Journal articles: 'Healthcare systems in Ethiopia'

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Kassa, Melkamu Dugassa, and Jeanne Martin Grace. "A mixed-method study of quality, availability and timeliness of non-communicable disease (NCD) related data and its link to NCD prevention: Perceptions of health care workers in Ethiopia." Health Information Management Journal 48, no. 3 (August 20, 2018): 135–43. http://dx.doi.org/10.1177/1833358318786313.

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Background: Three-quarters of non-communicable disease (NCD) mortality occurs in low- and middle-income countries. However, in most developing countries, quality and reliable data on morbidity, mortality and risk factors for NCD to predict its burden and prevalence are less well understood and availability of these data is limited. To better inform policymakers and improve healthcare systems in developing countries, it is also important that these factors be understood within the context of the particular country in question. Objective: The aim of this study is to further inform practitioners in Ethiopia about the availability and status of NCD information within the Ethiopian healthcare system. Method: A mixed method research design was used with data collected from 13 public referral hospitals in Ethiopia. In phase 1 quantitative data were collected from 312 health professionals (99 physicians; 213 nurses) using a cross-sectional survey. In phase 2, qualitative data were collected using: interviews ( n = 13 physician hospital managers); and one focus group ( n = 6 national health bureau officers). Results: Results highlighted the lack of NCD morbidity, mortality and risk factor data, periodic evaluation of NCD data and standardised protocols for NCD data collection in hospitals. The study also identified similar discrepancies in the availability of NCD data and standardised protocols for NCD data collection among the regions of Ethiopia. Conclusion: This study highlighted important deficiencies in NCD data and standardised protocols for data collection in the Ethiopian healthcare system. These deficiencies were also observed among regions of Ethiopia, indicating the need to strengthen both the healthcare system and health information systems to improve evidence-based decision-making. Implications: Identifying the status of NCD data in the Ethiopian healthcare system could assist policymakers, healthcare organisations, healthcare providers and health beneficiaries to reform and strengthen the existing healthcare system.

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Mekonnen, Yibeltal, Charlotte Hanlon, Solomon Emyu, Ruth Vania Cornick, Lara Fairall, Daniel Gebremichael, Telahun Teka, et al. "Using a mentorship model to localise the Practical Approach to Care Kit (PACK): from South Africa to Ethiopia." BMJ Global Health 3, Suppl 5 (November 2018): e001108. http://dx.doi.org/10.1136/bmjgh-2018-001108.

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The Federal Ministry of Health, Ethiopia, recognised the potential of the Practical Approach to Care Kit (PACK) programme to promote integrated, comprehensive and evidence-informed primary care as a means to achieving universal health coverage. Localisation of the PACK guide to become the ‘Ethiopian Primary Health Care Clinical Guidelines’ (PHCG) was spearheaded by a core team of Ethiopian policy and technical experts, mentored by the Knowledge Translation Unit, University of Cape Town. A research collaboration, ASSET (heAlth Systems StrEngThening in sub-Saharan Africa), has brought together policy-makers from the Ministry of Health and health systems researchers from Ethiopia (Addis Ababa University) and overseas partners for the PACK localisation process, and will develop, implement and evaluate health systems strengthening interventions needed for a successful scale-up of the Ethiopian PHCG. Localisation of PACK for Ethiopia included expanding the guide to include a wider range of infectious diseases and an expanded age range (from 5 to 15 years). Early feedback from front-line primary healthcare (PHC) workers is positive: the guide gives them greater confidence and is easy to understand and use. A training cascade has been initiated, with a view to implementing in 400 PHC facilities in phase 1, followed by scale-up to all 3724 health centres in Ethiopia during 2019. Monitoring and evaluation of the Ministry of Health implementation at scale will be complemented by indepth evaluation by ASSET in demonstration districts. Anticipated challenges include availability of essential medications and laboratory investigations and the need for additional training and supervisory support to deliver care for non-communicable diseases and mental health. The strong leadership from the Ministry of Health of Ethiopia combined with a productive collaboration with health systems research partners can help to ensure that Ethiopian PHCG achieves standardisation of clinical practice at the primary care level and quality healthcare for all.

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Yesuf, Elias Ali, Mirkuzie Woldie, Damen Haile-Mariam, Daniela Koller, Gönter Früschl, and Eva Grill. "Identification of relevant performance indicators for district healthcare systems in Ethiopia: a systematic review and expert opinion." International Journal for Quality in Health Care 32, no. 3 (March 31, 2020): 161–72. http://dx.doi.org/10.1093/intqhc/mzaa012.

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Abstract Purpose To identify potential performance indicators relevant for district healthcare systems of Ethiopia. Data sources Public Library of Medicine and Agency for Healthcare Research and Quality of the United States of America, Organization for Economic Cooperation and Development Library and Google Scholar were searched. Study selection Expert opinions, policy documents, literature reviews, process evaluations and observational studies published between 1990 and 2015 were considered for inclusion. Participants were national- and local-healthcare systems. The phenomenon of interest was the performance of healthcare systems. The Joanna Briggs Institute tools were adapted and used for critical appraisal of records. Data extraction Indicators of performance were extracted from included records and summarized in a narrative form. Then, experts rated the relevance of the indicators. Relevance of an indicator is its agreement with priority health objectives at the national and district level in Ethiopia. Results of data synthesis A total of 11 206 titles were identified. Finally, 22 full text records were qualitatively synthesized. Experts rated 39 out of 152 (25.7%) performance indicators identified from the literature to be relevant for district healthcare systems in Ethiopia. For example, access to primary healthcare, tuberculosis (TB) treatment rate and infant mortality rate were found to be relevant. Conclusion Decision-makers in Ethiopia and potentially in other low-income countries can use multiple relevant indicators to measure the performance of district healthcare systems. Further research is needed to test the validity of the indicators.

