). Only 8 (36.36%) health facilities met acceptable storage conditions. CONCLUSION: The availability of bin cards and reports and resupply forms was promising, but the data quality remains low. The majority of health facilities did not meet acceptable storage conditions and had frequent stock-outs.