The Quality of Care Provided To Patients with Chronic Non-Communicable Diseases: a Retrospective Multi-Setup Study In Jimma Zone; Southwest Ethiopia

BACKGROUND: Chronic Non-Communicable Diseases are among the major causes of morbidity and mortality worldwide. However; access to and quality of health care for patients is very low in developing countries including Ethiopia. Hospitals and Health Centers are the main sources of health care for such patients in Ethiopia. In this study we assessed the quality of care patients with Chronic Non- Communicable Diseases received in hospital and health center setups. METHODS: A retrospective multi-setup study was conducted in Jimma University Specialized Hospital and four Health Centers in Jimma Zone from February to March 2010. A total of 52 process indicators of quality covering three disease conditions: Diabetes; Hypertension and Epilepsy were measured by reviewing randomly selected medical records. Quality of care was measured as a proportion of recommended components of care actually provided to patients. And also outcome and structural measures were assessed to supplement process measures of quality. RESULTS: Six hundred seventy four medical records were reviewed. Recommended care components were actually provided to patients in 35.1(95CI:34.1;36.0); 38.5(95CI:37.5;39.5) and 60.1(95)CI:59.3;61.0) of times on which patients were eligible; among patients with Diabetes; Hypertension and Epilepsy; respectively. After case mix adjustment; it was found that 45.9(95CI:45.4;46.5) of recommended components of care was actually provided to patients. This was 45.1(95CI:44.4;45.8) in the hospital and 30.5(95CI:29.7;31.3) in the health centers. Among patients for whom outcome data was available; optimal level of disease control was achieved only for 47 (30.5); 40(38.5) and 193 (52.9) of patients with Diabetes; Hypertension and Epilepsy; respectively. CONCLUSION: The quality of care provided to patients with Chronic Non-Communicable Diseases is very low in both settings though it is relatively better in Jimma University Specialized Hospital. Therefore; a continuous process of quality improvement is recommended in both settings. KEYWORDS: Health care; Health care quality; Quality indicators; Guideline Adherence; Chronic diseases; Diabetes; Hypertension; Epilepsy

Community based study on maternal mortality in Jimma town, south western Ethiopia.

A cross-sectional five years retrospective community based study was conducted in 1990 to determine maternal mortality rate in Jimma town, south-western Ethiopia. The maternal mortality rate was found to be 4.02/1000 live births. The results of the study revealed that major causes of maternal mortality in this area are sepsis, eclampsia and abortion. Out of all deaths, more than 50% occurred after delivery of a child. Besides, the study indicates poor trend in following antenatal care and family planning among maternal mortality cases. Recommendations are made for detailed wide scale study to generate policy issues on the subject.

Intestinal parasitism among Jiren elementary and junior secondary students in South-Western Ethiopia

A cross-sectional survey on intestinal parasites was conducted in Jiren Elementary et Junior Secondary School; Jimma. A total of 301 stool specimens were collected by systematic random sampling from a total of 1626 population. The stools were examined for ova and parasites by direct saline suspension (wet mount) method. The result showed high prevalence rate of parasitic infection (68.4 percent). A total of 10 species were identified among which Ascaris lumbricoides was the leading (52.2 percent) followed by Trichuris trichiura (18.6 percent); while Schistosoma mansoni was the least (0.3 percent). No statistically significant difference was seen in the prevalence rate of intestinal parasites by sex; (P.0.01). However; there is significant association between water source for drinking and parasitoses; (P;0.01); where; unprotected source of water favouring infection of all infected. Most of the infected children (92.2 percent) were asymptomatic. It is suggested that affective PHC strategies; such as health education in schools; expansion of school health services and chemotherapy with broad spectrum antihelminthics should be implemented

Prevalence of onchocerciasis in Blue Nile valley of western Ethiopia.

A epidemiological study of Onchocerciasis among different ethnic groups in the Blue Nile valley of Western Ethiopia was conducted to obtain baseline data on disease prevalence, skin snips samples were obtained from 493 persons, representing different ethnic groups (Nilotic and Oromos), living under different geographic and climatic conditions (lowlands, Midland and highland) or Mendi district for parasitological verification. A total of 169 (34%) had microfilariae of the skin by direct microscopy. The highest prevalence rate (81%) was found among the Nilotic people living along the southern banks of the Blue Nile River. Most patient had wide spread skin infection. Epidemiological differences were also observed.