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Magge, Hema, Abiyou Kiflie, Kojo Nimako, Kathryn Brooks, Sodzi Sodzi-Tettey, Nneka Mobisson-Etuk, Zewdie Mulissa, et al. "The Ethiopia healthcare quality initiative: design and initial lessons learned." International Journal for Quality in Health Care 31, no. 10 (December 2019): G180—G186. http://dx.doi.org/10.1093/intqhc/mzz127.

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Abstract Objective To describe the development, implementation and initial outcomes of a national quality improvement (QI) intervention in Ethiopia. Design Retrospective descriptive study of initial prototype phase implementation outcomes. Setting All public facilities in one selected prototype district in each of four agrarian regions. Participants Facility QI teams composed of managers, healthcare workers and health extension workers. Interventions The Ethiopian Federal Ministry of Health (FMoH) and the Institute for Healthcare Improvement co-designed a three-pronged approach to accelerate health system improvement nationally, which included developing a national healthcare quality strategy (NHQS); building QI capability at all health system levels and introducing scalable district MNH QI collaboratives across four regions, involving healthcare providers and managers. Outcome measures Implementation outcomes including fidelity, acceptability, adoption and program effectiveness. Results The NHQS was launched in 2016 and governance structures were established at the federal, regional and sub-regional levels to oversee implementation. A total of 212 federal, regional and woreda managers have been trained in context-specific QI methods, and a national FMoH-owned in-service curriculum has been developed. Four prototype improvement collaboratives have been completed with high fidelity and acceptability. About 102 MNH change ideas were tested and a change package was developed with 83 successfully tested ideas. Conclusion The initial successes observed are attributable to the FMoH’s commitment in implementing the initiative, the active engagement of all stakeholders and the district-wide approach utilized. Challenges included weak data systems and security concerns. The second phase—in 26 district-level collaboratives—is now underway.

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TUEPKER, ANAIS, and CHUNHUEI CHI. "Evaluating integrated healthcare for refugees and hosts in an African context." Health Economics, Policy and Law 4, no. 2 (April 2009): 159–78. http://dx.doi.org/10.1017/s1744133109004824.

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Abstract:This paper argues on ethical and practical grounds for more widespread use of an integrated approach to refugee healthcare, and proposes a basic model of assessment for integrated systems. A defining element of an integrated approach is an equal ability by refugee and host nationals to access the same healthcare resources from the same providers. This differs fundamentally from parallel care, currently the predominant practice in Africa. The authors put forward a general model for evaluation of integrated healthcare with four criteria: (1) improved health outcomes for both hosts and refugees, (2) increased social integration, (3) increased equitable use of healthcare resources, and (4) no undermining of protection. Historical examples of integrated care in Ethiopia and Uganda are examined in light of these criteria to illustrate how this evaluative model would generate evidence currently lacking in debates on the merit of integrated healthcare.

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Argaw, Mesele Damte, Binyam Fekadu Desta, Melkamu Getu Abebe, Elias Mamo, Tesfaye Gebru, Wubishet Kebede Heyi, Chala Gela, and Temesgen Ayehu Bele. "Improving Performance Together: Twinning Partnership Between Medium and Low Performer Districts in Ethiopia." Medical University 3, no. 1 (January 1, 2020): 12–38. http://dx.doi.org/10.2478/medu-2020-0002.

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AbstractThis article describes the United States Agency for International Development Transform: Primary Health Care Activity supported a twinning partnership strategy, which was implemented between districts (woredas) in the different performance categories. This study presents the details of the partnership and the result observed in health systems strengthening in Ethiopia. The twinning partnership strategy was implemented with six steps. The established relationship helps the health systems to build the skill and capacities of the health workforce at primary healthcare entities. Both partner woredas improved their performances through the established win-win relationship and institutionalized the characteristics of a learning organization.

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Abdela, Seid Getahun, Johan van Griensven, Fikre Seife, and Wendemagegn Enbiale. "Neglecting the effect of COVID-19 on neglected tropical diseases: the Ethiopian perspective." Transactions of The Royal Society of Tropical Medicine and Hygiene 114, no. 10 (August 27, 2020): 730–32. http://dx.doi.org/10.1093/trstmh/traa072.

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Abstract Countries around the world are facing an enormous challenge due to the COVID-19 pandemic. The pressure that the pandemic inflicts on health systems could certainly impact on the care, control, and elimination of neglected tropical diseases (NTDs). From mid-January 2020, Ethiopia started to prepare for the prevention and treatment of COVID-19. The Federal Ministry of Health pledged to continue essential healthcare, including NTD care, during this pandemic. However, some hospitals have been closed for other healthcare services and have been turned into isolation and treatment centers for COVID-19. In addition to the healthcare facility measures, all community-based health promotion and disease prevention services have been stopped. The current shift in attention towards COVID-19 is expected to have a negative impact on NTD prevention and care.

