The Quality of Logistics Management Information System and the Availability of Tracer Drugs at Health Posts in Rural Ethiopia: A Mixed-Method Study

BACKGROUND: Proper implementation of the logistics management information system (LMIS) would facilitate access to essential pharmaceutical products. It also prevents wastage at health posts. The aim of this study was to assess the implementation of the LMIS and the availability of tracer drugs at health posts in rural Ethiopia. METHODS: We employed a cross-sectional descriptive design with a mixed-method approach. The data used for this paper was collected from March to May 2019 as part of the National HEP assessment. The study involved 343 health posts randomly selected from nine regions of Ethiopia. Women's Development Army members and household heads participated in the qualitative study (i.e. in FGD and KII). The quantitative data were exported from Open Data Kit (ODK) to Stata 15.1 for statistical analysis, and the qualitative data were entered into NVivo 12 and analyzed using thematic content analysis. RESULTS: Of the health posts, 59.4% had a space for storing drugs; less than half (41.9%; 95% confidence interval (CI) [36%, 48%]) had a functioning refrigerator. The mean percentage of the availability of selected tracer drugs at health posts was 59.6%, with a 95% CI (58.9%, 60.3%). Bin cards were available at 43% (95% CI [40%, 46%]) of health posts, and among these, only 27.5% of the health posts adequately used the bin cards. CONCLUSION: The absence and poor use of LMIS tools was observed at health posts. Proper implementation of the LMIS has the potential to improve the availability of essential drugs that, in turn, improve health post level delivery of health services.

Comparative efficacy and safety of anti-infective drugs for patients with mild to severe COVID-19: A systematic review and network meta-analysis of randomized controlled trials

Different anti-infecthe drugs have been proposedfor the treatment ofpatients with COVID-19. We carried out a network meta-analysis to assess their relath'e efficacy and safety. Methods: We searched relevant databases for all randomized controlled trials that reported the efficacy and or safety ofany anti-infective drugs published up to April 30, 2022 for different outcomes. We did both painvise and network meta-analysis with 95% confidence intervals using afixed-effect model. We assessed studies for quality of evidence using an extension of the standard Grading ofRecommendations, Assessment, Development and Evaluation approach considering P

Sexual and reproductive health service utilization of young girls in rural Ethiopia: What are the roles of health extension workers? Community-based cross-sectional study.

OBJECTIVE: Little is known about the extent to which Health Extension Programme (HEP) has played its role to increase service uptake among young girls. This study aims to estimate the status of young girls' sexual and reproductive health (SRH) services utilisation in rural Ethiopia and to examine the role of health extension workers (HEWs) in this regard. DESIGN: A cross-sectional study. SETTING: A community-based study among all nine regions of Ethiopia. PARTICIPANTS: Nine hundred and two young girls aged 15-24 years were included in this study. METHOD: We used data from the national HEP assessment, collected from March to May 2019. Multilevel binary logistic regression was used to investigate the association between exposure to HEP and SRH services utilisation of young girls and we reported an adjusted OR with a corresponding 95% CI as measure of the degree of associations. RESULT: Only 19.18% (95% CI 16.74% to 21.89%) of young girls used SRH services with significant regional variability (intraclass correlation coefficien=17.16%; 95% CI 6.30% to 39.99%). Exposure to HEP (adjusted OR, aOR 3.13, 95% CI 2.03 to 4.85), knowing about the availability of HEP services (aOR 3.06, 95% CI 1.75 to 5.33) and having good trust in HEWs (aOR 1.82, 95% CI 1.07 to 3.10) and other sociodemographic factors were significantly associated with increased SRH services utilisation. OUTCOME: SRH service utilisation. CONCLUSION: Although the overall SRH service utilization of young girls in rural Ethiopia was very low, HEWs have a great contribution to improving service utilization of young girls through strong health education provided during home visits, school visits and at health posts. More investment along this line has the potential to improve service uptake among young girls. Encouraging HEWs to build trust among this segment of the population and creating awareness of SRH-related services is crucial to improv service uptake.

