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Alzubaidi H, Saidawi W, Goldstone L, Saddik B, Abduelkarem AR, Abu-Gharbieh E, Alzoubi KH, Samorinha C. A roadmap beyond dispensing for educating and training community pharmacists on key mental health competencies: A mixed-methods national study. Res Social Adm Pharm 2024; 20:134-145. [PMID: 38503576 DOI: 10.1016/j.sapharm.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 02/26/2024] [Accepted: 03/01/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Including pharmacists in collaborative mental healthcare models has yielded positive results. Establishing processes to enhance pharmacists' mental health care capabilities is crucial for addressing the increasing burden and improving access to mental health services. OBJECTIVES This study evaluated community pharmacists' mental health competencies and analyzed associated factors using a rigorous international framework. Additionally, it sought to identify pharmacists' training needs and support requirements as the first stop in creating a roadmap for enhancing mental healthcare through community pharmacies. METHODS A large-scale national study employing a mixed-methods approach was conducted with community pharmacists in United Arab Emirates. Semi-structured individual interviews and a cross-sectional survey were conducted. Pharmacists' core competencies were assessed using the Core Mental Health Competencies Framework for all Pharmacy Professionals. Generalized linear models were utilized to identify predictors of pharmacists' competency levels. Thematic analysis was used to analyze qualitative data. RESULTS In total 650 community pharmacists completed the survey (93.7% response rate). Eight pharmacists participated in semi-structured interviews. Nearly two-thirds (63.7%) received general communication skills training, while training in motivational interviewing (44.7%), shared decision-making (37.2%), and mental illness stereotyping/stigma (23.9%) were less common. Pharmacists reported lower perceived competence in their relationship with multidisciplinary teams (M = 3.02, SD = 0.89), stigma recognition (M = 3.02, SD = 1.04), and identifying mental health crises and aiding in the person's safety (M = 3.01, SD = 1.05). Poor communication skills (p < 0.001) and working in pharmacies that do not stock psychotropic medications (p = 0.023) were associated with lower perceived competence. Qualitative analysis identified training needs in various domains, including attitudes, values, and beliefs about mental health; relationships with multidisciplinary teams; communication skills; pharmaceutical knowledge; and personal and service development. CONCLUSIONS Mental health-related training is needed for community pharmacists. Addressing these needs through an intentional roadmap approach will enable pharmacists to better engage with patients with mental illness and increase access to care.
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Affiliation(s)
- Hamzah Alzubaidi
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, University City Road, University City, PO Box, 27272, Sharjah, United Arab Emirates; Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates, University City, PO Box, 27272, Sharjah, United Arab Emirates; School of Medicine, Deakin Rural Health, Deakin University Faculty of Health, Warrnambool, Victoria 3216, Australia.
| | - Ward Saidawi
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates, University City, PO Box, 27272, Sharjah, United Arab Emirates.
| | - Lisa Goldstone
- USC Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, United States.
| | - Basema Saddik
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates, University City, PO Box, 27272, Sharjah, United Arab Emirates; Department of Family and Community Medicine & Behavioral Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates; School of Population Health, Faculty of Medicine and Health, UNSW Australia, Australia.
| | - Abduelmula R Abduelkarem
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, University City Road, University City, PO Box, 27272, Sharjah, United Arab Emirates; Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates, University City, PO Box, 27272, Sharjah, United Arab Emirates.
| | - Eman Abu-Gharbieh
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates, University City, PO Box, 27272, Sharjah, United Arab Emirates; Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.
| | - Karem H Alzoubi
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, University City Road, University City, PO Box, 27272, Sharjah, United Arab Emirates; Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates, University City, PO Box, 27272, Sharjah, United Arab Emirates.
| | - Catarina Samorinha
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates, University City, PO Box, 27272, Sharjah, United Arab Emirates.