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Islam, Muhammad, Muhammad Usman, Azhar Mahmood, Aaqif Afzaal Abbasi, and Oh-Young Song. "Predictive analytics framework for accurate estimation of child mortality rates for Internet of Things enabled smart healthcare systems." International Journal of Distributed Sensor Networks 16, no. 5 (May 2020): 155014772092889. http://dx.doi.org/10.1177/1550147720928897.

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Globally, under-five child mortality is a substantial health problem. In developing countries, reducing child mortality and improving child health are the key priorities in health sectors. Despite the significant reduction in deaths of under-five children globally, developing countries are still struggling to maintain an acceptable mortality rate. Globally, the death rate of under-five children is 41 per 1000 live births. However, the death rate of children in developing nations like Pakistan and Ethiopia per 1000 live births is 74 and 54, respectively. Such nations find it very challenging to decrease the mortality rate. Data analytics on healthcare data plays a pivotal role in identifying the trends and highlighting the key factors behind the children deaths. Similarly, predictive analytics with the help of Internet of Things based frameworks significantly advances the smart healthcare systems to forecast death trends for timely intervention. Moreover, it helps in capturing hidden associations between health-related variables and key death factors among children. In this study, a predictive analytics framework has been developed to predict the death rates with high accuracy and to find the significant determinants that cause high child mortality. Our framework uses an automated method of information gain to rank the information-rich mortality variables for accurate predictions. Ethiopian Demographic Health Survey and Pakistan Demographic Health Survey data sets have been used for the validation of our proposed framework. These real-world data sets have been tested using machine learning classifiers, such as Naïve Bayes, decision tree, rule induction, random forest, and multi-layer perceptron, for the prediction task. It has been revealed through our experimentation that Naïve Bayes classifier predicts the child mortality rate with the highest average accuracy of 96.4% and decision tree helps in identifying key classification rules covering the factors behind children deaths.

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Maat, Harro, Dina Balabanova, Esther Mokuwa, Paul Richards, Vik Mohan, Freddie Ssengooba, Revocatus Twinomuhangi, Mirkuzie Woldie, and Susannah Mayhew. "Towards Sustainable Community-Based Systems for Infectious Disease and Disaster Response; Lessons from Local Initiatives in Four African Countries." Sustainability 13, no. 18 (September 9, 2021): 10083. http://dx.doi.org/10.3390/su131810083.

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This paper explores the role of decentralised community-based care systems in achieving sustainable healthcare in resource-poor areas. Based on case studies from Sierra Leone, Madagascar, Uganda and Ethiopia, the paper argues that a community-based system of healthcare is more effective in the prevention, early diagnosis, and primary care in response to the zoonotic and infectious diseases associated with extreme weather events as well as their direct health impacts. Community-based systems of care have a more holistic view of the determinants of health and can integrate responses to health challenges, social wellbeing, ecological and economic viability. The case studies profiled in this paper reveal the importance of expanding notions of health to encompass the whole environment (physical and social, across time and space) in which people live, including the explicit recognition of ecological interests and their interconnections with health. While much work still needs to be done in defining and measuring successful community responses to health and other crises, we identify two potentially core criteria: the inclusion and integration of local knowledge in response planning and actions, and the involvement of researchers and practitioners, e.g., community-embedded health workers and NGO staff, as trusted key interlocuters in brokering knowledge and devising sustainable community systems of care.

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Gebremichael, Gebrewahd Bezabh, and Teklewoini Mariye Zemicheal. "Hypoglycemia Prevention Practice and Associated Factors among Diabetic Patients on Follow-Up at Public Hospitals of Central Zone, Tigray, Ethiopia, 2018." International Journal of Endocrinology 2020 (March 13, 2020): 1–7. http://dx.doi.org/10.1155/2020/8743531.

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Background. Hypoglycemia is an acute medical situation that occurs when blood glucose level falls below 70 mg/dl. Although prevention of hypoglycemia is one cornerstone in the management of diabetes mellitus, its prevention practice among patients with diabetes mellitus is insufficiently studied. Moreover, the existed scarce literature in Ethiopia revealed hypoglycemia prevention practice is inadequate. Thus, this study tried to assess hypoglycemia prevention practices and associated factors among diabetic patients. Methods. Hospital-based cross-sectional study design was employed from March 1 to April 1, 2018, in the central zone of Tigray regional state of Ethiopia. A total of 272 diabetes mellitus patients selected by a systematic random sampling method were included in the study. Data were entered into Epi-data version 3.1 and exported to SPSS version 23 for further analysis. The binary logistic regression model (AOR, 95% CI, and p value < 0.05) was used to determine the predictors of hypoglycemia prevention practice. Results. The mean age of respondents was 43.62 years, and about 100 (63.2%) participants had good hypoglycemia prevention practice. Good knowledge on hypoglycemia (AOR = 10.34; 95% CI [5.41, 19.89]), having a glucometer at home (AOR = 3.02; 95% CI [1.12, 8.12]), favorable attitude towards diabetes mellitus (AOR = 2.36 CI [1.26, 4.39]), and being governmental employee (AOR = 5.19, 95% CI [1.63, 16.58]) were positive predictors of good hypoglycemia prevention practice. However, being divorced (AOR = 0.13, 95% CI [0.32, 0.53]) was found negatively associated with good hypoglycemia prevention practice. Conclusion. Only two-thirds of the study participants were found to have good hypoglycemia prevention practices. Healthcare personnel and Ethiopian diabetic association should promote patients’ attitude towards DM and knowledge on hypoglycemia by strengthening information, education, and communication program. Stakeholders should also try to provide glucometers to diabetic patients.