Levels of HIV/AIDS stigma and associated factors among sexually active Ethiopians: analysis of 2016 Ethiopian Demographic and Health Survey Data.

BACKGROUND: Stigma and discrimination have fueled the transmission of the disease and dramatically increased its negative public health impact. Even though the disease has extremely ravaged human life, stigma, and discrimination attached to it are not well addressed in Ethiopia at the country level. The reduction of stigma and discrimination in a population are important indicators of the success of programs that target HIV prevention and control. This study aimed to assess the level of HIV-related stigma and its determinants among sexually active Ethiopians. METHODS: A public domain data were obtained from 2016 Ethiopian Demographic and Health Survey in which two-stage cross-sectional stratified cluster sampling was applied. A total of 28,371 sexually active Ethiopians were interviewed from both rural and urban parts of Ethiopia. Descriptive Statistics and multilevel ordinal logistic regression (proportional odds model) were used to summarize data and to investigate correlates of HIV-related stigma. RESULTS: Only 5.1% (95% CI: 4.5%, 5.8%) of sexually active Ethiopians did not have a stigmatizing attitude, whereas, 59.2% (95% CI: 57.3%, 61.1%) and 35.65% (95% CI: 33.5%, 37.9%) of them had a moderate and high level of stigma respectively. Regression results show that residence (AOR = 1.82, 95% CI:1.46, 2.27), education (AOR = 0.65,95% CI: 0.50,0.84), owning mobile (AOR = 0.63,95% CI:0.55,0.72), HIV-testing (AOR = 0.77, 95% CI:0.70,0.84), age (AOR = 0.81, 95% CI: 0.73, 0.91), religion (AOR = 1.53,95% CI:1.33,1.76), and marital status (AOR = 1.38, 95% CI:1.19, 1.61) were significantly associated with HIV-related stigma (p < 0.0001). CONCLUSION: Regardless of all efforts put in a place to prevent and control HIV, a significant proportion of sexually active Ethiopians have stigmatizing attitudes. Residence, educational level, owning mobile, HIV test uptake, age, religion, and marital status were determinants of HIV-related stigma. Expanding mobile coverage, promoting HIV counseling and tests, promoting HIV education, and working with religious leaders, among other strategies could be used to minimize the stigma attached to the disease to best prevent and control it.

Medication Adherence Among Patients with Multimorbidity in the United Arab Emirates.

Background: Multimorbidity, defined as having two or more chronic diseases, has a major impact on public health and Sustainable Development Goals (SDG). This study aims to assess the prevalence of medication adherence and associated factors among patients with multimorbidity. Methods: A questionnaire-based, cross-sectional survey was conducted by a trained interviewer across patients with multimorbidity attending outpatient clinics in two tertiary referral hospitals in the United Arab Emirates (UAE). Demographic and social variables and the outcome (self-reported adherence to long-term medication) were measured using the General Medication Adherence Scale (GMAS). Multiple logistic regression was used to assess medication adherence and associated factors. Results: From a total of 630 participants included in this study, the estimated prevalence of high medication adherence is 78.57% (±1.63478) with a 95% confidence interval (CI) [75.19, 81.61]. The odds of high medication adherence increased with age. The odds of high medication adherence for patients aged 66 years and older than those aged 19-35 years is adjusted odds ratio (AOR) = 3.880, with a 95% CI [1.124, 13.390]. Patients with income more than 50,000 had the odds, AOR = 5.169 with a 95% CI [1.282, 20.843], compared to those earning less than 10,000 Dirhams (AED). Patients aged 36-65 with health insurance coverage had higher medication adherence than groups on the other end. The number of current medications is significantly (p-value = 0.027) associated with high medication adherence with the odds of high medication adherence, AOR = 4.529 with a 95% CI [1.184, 17.326], the highest for those currently taking four medications. Conclusion: This study highlights younger population having multimorbidity in the context of an increasing life expectancy and suboptimal therapeutic outcomes. Furthermore, the study highlights multimorbidity is associated with low medication adherence and out-of-pocket payment, and non-availability of insurance is a major hindrance to medication adherence.

