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Dougherty K, Gebremariam A, Biza H, Belew M, Benda N, Tesfaye Y, Cranmer J, Bakken S. Obstetric Emergency Supply Chain Dynamics and Information Flow Among Obstetric Emergency Supply Chain Employees: Key Informant Interview Study. JMIR Form Res 2024; 8:e59690. [PMID: 39235860 DOI: 10.2196/59690] [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: 04/19/2024] [Revised: 06/17/2024] [Accepted: 07/03/2024] [Indexed: 09/06/2024] Open
Abstract
BACKGROUND For the past several decades, the Ethiopian Ministry of Health has worked to decrease the maternal mortality ratio (MMR)-the number of pregnant women dying per 100,000 live births. However, with the most recently reported MMR of 267, Ethiopia still ranks high in the MMR globally and needs additional interventions to lower the MMR to achieve the sustainable development goal of 70. One factor contributing to the current MMR is the frequent stockouts of critical medications and supplies needed to treat obstetric emergencies. OBJECTIVE This study describes the obstetric emergency supply chain (OESC) dynamics and information flow in Amhara, Ethiopia, as a crucial first step in closing stockouts and gaps in supply availability. METHODS Applying qualitative descriptive methodology, the research team performed 17 semistructured interviews with employees of the OESC at the federal, regional, and facility level to describe and gain an understanding of the system in the region, communication flow, and current barriers and facilitators to consistent emergency supply availability. The team performed inductive and deductive analysis and used the "Sociotechnical Model for Studying Health Information Technology in Complex Adaptive Healthcare Systems" to guide the deductive portion. RESULTS The interviews identified several locations within the OESC where barriers could be addressed to improve overall facility-level readiness, such as gaps in communication about supply needs and availability in health care facilities and regional supply hubs and a lack of data transparency at the facility level. Ordering supplies through the integrated pharmaceutical logistics system was a well-established process and a frequently noted strength. Furthermore, having inventory data in one place was a benefit to pharmacists and supply managers who would need to use the data to determine their historic consumption. The greatest concern related to the workflow and communication of the OESC was an inability to accurately forecast future supply needs. This is a critical issue because inaccurate forecasting can lead to undersupplying and stockouts or oversupplying and waste of medication due to expiration. CONCLUSIONS As a result of these interviews, we gained a nuanced understanding of the information needs for various levels of the health system to maintain a consistent supply of obstetric emergency resources and ultimately increase maternal survival. This study's findings will inform future work to create customized strategies that increase supply availability in facilities and the region overall, specifically the development of electronic dashboards to increase data availability at the regional and facility levels. Without comprehensive and timely data about the OESC, facilities will continue to remain in the dark about their true readiness to manage basic obstetric emergencies, and the central Ethiopian Pharmaceutical Supply Service and regional hubs will not have the necessary information to provide essential emergency supplies prospectively before stockouts and maternal deaths occur.
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Affiliation(s)
- Kylie Dougherty
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Abebe Gebremariam
- Woodruff Health Sciences Center, Emory University, Atlanta, GA, United States
- Emory-Ethiopia Partnership, Bahir Dar, Ethiopia
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States
- College of Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Heran Biza
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States
| | | | - Natalie Benda
- School of Nursing, Columbia University, New York, NY, United States
| | - Yihenew Tesfaye
- College of Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - John Cranmer
- Woodruff Health Sciences Center, Emory University, Atlanta, GA, United States
- Emory-Ethiopia Partnership, Bahir Dar, Ethiopia
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States
- College of Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Center for the Study of Human Health, Emory University, Atlanta, GA, United States
| | - Suzanne Bakken
- School of Nursing, Columbia University, New York, NY, United States
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Hailegebreal S, Dileba T, Haile Y, Abebe S. Health professionals' readiness to implement electronic medical record system in Gamo zone public hospitals, southern Ethiopia: an institution based cross-sectional study. BMC Health Serv Res 2023; 23:773. [PMID: 37468930 DOI: 10.1186/s12913-023-09745-5] [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: 03/01/2023] [Accepted: 06/24/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND The adoption of Electronic Medical Records (EMR) by the healthcare sector can improve patient care and safety, facilitate structured research, and effectively plan, monitor, and assess disease. EMR adoptions in low-income countries like Ethiopia were delayed and failing more frequently, despite their critical necessity. The most popular way to solve the issue is to evaluate user preparedness prior to the adoption of EMR. However, little is known regarding the EMR readiness of healthcare professionals in this study setting. Therefore, the objective of this study was to assess the readiness and factors associated with health professional readiness toward EMR in Gamo Zone, Ethiopia. METHODS An institution-based cross-sectional survey was conducted by using a pretested self-administered questionnaire on 416 study participants at public hospital hospitals in southern Ethiopia. STAT version 14 software was used to conduct the analysis after the data was entered using Epi-data version 3.2. A binary logistic regression model was fitted to identify factors associated with readiness. Finally, the results were interpreted using an adjusted odds ratio (AOR) with a 95% confidence interval (CI) and p-value less than 0.05. RESULTS A total of 400 participants enrolled in the study, with a response rate of 97.1%. A total of 65.25% (n = 261) [95% CI: 0.60, 0.69] participants had overall readiness, 68.75% (n = 275) [95% CI: 0.64, 0.73] had engagement readiness, and (69.75%) (n = 279) [95% CI: 0.65, 0.74] had core EMR readiness. Computer skills (AOR: 3.06; 95% CI: 1.49-6.29), EMR training (AOR: 2.00; 95% CI: 1.06-3.67), good EMR knowledge (AOR: 2.021; 95% CI: 1.19-3.39), and favorable attitude (AOR: 3.00; 95% CI: 1.76-4.97) were factors significantly associated with EMR readiness. CONCLUSION Although it was deemed insufficient, more than half of the respondents indicated a satisfactory level of overall readiness for the adoption of EMR. Moreover, having computer skills, having EMR training, good EMR knowledge, and favorable EMR attitude were all significantly and positively related to EMR readiness.