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Kumar, Meghan Bruce, Jason J. Madan, Maryline Mireku Achieng, Ralalicia Limato, Sozinho Ndima, Aschenaki Z. Kea, Kingsley Rex Chikaphupha, Edwine Barasa, and Miriam Taegtmeyer. "Is quality affordable for community health systems? Costs of integrating quality improvement into close-to-community health programmes in five low-income and middle-income countries." BMJ Global Health 4, no. 4 (July 2019): e001390. http://dx.doi.org/10.1136/bmjgh-2019-001390.

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IntroductionCountries aspiring to universal health coverage view close-to-community (CTC) providers as a low-cost means of increasing coverage. However, due to lack of coordination and unreliable funding, the quality of large-scale CTC healthcare provision is highly variable and routine data about service quality are not trustworthy. Quality improvement (QI) approaches are a means of addressing these issues, yet neither the costs nor the budget impact of integrating QI approaches into CTC programme costs have been assessed.MethodsThis paper examines the costs and budget impact of integrating QI into existing CTC health programmes in five countries (Ethiopia, Indonesia, Kenya, Malawi, Mozambique) between 2015 and 2017. The intervention involved: (1) QI team formation; (2) Phased training interspersed with supportive supervision; which resulted in (3) QI teams independently collecting and analysing data to conduct QI interventions. Project costs were collected using an ingredients approach from a health systems perspective. Based on project costs, costs of local adoption of the intervention were modelled under three implementation scenarios.ResultsAnnualised economic unit costs ranged from $62 in Mozambique to $254 in Ethiopia per CTC provider supervised, driven by the context, type of community health model and the intensity of the intervention. The budget impact of Ministry-led QI for community health is estimated at 0.53% or less of the general government expenditure on health in all countries (and below 0.03% in three of the five countries).ConclusionCTC provision is a key component of healthcare delivery in many settings, so QI has huge potential impact. The impact is difficult to establish conclusively, but as a first step we have provided evidence to assess affordability of QI for community health. Further research is needed to assess whether QI can achieve the level of benefits that would justify the required investment.

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Moore, Jolene, Duncan Thomson, Iona Pimentil, Bazezew Fekad, and Wendy Graham. "Introduction of a modified obstetric early warning system (MOEWS) at an Ethiopian referral hospital: a feasibility assessment." BMJ Open Quality 8, no. 1 (March 2019): e000503. http://dx.doi.org/10.1136/bmjoq-2018-000503.

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Early warning scores are points-based or colour-coded systems used to detect changes in physiological parameters and prompt earlier recognition and management of deteriorating patients. Vital signs recorded within a coloured zone corresponding to degree of derangement (‘trigger’) should prompt an action. The report of the UK Confidential Enquiry into Maternal and Child Health recommends the use of modified versions in the obstetric population. Currently, there is limited research into the effects of early warning scores in low-resource settings where maternal mortality remains high, and there is a need for low-cost, simple methods to reduce this. A modified obstetric early warning system (MOEWS) was introduced for parturients who had undergone surgical intervention at Felege Hiwot Referral Hospital, a tertiary centre in Bahir Dar, Ethiopia. A guideline was developed to accompany the MOEWS, together with training of healthcare workers. Prior to introduction, the quality of postoperative monitoring was assessed through retrospective case note review. This was reassessed at 8 months and 11 months postimplementation, with assessment of response to ‘triggers’. A questionnaire and qualitative interviews were undertaken to establish views of healthcare workers on its acceptability and usability. Recording of postoperative vital signs improved with the implementation of the MOEWS and was sustained at both monitoring periods. The number of patients with vital signs within the coloured zones (‘trigger’) was reduced, although documented action to these remained low. Staff were positive towards the MOEWS, its impact on patient care and felt confident using the system. The introduction of a MOEWS in an Ethiopian referral hospital in this study appeared to improve the monitoring of postoperative patients. With modifications to suit the setting and senior clinician involvement, coupled with regular training, the early warning score is a feasible and acceptable tool to cope with the unique demands faced in this low-resource setting.

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Aklilu, Mesfin, Waleleng Warku, Wogayehu Tadele, Yimer Mulugeta, Hussene Usman, Amelework Alemu, Sintayehu Abdela, Alemnesh Hailemariam, Endalkachew Birhanu, and Giuseppe La Torre. "Assessment of Job Satisfaction Level and Its Associated Factors among Health Workers in Addis Ababa Health Centers: A Cross-Sectional Study." Advances in Public Health 2020 (September 29, 2020): 1–6. http://dx.doi.org/10.1155/2020/1085029.