Levels of mother-to-child HIV transmission knowledge and associated factors among reproductive-age women in Ethiopia: Analysis of 2016 Ethiopian Demographic and Health Survey Data.

BACKGROUND: The world community has committed to eliminating the mother-to-child transmission of human immunodeficiency virus. Even though different studies have been done in Ethiopia, to the knowledge of the investigators, the Ethiopian women's level of knowledge on the mother-to-child transmission of human immunodeficiency virus is not well studied and the existing evidence is inconclusive. The current study is aimed to study the Ethiopian women's level of knowledge on the mother-to-child transmission of human immunodeficiency virus and its associated factors using the 2016 Ethiopian Demographic and Health Survey Data. METHODS: Data of 15,683 women were extracted from the 2016 Ethiopia Demographic and Health Survey. Descriptive statistics and multilevel ordinal logistic regression were respectively used for the descriptive and analytical studies. RESULTS: 41.1% [95% CI: 39.5%, 42.7%] of the Ethiopian reproductive-age women have adequate knowledge of the mother-to-child transmission of human immunodeficiency virus. 77%, 84% and 87.8% of the women respectively know that human immunodeficiency virus can be transmitted during pregnancy, delivery, and breastfeeding. There are wider regional variations in the women's level of knowledge of the mother-to-child transmission of human immunodeficiency virus. Being an urban resident, having better educational status, being from a wealthy household, owning of mobile phone, frequency of listening to the radio, frequency of watching television, and being visited with field workers were significantly associated with having adequate knowledge of the mother-to-child transmission of human immunodeficiency virus. CONCLUSION: Despite all collective measures put in a place by different stakeholders to prevent the mother-to-child transmission of HIV in Ethiopia, a large proportion of the Ethiopian women do not know about the mother-to-child transmission of the disease. Stakeholders working on HIV prevention and control should give due emphasis to promoting mobile phone technology and other media like radio and television by giving due focus to rural residents and poor women to promote the current low level of the knowledge. Emphasis should also be given to the information, education, and communication of the mother-to-child transmission of the disease through community-based educations.

HIV knowledge and associated factors among young Ethiopians: application of multilevel order logistic regression using the 2016 EDHS.

BACKGROUND: Human Immunodeficiency virus continues to be a major global health problem infecting 75 million and killing 32 million people since the beginning of the epidemic. It badly hit Sub Saharan Africa than any country in the world and youths are sharing the greatest burden. The study aims to assess the level of HIV-knowledge and its determinants among Ethiopian youths using the 2016 Ethiopia Demographic and Health Survey data. METHODS: A nationally representative 2016 Ethiopian Demographic and Health Survey data were used. A total of 10,903 youths comprising 6401 females and 4502 males were included in the study. Descriptive statistics and multilevel order logistic regression were used and confidence interval was used to declare statistical significance in the final model. RESULTS: The mean age and SD of youths included in this study was 19.10 (±2.82). Among Ethiopian youths, 20.92% (95% CI: 18.91, 23.09%) had low knowledge of HIV whereas, 48.76% (95% CI: 47.12, 50.41%) and 30.31% (95% CI: 28.51, 32.18%) of them had moderate and comprehensive HIV knowledge respectively. Being male, access to TV and radio, ever tested for HIV/AIDS, owning a mobile telephone, and attending primary school and above compared to non-attendants were associated with having higher HIV knowledge. But, dwelling in rural Ethiopia, being in the Protestant and Muslim religious groups as compared to those of Orthodox followers and being in married groups were associated with having lower HIV knowledge. Approximately, 12% of the variation in knowledge of HIV was due to regions. CONCLUSION: Only one-third of Ethiopian youths have deep insight into the disease, whereas, nearly one-fifth of them have lower HIV-knowledge. There is a significant disparity in HIV-related knowledge among Ethiopian youths living in different regions. Rural residents, less educated, female, and married youths have less knowledge of HIV as compared to their counterparts. Youths who do not have a mobile phone, who lack health insurance coverage, and who have limited access to media have less knowledge about HIV. Therefore, the due focus should be given to the aforementioned factors to minimize the disparities between regions and to enhance Ethiopian youths' HIV-knowledge.