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Alghamdi KS, Petzold M, Alsugoor MH, Makeen HA, Al Monif KH, Hussain-Alkhateeb L. Community pharmacists' perspectives towards automated pharmacy systems and extended community pharmacy services: An online cross-sectional study. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 12:100363. [PMID: 38023630 PMCID: PMC10679933 DOI: 10.1016/j.rcsop.2023.100363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/05/2023] [Accepted: 11/05/2023] [Indexed: 12/01/2023] Open
Abstract
Background Private sector partnerships through community pharmacies are essential for effective healthcare integration to achieve the United Nations 2030 Agenda for Sustainable Development Goals. This partnership can provide significant clinical outcomes and reduce health system expenditures by delivering services focused on patient-centred care, such as public health screening and medication therapy management. Objectives To assess the understanding of the proposed strategic and health system reform in Saudi Arabia by exploring community pharmacists' perspectives towards the capacity and readiness of community pharmacies to use automated pharmacy systems, provide extended community pharmacy services, and identify perceived barriers. Materials and methods This multicentre, cross-sectional, web-based survey was conducted in Saudi Arabia (October-December 2021). Graphical and numerical statistics were used to describe key dimensions by the background and characteristics of the respondents, and multiple ordinal logistic regression analyses were sought to assess their associations. Results Of the 403 consenting and participating community pharmacists, most were male (94%), belonged to chain pharmacies (77%), and worked >48 h per week (72%). Automated pharmacy systems, such as electronic prescriptions, were never utilised (50%), and health screening services, such as blood glucose (76%) and blood pressure measurement (74%), were never provided. Services for medication therapy management were somewhat limited. Age groups ≤40 years, chain pharmacies, >10 years of experience and ≥ 3 pharmacists in place with <100 daily medication prescriptions and Jazan province were significantly more likely to provide all medication therapy management services than others. Operational factors were the barriers most significantly associated with the independent variables. Conclusion The results showed that most services and automated pharmacy systems remained limited and well-needed. When attempting to implement these services to drive change, community pharmacies face numerous challenges, and urgent efforts by private and government sectors are essential to improve pharmaceutical care in community pharmacy settings.
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Affiliation(s)
- Khalid S. Alghamdi
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Sweden
- Faculty of Clinical Pharmacy, Al Baha University, Al Baha, Saudi Arabia
| | - Max Petzold
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Sweden
| | - Mahdi H. Alsugoor
- Department of Emergency Medical Services, Faculty of Health Sciences, Al-Qunfudah, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Hafiz A. Makeen
- Clinical Pharmacy Department, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Kudaisi H. Al Monif
- Medical Supply Department, Najran Health Affairs, Ministry of Health, Najran, Saudi Arabia
| | - Laith Hussain-Alkhateeb
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Sweden
- Population Health Research Section, King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
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Jarab AS, Al-Qerem W, Alzoubi KH, Tharf M, Abu Heshmeh S, Al-Azayzih A, Mukattash TL, Akour A, Al Hamarneh YN. Patterns of drug-related problems and the services provided to optimize drug therapy in the community pharmacy setting. Saudi Pharm J 2023; 31:101746. [PMID: 37649677 PMCID: PMC10462881 DOI: 10.1016/j.jsps.2023.101746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/06/2023] [Indexed: 09/01/2023] Open
Abstract
Introduction Drug-related problems (DRPs) are events or circumstances involving drug therapy that actually or potentially interferes with desired health outcomes. Objectives To assess community pharmacists' knowledge and practice regarding DRP-reduction services, as well as the barriers and factors associated with decreased provision of these services. Methods This cross-sectional study utilized a validated questionnaire to assess pharmacists' knowledge, practice, and barriers to the provision of DRP-reduction services in the community pharmacy setting. Binary regression model was used to assess the variables associated with the practice of DRP-reduction services. Results A total of 412 pharmacists participated in the study. The pharmacists demonstrated strong knowledge but inadequate practice of DRP-reduction services. The most reported DRPs were inappropriate combination of drugs, or drugs and herbal medications, or drugs and dietary supplements (52.4%), patients' inability to understand instructions properly (46.1%), inappropriate drug according to guidelines (43.7%), and too high dose (40.3%). The most common barriers to these services were increased workload (60.5%), limited time (53.2%), and lack of good communication skills (49.8%). The presence of a counselling area in the pharmacy increased the practice of DRP-reduction services (OR: 3.532, 95%Cl: 2.010-5.590, P < 0.001), while increased weekly working hours (OR: 0.966, 95%Cl: 0.947-0.986), P < 0.01) and serving < 10 patients daily (OR = 0.208, 95%Cl: 0.072-0.601, P < 0.01) decreased it. Conclusions Community pharmacists' practice of DRP-reduction services showed a scope for improvement. Future pharmaceutical care initiatives should increase the number of personnel working in the pharmacy and provide them with opportunities for continued education and training in order to improve the provision of DRP services and optimize patients' outcomes.