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Health workers account for the largest share of public expenditures on health and play an important role in improving the quality of health services. There is concern that poor health worker performance limits the effectiveness of health systems strengthening efforts. A cross-sectional study was conducted from September to October 2016 in Addis Ababa health centers. Data were collected from 420 healthcare workers using a pretested and structured questionnaire by trained data collectors. EPI Info 7 was used for data entry, and analysis was done by SPSS version 20. Bivariate and multivariate logistic analyses were used to identify factors associated with the outcome variable and to control confounders. P values less than 0.05 were considered statistically significant. The overall job satisfaction level accounts for 53.8% with 95% CI of (48.9%, 59.0%). Marital status and professional qualification were the potent predictors of job satisfaction. Respondents who never married were 1.65 times more likely to be satisfied in their job than those married or divorced (AOR: 1.65 (95% CI: 1.02, 2.66)). Laboratory professionals and nursing professionals were 2.74 and 1.97 times more likely to be satisfied in their job compared to health officers (AOR: 2.47 (95% CI: 1.14, 6.59) and AOR: 1.97 (95% CI: 1.12, 3.48), respectively). More than half of the healthcare workers in the study area were satisfied in their job. Marital status and healthcare workers’ profession type were predictors of job satisfaction. Research studies indicate that there is a positive relationship between performance and job satisfaction. Accordingly, the present study aimed at determining the level of job satisfaction of health workers and its associated factors in the health centers of Addis Ababa, Ethiopia.

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Derseh, Tesfaye, Tariku Dingeta, Mohammed Yusouf, and Binyam Minuye. "Clinical Outcome and Predictors of Intestinal Obstruction Surgery in Ethiopia: A Cross-Sectional Study." BioMed Research International 2020 (November 23, 2020): 1–6. http://dx.doi.org/10.1155/2020/7826519.

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Background. Despite the advancement in the healthcare system, the impact of surgical interventions on public health systems will continue to grow. But predicting the outcome is challenging. Concerns related to unexpected outcomes and delays in the diagnosis of postoperative complications are the major issue. Intestinal obstruction is a common life-threatening surgical condition followed by fatal and nonfatal postoperative complications. This study was aimed at assessing results after surgery for intestinal obstruction in a hospital of Ethiopia. Methodology. An institutional-based cross-sectional study was conducted among 254 postoperative patients admitted with intestinal obstruction from January 1, 2014, to December 31, 2017. Data were coded and entered into EpiData 4.2.0.0 software and exported to the Statistical Package for the Social Sciences version 22 for analysis. A binary logistic regression model was used for analysis. All variables with a p value < 0.25 during bivariable analysis were considered for multivariable logistic regression analysis. Results. The magnitude of poor surgical outcome of intestinal obstruction was 21.3% for patients enrolled into this investigation. The age group of ≥55 years ( adjusted odds ratio AOR = 2.9 , 95% CI: 1.03, 8.4), duration of illness of ≥24 hrs ( AOR = 3.1 , 95% CI: 1.03, 9.4), preoperative diagnosis of a gangrenous large bowel ( AOR = 3.6 , 95% CI: 1.3, 9.8), and a gangrenous small bowel ( AOR = 4.2 , 95% CI: 1.3, 13.7) were significantly associated with poor surgical outcome. Conclusions. The magnitude of poor surgical outcome was high. Age, late presentation of illness, and gangrenous bowel obstructions were significantly associated with poor outcomes. So, concern should be given in early detection and follow-up of patients who came late and older patients.

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Cornick, Ruth, Sandy Picken, Camilla Wattrus, Ajibola Awotiwon, Emma Carkeek, Juliet Hannington, Pearl Spiller, et al. "The Practical Approach to Care Kit (PACK) guide: developing a clinical decision support tool to simplify, standardise and strengthen primary healthcare delivery." BMJ Global Health 3, Suppl 5 (October 2018): e000962. http://dx.doi.org/10.1136/bmjgh-2018-000962.

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For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income countries that ignores LMIC resource constraints and burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.

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Eyowas, Fantu Abebe, Marguerite Schneider, Shitaye Alemu, and Fentie Ambaw Getahun. "Multimorbidity of chronic non-communicable diseases: burden, care provision and outcomes over time among patients attending chronic outpatient medical care in Bahir Dar, Ethiopia—a mixed methods study protocol." BMJ Open 11, no. 9 (September 2021): e051107. http://dx.doi.org/10.1136/bmjopen-2021-051107.