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Affiliation(s)
- Samuel Hailegebreal
- College of Medicine and Health Sciences, School of Public Health, Department of Health Informatics, Wachemo University, Hosaena, Ethiopia.
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
| | - Temesgen Dileba
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Yosef Haile
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Sintayehu Abebe
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Tegegne MD, Wubante SM, Melaku MS, Mengiste ND, Fentahun A, Zemene W, Zeleke T, Walle AD, Lakew GT, Tareke YT, Abdi MS, Alemayehu HM, Girma EM, Tilahun GG, Demsash AW, Dessie HS. Tele-pharmacy perception, knowledge and associated factors among pharmacy students in northwest Ethiopia: an input for implementers. BMC MEDICAL EDUCATION 2023; 23:130. [PMID: 36849956 PMCID: PMC9969706 DOI: 10.1186/s12909-023-04111-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 02/16/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND Tele-pharmacy is a subset of telemedicine in which pharmacies use telecommunication technology to provide patient care. Tele-pharmacy can improve pharmaceutical care service delivery by reducing medication errors, improving access to health professionals and facilities in remote and rural areas, and minimizing adverse drug events. However, there is limited evidence regarding future pharmacists' knowledge and perceptions of the Tele-pharmacy system in Ethiopia. As a result, this study aimed to assess tele-Pharmacy perception, knowledge and associated factors among pharmacy students in Northwest Ethiopia. METHODS An institutional-based cross-sectional study was conducted among 376 pharmacy students in Northwest Ethiopia between July 15 and August 27, 2022. A pre-tested self-administered questionnaire was used to collect data. The data were entered using Epi info version 7.0 and analyzed using SPSS version 25. Descriptive statistics, bivariable and multivariable logistic regression analysis were used to describe pharmacy students' knowledge and perceptions of Tele-pharmacy and identify associated factors. An adjusted odds ratio (OR) and a p-value with a 95% confidence interval (CI) were calculated to declare statistical significance. RESULTS From a total of 352 participants, about 32.4% with [95% CI (27%-37%)] and 48.6% with [95% CI (43%-54%)] had good knowledge and a positive perception toward Tele-pharmacy, respectively. Being age group of 26-30 (AOR = 0.35, 95% CI: 0.17-0.68), being male (AOR = 2.38, 95% CI: 1.26-4.49), Having a CPGA of > 3.5 (AOR = 2.28, 95% CI: 1.24-4.19), Taking basic computer training (AOR = 2.00, 95% CI: 1.17-3.39), Management support (AOR = 1.84, 95% CI: 1.06-3.19) were found to be significantly associated with pharmacy students' knowledge of Tele-pharmacy. Similarly, having access to electronic devices (AOR = 3.80, 95% CI: 1.81-7.97), training related to pharmacy information systems (AOR = 6.66, 95% CI: 3.34-13.29), availability of guidelines (AOR = 2.99, 95% CI: 1.62-5.50) were found to be significantly associated with pharmacy students' perceptions of Tele-pharmacy. CONCLUSION This study found that pharmacy students have limited knowledge and perceptions of the Tele-pharmacy system. A continuing Tele-pharmacy training package, incorporating pharmacy information system guidelines as part of their education, and providing managerial support could be recommended to improve pharmacy students' knowledge and perception of Tele-pharmacy.
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Affiliation(s)
- Masresha Derese Tegegne
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Sisay Maru Wubante
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mequannent Sharew Melaku
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Nebyu Demeke Mengiste
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ashenafi Fentahun
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wondwossen Zemene
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tirualem Zeleke
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Agmasie Damtew Walle
- Department of Health Informatics, Institute of Public Health, Mettu University, Mettu, Ethiopia
| | - Getnet Tadesse Lakew
- Health Management Information System Unit, Gazo Woreda Health Office North Wello, Woldia, Ethiopia
| | - Yonas Tsegaw Tareke
- Health Management Information System Unit, Amhara Public Health Institution, Dessie, Ethiopia
| | - Mubarek Suleman Abdi
- Health Management Information System Unit, Asossa Zonel Health Department, Benishangul-Gumuz, Ethiopia
| | | | - Eskedar Menkir Girma
- Health Management Information System Unit, Debremarkos Hospital, Debre Markos, Ethiopia
| | - Gizaw Getye Tilahun
- Health Management Information System Unit, Enat Hospital, Debre Birhan, Ethiopia
| | | | - Hiwote Simane Dessie
- Departement of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
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