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Affiliation(s)
- Anan S. Jarab
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Walid Al-Qerem
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, P.O. Box 130, Amman 11733, Jordan
| | - Karem H. Alzoubi
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad Tharf
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Shrouq Abu Heshmeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Ahmad Al-Azayzih
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Tareq L. Mukattash
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Amal Akour
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, Al Ain, United Arab Emirates
| | - Yazid N Al Hamarneh
- Department of Pharmacology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
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Murry LT, Flood M, Holton A, Kenny RA, Moriarty F. Use of pharmacy services in community-dwelling middle-aged and older adults; findings from The Irish Longitudinal Study on Ageing (TILDA). EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 10:100265. [PMID: 37181502 PMCID: PMC10173775 DOI: 10.1016/j.rcsop.2023.100265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/11/2023] [Accepted: 04/11/2023] [Indexed: 05/16/2023] Open
Abstract
Introduction The role of community pharmacists has evolved in recent years with expansion in pharmacy services offered. The extent to which patients utilise such services in community pharmacies in Ireland is unclear. Objective To assess pharmacy services use among adults aged ≥56 years in Ireland, and determine the demographic and clinical factors associated with pharmacy services use. Methods This cross-sectional study included community-dwelling participants in wave 4 of The Irish Longitudinal Study on Ageing (TILDA), aged ≥56 years who were self-respondents. TILDA is a nationally representative cohort study, with wave 4 data collected during 2016. TILDA collects participant demographics and health data, in addition to information on the use of several services when visiting the pharmacy in the last 12 months. Characteristics and pharmacy services use were summarised. Multivariate logistic regression was used to examine the association of demographic and health factors with reporting (i) any pharmacy service use and (ii) requesting medicines advice. Results Among 5782 participants (55.5% female, mean age 68 years), 96.6% (5587) reported visiting a pharmacy in the previous 12 months, and almost one fifth of these (1094) utilised at least one non-dispensing pharmacy service. The most common non-dispensing services reported were requesting advice about medications (786, 13.6%), blood pressure monitoring (184, 3.2%), and vaccination (166, 2.9%). Controlling for other factors, female sex (odds ratio (OR) 1.32, 95% CI 1.14-1.52), third-level education (OR 1.85, 95% CI 1.51-2.27), higher rates of GP visits, private health insurance (OR 1.29, 95% CI 1.07-1.56), higher number of medications, loneliness, and respiratory condition diagnosis (OR 1.42, 95% CI 1.14-1.74) were associated with higher likelihood of utilising pharmacy services. The relationship between these factors and requesting medicines advice was similar. Conclusion A high proportion of middle-aged and older adults visit community pharmacy and a fifth utilise specified pharmacy services. Despite advances in the services offered in pharmacies, medicines advice remains at the core of pharmacists' practice.
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Affiliation(s)
- Logan T. Murry
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Michelle Flood
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Alice Holton
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin., Ireland
| | - Frank Moriarty
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin., Ireland
- Corresponding author at: School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, 123 St Stephen's Green, Dublin 2, Ireland.
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Community pharmacists' response to complaints of gastroesophageal reflux: A simulated patient study in the Northern United Arab Emirates. PLoS One 2023; 18:e0279922. [PMID: 36607970 PMCID: PMC9821703 DOI: 10.1371/journal.pone.0279922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 12/16/2022] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Patients frequently use gastric acid-reducing agents (ARAs) to treat symptoms affecting the gastrointestinal tract. Thus, the risk for drug-drug interactions (DDI) is a serious concern. This potentially makes the community pharmacist (CP) act as a primary intervention by providing the appropriate counseling and dispensing practice. OBJECTIVE To evaluate CPs' counseling and dispensing practices regarding complaints of Gastroesophageal Reflux Disease (GERD), including recommending an appropriate course of action to prevent possible DDIs. MATERIALS AND METHODS A simulated patient (SP) methodology was used in this study. The community pharmacies in Ajman and Sharjah were visited by SP who's responsible for acting as a patient, and by an observer who's responsible for focusing on the interaction between the SP and the CPs without engagement. Data were recorded using a preprepared data collection form. Performance feedback was sent to the CPs after concluding all visits. Counseling and dispensing scores were classified based on the total scores to poor, inadequate, and complete. Appropriateness of the pharmacist's decision was defined as dispensing antacid and advising of separating doses apart in time. RESULTS A total of 150 community pharmacies was included in the data analysis. The findings of the current study demonstrated poor counseling and dispensing for the vast majority of the participants (81.3% and 67.3% of respondents, respectively). Only 4% of the CPs advised the SP to have a time interval between antacid and cefuroxime axetil. A significant difference in counseling scores was found between pharmacies located in Ajman and Sharjah (p = 0.01). Also, there was a significant difference in dispensing scores between independent and chain pharmacies (p = 0.003). CONCLUSIONS The findings revealed inadequate counseling and dispensing practice by CPs. This study highlighted the need for continuous professional training programs to endow the CPs with the knowledge necessary for improving the CPs' counseling and dispensing practices.