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IntroductionMultimorbidity refers to the presence of two or more chronic non-communicable diseases (NCDs) in a given individual. It is associated with premature mortality, lower quality of life (QoL) and greater use of healthcare resources. The burden of multimorbidity could be huge in the low and middle-income countries (LMICs), including Ethiopia. However, there is limited evidence on the magnitude of multimorbidity, associated risk factors and its effect on QoL and functionality. In addition, the evidence base on the way health systems are organised to manage patients with multimorbidity is sparse. The knowledge gleaned from this study could have a timely and significant impact on the prevention, management and survival of patients with NCD multimorbidity in Ethiopia and in LMICs at large.Methods and analysisThis study has three phases: (1) a cross-sectional quantitative study to determine the magnitude of NCD multimorbidity and its effect on QoL and functionality, (2) a qualitative study to explore organisation of care for patients with multimorbidity, and (3) a longitudinal quantitative study to investigate disease progression and patient outcomes over time. A total of 1440 patients (≥40 years) on chronic care follow-up will be enrolled from different facilities for the quantitative studies. The quantitative data will be collected from multiple sources using the KoBo Toolbox software and analysed by STATA V.16. Multiple case study designs will be employed to collect the qualitative data. The qualitative data will be coded and analysed by Open Code software thematically.Ethics and disseminationEthical clearance has been obtained from the College of Medicine and Health Sciences, Bahir Dar University (protocol number 003/2021). Subjects who provide written consent will be recruited in the study. Confidentiality of data will be strictly maintained. Findings will be disseminated through publications in peer-reviewed journals and conference presentations.

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Shiferaw, Kirubel Biruk, Shegaw Anagaw Mengiste, Monika Knudsen Gullslett, Atinkut Alamirrew Zeleke, Binyam Tilahun, Tsion Tebeje, Robel Wondimu, Surafel Desalegn, and Eden Abetu Mehari. "Healthcare providers’ acceptance of telemedicine and preference of modalities during COVID-19 pandemics in a low-resource setting: An extended UTAUT model." PLOS ONE 16, no. 4 (April 22, 2021): e0250220. http://dx.doi.org/10.1371/journal.pone.0250220.

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Background In almost all lower and lower middle-income countries, the healthcare system is structured in the customary model of in-person or face to face model of care. With the current global COVID-19 pandemics, the usual health care service has been significantly altered in many aspects. Given the fragile health system and high number of immunocompromised populations in lower and lower-middle income countries, the economic impacts of COVID-19 are anticipated to be worse. In such scenarios, technological solutions like, Telemedicine which is defined as the delivery of healthcare service remotely using telecommunication technologies for exchange of medical information, diagnosis, consultation and treatment is critical. The aim of this study was to assess healthcare providers’ acceptance and preferred modality of telemedicine and factors thereof among health professionals working in Ethiopia. Methods A multi-centric online survey was conducted via social media platforms such as telegram channels, Facebook groups/pages and email during Jul 1- Sep 21, 2020. The questionnaire was adopted from previously validated model in low income setting. Internal consistency of items was assessed using Cronbach alpha (α), composite reliability (CR) and average variance extracted (AVE) to evaluate both discriminant and convergent validity of constructs. The extent of relationship among variables were evaluated by Structural equation modeling (SEM) using SPSS Amos version 23. Results From the expected 423 responses, 319 (75.4%) participants responded to the survey questionnaire during the data collection period. The majority of participants were male (78.1%), age <30 (76.8%) and had less than five years of work experience (78.1%). The structural model result confirmed the hypothesis “self-efficacy has a significant positive effect on effort expectancy” with a standardized coefficient estimate (β) of 0.76 and p-value <0.001. The result also indicated that self-efficacy, effort expectancy, performance expectancy, facilitating conditions and social influence have a significant direct effect on user’s attitude toward using telemedicine. User’s behavioral intention to use telemedicine was also influenced by effort expectancy and attitude. The model also ruled out that performance expectancy, facilitating conditions and social influence does not directly influence user’s intention to use telemedicine. The squared multiple correlations (r2) value indicated that 57.1% of the variance in attitude toward using telemedicine and 63.6% of the variance in behavioral intention to use telemedicine is explained by the current structural model. Conclusion This study found that effort expectancy and attitude were significantly predictors of healthcare professionals’ acceptance of telemedicine. Attitude toward using telemedicine systems was also highly influenced by performance expectancy, self-efficacy and facilitating conditions. effort expectancy and attitude were also significant mediators in predicting users’ acceptance of telemedicine. In addition, mHealth approach was the most preferred modality of telemedicine and this opens an opportunity to integrate telemedicine systems in the health system during and post pandemic health services in low-income countries.

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Argaw, Mesele Damte, Asfawesen GebreYohannes Woldegiorgis, Habtamu Aderaw Workineh, Berhane Alemayhu Akelom, Mesfin Eshetu Abebe, Derebe Tadesse Abate, and Eshetu Gezahegn Ashenafi. "Access to malaria prevention and control interventions among seasonal migrant workers: A multi-region formative assessment in Ethiopia." PLOS ONE 16, no. 2 (February 23, 2021): e0246251. http://dx.doi.org/10.1371/journal.pone.0246251.

