Optimizing data quality of pharmaceutical information systems in public health care in resource limited settings.

BACKGROUND: Robust pharmaceutical management information systems (PMIS) strengthen healthcare planning and delivery. Few nationwide studies in resource limited settings in Africa validate the data quality of PMIS in public healthcare. OBJECTIVE: To determine predictors and quality of data in a nationwide PMIS database in Namibia. METHODS: A population-level analysis of the quality of data i.e. completeness, accuracy and consistency in a nationwide PMIS database, 2007-2015. Data quality of the PMIS was determined by three domains, completeness, accuracy and consistency. Data completeness was determined by level of missing data in SPSSv25, with acceptable level set at <5%. Data accuracy was determined by proportion of PMIS indicators with extreme outliers. Data consistence was determined by patterns of missingness, i.e. random or systematic. Predictors of data quality were determined using logistic regression modelling. RESULTS: A total of 544 entries and 12 indicators were registered in the PMIS at 38 public health facilities. All the PMIS indicators had missing data and 50% (n = 6) had inaccurate data i.e. extreme values. The data for most PMIS indicators (75%, n = 12) were consistent with the pattern of missing completely at random (MCAR, i.e. missingness <5%). Incompleteness of PMIS data was highest for average number of prescriptions 6%, annual expenditure per capita for pharmaceuticals 5% and population per pharmacist's assistant 5%. The main predictors of poor quality of PMIS data were year of reporting of PMIS data (p = 0.035), level of health facility (p < 0.001), vital reference materials available at the pharmacy (p = 0.002), and pharmacists' posts filled (p = 0.013). CONCLUSIONS: The data quality of PMIS in public health care in Namibia is sub-optimal and widely varies by reporting period, level of health facility and region. The integration of data quality assurance systems is required to strengthen quality of PMIS data to optimize quality of PMIS data in public health care.

Healthcare providers' attitudes and perceptions in infection diagnosis and antibiotic prescribing in public health institutions in Lesotho: a cross sectional survey.

BACKGROUND: The decision to prescribe antibiotics and the selection of an appropriate antibiotic are important in the treatment of infectious diseases. As any human decision, it can be influenced by individual attitudes and perceptions. OBJECTIVES: To assess the attitudes and perceptions of healthcare providers regarding antibiotic prescribing and the use of laboratory results in infection diagnosis. METHODS: A cross sectional survey in five selected Health Service Areas (HSAs) in the Southern Africa country of Lesotho. The questionnaires were self-administered to 67 healthcare providers in public health institutions within the selected HSAs. Data were analyzed using Fisher's exact test or the McNemar Test for dependent proportions. RESULTS: 51 surveys were returned (39 medical doctors, 12 nurses). Respondents typically practiced in urban settings, worked with both inpatients and outpatients, had over 10 years experience, and attended to at least 26 patients per day. We identify several inappropriate practices related to the use of on-site microbiology laboratories. For example, only 17% always send a sample for microscopic identification prior to prescribing antibiotics and only 32% always send a sample for culture sensitivity tests. Delays in obtaining laboratory results and high patient workloads were cited as reasons for under-utilization of laboratory facilities. Nearly all respondents recognize the need for guidelines and further training in antibiotic prescribing. CONCLUSION: Healthcare providers demonstrated attitudes and perceptions in antibiotic prescribing or use of laboratory derived information in infection diagnosis that could have negative impacts on antibiotic prescribing.

Medical and pharmacy students' perceptions of the grading and assessment practices.

Many students at the University of Namibia have frequently complained about ineffective assessment practices used at the institution. On many occasions, these complaints have not been substantiated with evidence of any kind. The purpose of this study was to obtain some empirical evidence that would ascertain undergraduate students' perceptions of the University of Namibia's grading and assessment practices. Using a structured scaled questionnaire, data were obtained from a representative sample of the University's undergraduate students studying for Medical and Pharmacy degrees. The questionnaire items covered matters related to students' experiences of assessment practices, feedback on assessment tasks, reliability and validity of assessment tools used by lecturers, efficacy of processes of administering examinations, perceptions of irregular and unfair assessment practices, impact of assessment regimes on students' cost of studies, motivation, morale, rate of progression in studies and graduation, the degree of compliance with assessment ethics and on academic quality assurance. According to the data reported in this article, the majority of the respondents perceived that the Schools of Medicine and Pharmacy at the University of Namibia applied assessment practices that yielded reliable and valid results. This was the case because most lecturers in the two schools used appropriate assessment tools and provided their students with prompt and informative feedback on the results of assignments, tests and examinations. In addition, most respondents reported that whereas examination procedures used in the two schools were efficient and effective, lecturers graded examination scripts fairly. These and other results are discussed in the article to communicate the message that the assessment procedures used in the Schools of Medicine and Pharmacy at the University of Namibia would promote effective learning and understanding amongst students as they were of high quality.

Knowledge and attitudes of infection prevention and control among health sciences students at University of Namibia.

BACKGROUND: Health Sciences students are exposed early to hospitals and to activities which increase their risk of acquiring infections. Infection control practices are geared towards reduction of occurrence and transmission of infectious diseases. OBJECTIVE: To evaluate knowledge and attitudes of infection prevention and control among Health Science students at University of Namibia. METHODS: To assess students' knowledge and attitudes regarding infection prevention and control and their sources of information, a self-administered questionnaire was used to look at standard precautions especially hands hygiene. RESULTS: One hundred sixty two students participated in this study of which 31 were medical, 17 were radiography and 114 were nursing students. Medical students had better overall scores (73%) compared to nursing students (66%) and radiology students (61%). There was no significant difference in scores between sexes or location of the high school being either in rural or urban setting. CONCLUSION: Serious efforts are needed to improve or review curriculum so that health sciences students' knowledge on infection prevention and control is imparted early before they are introduced to the wards.