BackgroundClinical pharmacy service has evolved steadily over the past few decades and is contributing to the ‘patient care journey’ at all stages. The service improves safety and effectiveness of medicines, thereby avoiding medication errors. As part of this global shift in pharmacy education and practice, Ethiopian Universities revamped the undergraduate pharmacy curriculum and the first graduates came out in July 2013. These graduates were immediately deployed in public hospital settings, with the ultimate aim of providing clinical pharmacy services. As such an initiative is new to the Ethiopian pharmacy sector, there is a need to do assessment of the health care providers’ perception and satisfaction towards the service.MethodsA cross-sectional survey using self-administered questionnaire was conducted in six regions and one-city administration of the country. Physicians, Health officers and Nurses working along with the new pharmacy graduates formed the study population. A total of 650 healthcare professionals participated in the study. Data were entered, cleaned and analyzed using appropriate statistical tools.ResultsMajority of the health care providers agreed that clinical pharmacy service could have a significant contribution to the patient care. A large proportion of them (70–90 %) had a positive attitude, although there appeared to be some differences across professions. About 50 % of the professionals were of the opinion that patient care should be left to the health care providers and pharmacists should concentrate on drug products. In addition, the same proportion of respondents said that the setup in their respective hospital was appropriate for provision of clinical pharmacy service. Multivariable analysis indicated that attitude of the health care providers was significantly associated with year of experience.ConclusionsA large proportion of the health care providers had positive attitude towards the service, although the extent of the service was below their expectation. Hence, efforts should be in place to organize continuous professional training for pharmacists and awareness creation forums for other healthcare professionals.

BackgroundA wide range of pharmaceutical products are needed for diagnosis, treatment, and prevention of HIV/AIDS. However, interrupted supplies and stock-outs are the major challenges in the supply chain of ARV medicines and related commodities. The aim of this study was to assess the supply chain management of HIV/AIDS related commodities in public health facilities of Addis Ababa, Ethiopia.MethodsA descriptive cross-sectional survey complemented by qualitative method was conducted in 24 public health facilities (4 hospitals and 20 health centers). A semi-structured questionnaire and observation check list were used to collect data on HIV/AIDS related service, reporting and ordering; receiving, transportation and storage condition of ARV medicines and test kits; and supportive supervision and logistics management information system. In addition, in-depth interview with flexible probing techniques was used to complement the quantitative data with emphasis to the storage condition of ARV medicines and test kits. Quantitative data was analyzed using SPSS version-20. Analysis of qualitative data involved rigorous reading of transcripts in order to identify key themes and data was analyzed using thematic approach.ResultsThe study revealed that 16 health centers and one hospital had recorded and reported patient medication record. Six months prior to the study, 14 health centers and 2 hospitals had stopped VCT services for one time or more. Three hospitals and 18 health centers claimed to have been able to submit the requisition and report concerning ARV medicines to Pharmaceutical Fund and Supply Agency according to the specific reporting period. More than three-fourth of the health centers had one or more emergency order of ARV medicines on the day of visit, while all of hospitals had emergency order more than 3 times within 6 months prior to the study. All of the hospitals and nearly half of the health centers had an emergency order of test kits more than 3 times in the past 6 months. Overall, nearly 3/4th of the health facilities faced stock-out of one or more ARV medicines and test kits on the day of visit.ConclusionThere was no adequate data on patient medication record and stock status of HIV/AIDS related commodities. Moreover there were frequent stock-outs of ARV medicines and HIV test kits, which was an indicator of the weak supply chain management. Hospitals and health centers, therefore, should devise a system to capture and make use of patient medication record and stock status information so as to ensure continuous supply of the commodities.