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Background Mobile or seasonal migrant workers are at increased risk for acquiring malaria infections and can be the primary source of malaria reintroduction into receptive areas. The aim of this formative assessment was to describe access to malaria prevention and control interventions among seasonal migrant or mobile workers in seven regional states of Ethiopia. Methods A cross-sectional formative assessment was conducted using a qualitative and quantitative mixed-method design, between October 2015 and October 2016. Quantitative data were collected from organizations that employ seasonal migrant workers and were analyzed using Microsoft Excel and ArcGIS 10.8 (Geo-spatial data). Qualitative data were collected using in-depth interview from 23 key informants (7 seasonal migrant workers, and 16 experts and managers of development projects who had hired seasonal migrant workers), which were recorded, transcribed, translated, coded, and thematically analyzed. Results There were 1,017,888 seasonal migrant workers employed in different developmental organizations including large-scale crop cultivating farms, sugar cane plantations, horticulture, road and house construction work, and gold mining and panning. Seasonal migrant workers’ housing facilities were poorly structured and overcrowded (30 people living per 64 square meter room) limiting the use of indoor residual spraying (IRS), and forcing seasonal migrant workers not to use long lasting insecticidal treated nets (LLINs). Seasonal migrant workers are engaged in nighttime activities when employment includes watering farmlands, harvesting sesame, and transporting sugar cane from the field to factories. Despite such high-risk living conditions, access and utilization of preventive and curative services by the seasonal workers were limited. Informal migrant worker employment systems by development organizations and inadequate technical and financial support coupled with poor supply chain management limited the planning and delivery of malaria prevention and treatment strategies targeting seasonal migrant workers. Conclusions Seasonal migrant workers in seven regions of Ethiopia were at substantial risk of acquiring malaria. Existing malaria prevention, control and management interventions were inadequate. This will contribute to the resurgence of outbreaks of malaria in areas where transmission has been lowered. A coordinated action is needed among all stakeholders to identify the size of seasonal migrant workers and develop and implement a comprehensive strategy to address their healthcare needs.

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Berman, Leigh R., Meredith Kavalier, Beshea G. Deressa, Daniel Yilma, Getnet Tesfaw, and Daniel Shirley. "856. Assessment of Hand Hygiene amongst Health Care Professionals at Jimma University Medical Center." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S468. http://dx.doi.org/10.1093/ofid/ofaa439.1045.

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Abstract Background Lack of hand hygiene (HH) amongst healthcare workers (HCWs) contributes to healthcare associated infections and the spread of multidrug-resistant organisms. We assessed HCW HH knowledge, attitudes, and compliance using WHO tools and applied the Systems Engineering Initiative for Patient Safety (SEIPS) model in interviews to help guide and increase sustainability of HH interventions. Methods We conducted a cross-sectional study at Jimma University Medical Center (JUMC) in Jimma, Ethiopia. We assessed HCW’s HH knowledge and attitudes using questionnaires adapted from WHO resources via systematic sampling. Observations of HH practices at WHO’s 5 Moments of HH were conducted by non-identified, trained observers via systematic sampling. 22 semi-structured interviews were conducted via convenience sampling with HCWs using an interview guide based on the SEIPS model. Results We observed 1,386 HH moments and found a compliance rate of 9.38%, with compliance highest after contact with patient surroundings (27.92%) compared to the other four HH moments (1.77 - 9.57%). Of 251 survey participants, 13.6% had prior HH training and 69.9% reported routine HH compliance. The average knowledge score was 61.4%, with no significant difference between participants that identified as trained vs untrained (p=0.41). 68% of interview participants stated they were unaware of JUMC’s Infection Prevention and Control (IPC) team and are more likely to perform HH if a patient appears infectious. Interview participants cited multiple barriers to HH (table 1). Table 1 Conclusion Baseline HH compliance and knowledge were low despite perceived compliance and regardless of prior HH training. Relatively higher compliance after patient contact may be due to perceptions of patient infectiousness. Utilizing the SEIPS model as an adjunct to WHO HH guidelines has provided actionable items upon which the JUMC IPC team can focus to improve HH practices: providing a sustainable supply of alcohol hand rub, ongoing HH education targeting knowledge deficits, and enhanced IPC presence and HH monitoring. Disclosures Meredith Kavalier, MD, University of Wisconsin-Madison Global Health Institute (Grant/Research Support)

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Rizk, Soha S., Wafaa H. Elwakil, and Ahmed S. Attia. "Antibiotic-Resistant Acinetobacter baumannii in Low-Income Countries (2000–2020): Twenty-One Years and Still below the Radar, Is It Not There or Can They Not Afford to Look for It?" Antibiotics 10, no. 7 (June 23, 2021): 764. http://dx.doi.org/10.3390/antibiotics10070764.

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Acinetobacter baumannii is an emerging pathogen, and over the last three decades it has proven to be particularly difficult to treat by healthcare services. It is now regarded as a formidable infectious agent with a genetic setup for prompt development of resistance to most of the available antimicrobial agents. Yet, it is noticed that there is a gap in the literature covering this pathogen especially in countries with limited resources. In this review, we provide a comprehensive updated overview of the available data about A. baumannii, the multi-drug resistant (MDR) phenotype spread, carbapenem-resistance, and the associated genetic resistance determinants in low-income countries (LIICs) since the beginning of the 21st century. The coverage included three major databases; PubMed, Scopus, and Web of Science. Only 52 studies were found to be relevant covering only 18 out of the 29 countries included in the LIC group. Studies about two countries, Syria and Ethiopia, contributed ~40% of the studies. Overall, the survey revealed a wide spread of MDR and alarming carbapenem-resistance profiles. Yet, the total number of studies is still very low compared to those reported about countries with larger economies. Accordingly, a discussion about possible reasons and recommendations to address the issue is presented. In conclusion, our analyses indicated that the reported studies of A. baumannii in the LICs is far below the expected numbers based on the prevailing circumstances in these countries. Lack of proper surveillance systems due to inadequate financial resources could be a major contributor to these findings.

