Cochrane, evidence-based medicine and associated factors: A cross-sectional study of the experiences and knowledge of Ethiopian specialists in training

Introduction: Evidence-based healthcare is a core competency for practicing healthcare practitioners and those in speciality training. In sub-Saharan Africa, little is known about the teaching of evidence-based medicine (EBM) in residency program. This survey evaluated the experiences and knowledge of Cochrane, EBM and associated factors among Ethiopian specialists in training.Methods: A convenient sample of trainee specialists completed a pretested self-administered survey. The majority (93%) were ≤30 years old, males (63%) and 41% in paediatrics speciality. The associations of categorical variables with EBM knowledge was assessed by Fisher's exact or Chi-Square tests. Covariates contributing to EBM knowledge were identified using multivariate logistic regression analysis.Results: Eighty-three trainees participated in the survey (response rate 88.2%). About 75% have heard aboutCochrane but no one recognized Cochrane South Africa. Only 25% of the trainees knew the Cochrane Library but none used it in clinical practice. Most (78%) have heard of EBM, 15% had attended EBM course, 96% wanted to attend EBM course and 81% had positive attitudes to EBM. Trainees EBM knowledge was associated withawareness of Cochrane [Adjusted odds ratio (AOR) = 8.5, 95% Confidence interval (CI) 1.3­54.6, P = 0.02], EBM (AOR = 51.2, 95% CI 2.7­960.8, P = 0.009), and being in third year training (AOR = 28.4, 95% CI 1.9­427.2, P = 0.02). The promotion of EBM in residency hospital (AOR = 22.2, 95% CI 2.2­223.8, P = 0.008) and being aware of Cochrane (AOR = 4.8, 95% CI 1.1­21.7, P = 0.04) were predictors of positive attitude. Familiarity with Cochrane Library was influenced by EBM knowledge (AOR = 6.6, 95% CI 1.4­31.5, P = 0.02) and perceived organization barrier to accessing the resource (AOR = 3.2, 95% CI 1.03­10.1, P = 0.04). Conclusion: Ethiopian trainee specialists lacked formal EBM training, awareness and use of the Cochrane Library. To improve the healthcare quality and patient outcomes, EBM education should be integrated into residency curricula

Retrospective review of antiretroviral therapy program data in accredited private hospitals in Addis Ababa City Administration, Ethiopia

Background: Ethiopia is committed to improving access to human immunodeficiency virus (HIV) care and antiretroviral therapy (ART) service. In May 2005; some private hospitals in Addis Ababa City Administration received accreditation to provide ART services to eligible patients. Objective: To examine and describe the achievements of the ART Program in accredited private hospitals. Methods: Descriptive retrospective analyses of reported ART Program Data from accredited private hospitals; between May 2005 and 31st December 2009. The aggregate data was obtained from Addis Ababa Regional Health Bureau and consisted of information about patients enrolled for care; those who started ART; and those presently are on ART. Results: During the study period; 10;849 patients were enrolled for care; 9;442 who had just started ART and 5;608 already on it across the study private facilities. In general close to 75of the total patients enrolled for care at five facilities. Although the majority (87) had started treatment in the past; only 59.4were currently on treatment. Overall; the program retained 66.4of the patients (n=6;270) and attrition was 32(n=3;021). Conclusions: Differences in patient enrollment for care; ART initiation and retention were observed across facilities. A significant number of patients discontinued treatment and their outcome status was unclear. A better monitoring and reporting of ART Program Data will improve program quality. An effective strategy is needed to enhance patient retention and tracing in the accredited private hospitals in Addis Ababa City Administration