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Background: HIV/AIDS is a major public health, social and economic problem in Ethiopia. However, little has been done on assessment of the quality of the services given to patients in this country. Objective: To assess the quality of HIV/AIDS services in health centers of East Shoa Zone, Oromia region, Ethiopia. Method: Cross sectional survey was undertaken in selected health centers of East Shoa Zone between February and May, 2017. Data was collected using researcher administered structured questionnaire, logistics indicators assessment tool and observation check list. SPSS for windows version 20 was utilized in the analysis of the collected data. Results: The study facilities were providing various services to HIV/AIDS patients. All (100%) and 6(75%) facilities respectively had shortage of trained human power required to give ART and TB services. Regarding ARV medicines availability, majority of the study facilities, 5 (62.50%) reported that they had the stockout of AZT300/3TC150/NVP200 in six months prior to study while 4 (66.7%) of the facilities had the stockout of NVP 240ml (50mg/5ml) syrup on day of visit. Among anti-TB medicines, E100 was out of stock in three facilities (37.5%) on day of visit and INH100 had been out of stock in 4 (50%) of the facilities in six months prior to the study. From OIs medicines, Cotrimoxazole 960mg tablet stockedout in 4 (66.70%) on day of visit and in5 (83.30%) health centers in six months prior to the study. Considerable number of study facilities, 4 (66.70%) had the stockout of tramadol 50mg tablet on day of visit and ibuprofen 400mg tablet in six months prior to the study, 5 (71.40%). Conclusion: The studied facilities were challenged by different factors including, scarcity of human power, stockout of various HIV/AIDS related medicines and inability to make patients adhere to the services given by the facilities. The consequences of these factors can be dangerous to the patients as well as to the wider public and hence making available the appropriate human resource and HIV/AIDS related commodities including medicines should be the priority for the health facilities and the region to improve the quality of HIV/AIDS services in the study area. Keywords: HIV/AIDS; Services quality; Health center; East Shoa Zone.

Background:The growing burden of antibiotic resistance (AR) is a global public health problem. Despite the threats to global efforts to combat infectious diseases, data to guide its prevention and control in sub-Saharan Africa is limited. This study aimed to assess AR and antibiotic use among adult inpatients in an urban tertiary hospital in Sierra Leone.Methods and materials: Using a cross-sectional study design, data on antibiotic use was collected from consecutive adult inpatients (≥18 years) between October 2017 and February 2018 at Connaught Hospital in Freetown, Sierra Leone. Antibiotic resistance rates of bacterial isolates from urine and sputum of adult inpatients (≥ 18 years) were assessed from February through June 2018.Results: Of the 920 patients interviewed, 753 (81.8%) were prescribed an antibiotic. Before antibiotics use, 85.1% had no leucocytes count and none had a bacterial culture. Antibiotics commonly prescribed were cephalosporins (25.0%), penicillins (23.2%) and imidazoles (20.8%). Indications for prescribing were surgical prophylaxis (15.7%), pneumonia (15.1%), and trauma (5.8%).Of the 164 samples, 90.8% was urine. The common urinary isolates were Escherichia coli (29.2%), Klebsiella pneumoniae (19.0%), Enterococcus faecalis (13.1%) and Acinetobacter baumanii (9.4%), while that of sputum were K. pneumoniae (31.3%), E. coli (18.8%), S. aureus (12.5%) and P. aeruginosa (12.5%). Penicillin resistance rate for E. faecium and S. aureus was 100%. Gram negative resistance patterns were ampicillin (93% for both E. coli and A. baumanii and 90% K. pneumoniae), ampicillin-sulbactam (67% for both E. coli and K. pneumoniae), ciprofloxacin (82% K. pneumoniae, 70%E. coli, and 50% P. aeruginosa) and ceftriaxone (70%E. coli, 68%K. pneumoniae and 67% E. cloacae). The resistance rate to carbapenems for all Enterobacteriaceae was 13%, and 32% for all Gram-negative organisms. Conclusion:We found high rates of AR, and antibiotic use, most of which were not guided by laboratory evidence. Drivers of poor prescribing practices and AR are lack of microbiological support and oversight. These are common factors in many developing countries, which lack funds and serve a sicker population. Greater investments are needed to establish antimicrobial stewardship programs and provide clinicians with diagnostic support to enable improvements in patient outcomes and rational use of antibiotics.