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Evaluation of Community Pharmacists' Competences in Identifying and Resolve Drug-Related Problems in a Pediatric Prescription Using the Simulated Patient Method. PHARMACY 2022; 11:pharmacy11010006. [PMID: 36649016 PMCID: PMC9844477 DOI: 10.3390/pharmacy11010006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/19/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023] Open
Abstract
Background: Drug-related problems (DRPs) are a global issue that impacts the efficacy and safety of the therapy, and pediatric patients are considered to be more vulnerable to DRPs, thus requiring more attention. Community pharmacists (CPs) are in a position that allow them to identify and alleviate these DRPs. Objectives: This study evaluated the ability of CPs in identifying and resolving DRPs in a pediatric prescription. Methods: A cross-sectional study was carried out in 235 community pharmacies to evaluate the ability of CPs working in the Khartoum locality to identify DRPs in a pediatric prescription and how they intervene to resolve these problems. Fifth-final year B. Pharm. Students were selected and trained to act as simulated patients (SPs) for this study. The visits were performed by using a simulated prescription that contains three different types of DRPs. The information obtained from the visits was documented immediately by the SPs after leaving the pharmacy in a data collection form. Results: All planned SPs visits were completed. Of the 235 community pharmacies, only 50 (21.3%) CPs were able to identify at least one of the DRPs. The most common type of DRP identified was the wrong duration of the treatment 19%, followed by the wrong dose 4%. The interventions made by CPs to mitigate the identified DRPs included recalculation and correction of the dose according to weight, which was made by 10 CPs, and correction of the duration, which was done by 45 CPs. None of the CPs who identified the presented DRPs communicated with the physician or referred the SP to the prescriber. The average dispensing time of the CPs was 68.18 ± 36.1 s. Conclusions: The majority of the CPs in the Khartoum locality were unable to identify DRPs in a pediatric prescription. Correction of the dose and duration of treatment were from the attempts of CPs to resolve DRPs. However, no collaboration was observed between CPs and physicians. In general, the practice of CPs in Khartoum locality in this area requires substantial improvement.
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Demissie F, Buno H, Paulos G. Assessment of Pharmaceutical Service Quality Provided in Community Drug Retail Outlets in Selected Towns, South West Ethiopia. Integr Pharm Res Pract 2022; 11:117-126. [PMID: 36035245 PMCID: PMC9416480 DOI: 10.2147/iprp.s375155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 08/12/2022] [Indexed: 11/23/2022]
Abstract
Background Inappropriate pharmaceutical services may result in unsafe, ineffective, and poor-quality treatment. This practice ultimately will lead to prolonged illness, suffering and damage to the patient and an increase in the cost of treatment. This study aims to assess the activities of pharmacy professionals and the pharmaceutical service quality given in community drug retail outlets of selected towns, Southern Ethiopia. Methods A cross-sectional study was conducted on all drug retail outlets working in Adola, Bule Hora, Dilla, and Yabelo towns, southern Ethiopia from October 1 to November 30, 2021, by interview through self- structured questionnaires and participant observations of the dispensing process. Results A total of 46 (100%) dispensers participated. Out of which 18 (39.13%) respondents were from Dilla town, 11 (23.91%) were from Adola, 8 (17.39%) were from Bule Hora and 9 (19.57%) were from Yabelo town. Standard Reference Books 21 (45.7%) and Internet 20 (43.5%) were used as drug information sources by pharmacy professionals to get the latest facts about medicines. The leading causes of a dispensing error were incomplete prescription (54.34%) and illegible prescription (30.43%) from the prescriber. The errors were managed by communicating with patients (23, 50%), and prescribers (18, 39.13%). There was a high frequency of dispensing prescription drugs without prescription paper. Conclusion The study revealed that less than half of the respondents use standard reference books and the internet as their drug information sources. Incomplete prescriptions from the prescribers were found to be the leading cause of dispensing errors. Dispensing of prescription drugs without receiving an order from a prescriber remains a common problem. Therefore, extensive work from regulatory authorities and pharmacy professionals is required to improve the quality of pharmaceutical services provided in drug retail outlets.
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Affiliation(s)
- Fitsum Demissie
- Department of Pharmacy, Institute of Health, Bule-Hora University, Bule-Hora, Oromia, Ethiopia
| | - Henok Buno
- Department of Pharmacy, Institute of Health, Bule-Hora University, Bule-Hora, Oromia, Ethiopia
| | - Getahun Paulos
- Department of Pharmaceutics, School of Pharmacy, Institute of Health Sciences, Jimma University, Jimma, Oromia, Ethiopia
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