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Belien, Paul. "Healthcare Systems." PharmacoEconomics 18, Supplement 1 (2000): 85–93. http://dx.doi.org/10.2165/00019053-200018001-00011.

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Williams, Ruth. "Healthcare systems." Nursing Management 24, no. 6 (September 28, 2017): 11. http://dx.doi.org/10.7748/nm.24.6.11.s17.

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Hayleeyesus, Samuel Fekadu, and Wondemagegn Cherinete. "Healthcare Waste Generation and Management in Public Healthcare Facilities in Adama, Ethiopia." Journal of Health and Pollution 6, no. 10 (June 2016): 64–73. http://dx.doi.org/10.5696/2156-9614-6-10.64.

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Husting, Pamela M., and Lourdes Cintron. "HEALTHCARE INFORMATION SYSTEMS." Journal for Nurses in Staff Development (JNSD) 19, no. 5 (September 2003): 249–53. http://dx.doi.org/10.1097/00124645-200309000-00008.

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Snyder, Kimberlee D., and Patrick Paulson. "Healthcare Information Systems: Analysis of Healthcare Software." Hospital Topics 80, no. 4 (January 2002): 5–12. http://dx.doi.org/10.1080/00185860209598004.

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Melese, Wondiber, Shirnevas Darak, and Mesay Tefera. "Determinants of Utilization of Maternal Healthcare Services in Ethiopia." International Journal of Statistics in Medical Research 4, no. 4 (November 3, 2015): 378–90. http://dx.doi.org/10.6000/1929-6029.2015.04.04.7.

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Wolde, B. "HORTICULTURE MARKETING SYSTEMS IN ETHIOPIA." Acta Horticulturae, no. 270 (May 1991): 21–32. http://dx.doi.org/10.17660/actahortic.1991.270.2.

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Prochaska, James O., and Janice M. Prochaska. "Helping Cure Healthcare Systems." Disease Management and Health Outcomes 6, no. 6 (1999): 335–41. http://dx.doi.org/10.2165/00115677-199906060-00004.

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Land, Walker H. "Part III: Healthcare Systems." Procedia Computer Science 20 (2013): 360–61. http://dx.doi.org/10.1016/j.procs.2013.09.286.

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Parnaby, John, and Denis R. Towill. "Seamless healthcare delivery systems." International Journal of Health Care Quality Assurance 21, no. 3 (May 2, 2008): 249–73. http://dx.doi.org/10.1108/09526860810868201.

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Anderson, Laurie M., Susan C. Scrimshaw, Mindy T. Fullilove, Jonathan E. Fielding, and Jacques Normand. "Culturally competent healthcare systems." American Journal of Preventive Medicine 24, no. 3 (April 2003): 68–79. http://dx.doi.org/10.1016/s0749-3797(02)00657-8.

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Unger, Chris, and Mike Celentano. "AGILE SYSTEMS IN HEALTHCARE." INSIGHT 19, no. 2 (July 2016): 66–68. http://dx.doi.org/10.1002/inst.12093.

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Maxwell, Nancy A. "Shaping Humane Healthcare Systems." Nursing Administration Quarterly 31, no. 3 (July 2007): 195–201. http://dx.doi.org/10.1097/01.naq.0000278932.26621.51.

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Lorence, Daniel P., and Amanda Spink. "Healthcare information systems outsourcing." International Journal of Information Management 24, no. 2 (April 2004): 131–45. http://dx.doi.org/10.1016/j.ijinfomgt.2003.12.011.

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Faul, Anna, and Nina Tumosa. "Changing Safety Net Healthcare Systems to Age-Friendly Healthcare Systems: Lessons Learned." Innovation in Aging 4, Supplement_1 (December 1, 2020): 813. http://dx.doi.org/10.1093/geroni/igaa057.2957.

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Abstract Federally Qualified Health Centers (FQHC) are important safety net providers in disadvantaged communities. As outpatient clinics in these areas, they qualify for specific reimbursement systems under Medicare and Medicaid. Age-friendly health care is an urgent need to be able to provide quality healthcare to more than 46 million Americans age 65 and older, with that number projected to double to more than 98 million by 2060. Friendly healthcare systems require a focus on the 4Ms framework and is focused on improving the health of people at every life stage and in every community across the country. The 4Ms are as follows: 1) What Matters: Aligning care with each older adult’s specific health outcome goals and care preferences; 2) Medications: If medications are necessary, use age-friendly medications that do not interfere with What Matters, Mentation or Mobility; 3) Mentation: Prevent, identify, treat and manage depression, dementia and delirium across settings of care and 4) Mobility: Ensure that older adults move safely every day in order to maintain function and do What Matters. An age-friendly health system is one in which every older adult’s care is guided by these evidence-based practices (the 4Ms), where the care causes no harms, and where the care is consistent with what matters to older adults and their families. In this symposium five Geriatric Workforce Enhancement Programs at five diverse universities will share their experiences with supporting FQHC in their areas to become age-friendly healthcare systems. The unique lessons learned at these different sites will be shared.

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Debalkie, Desta, and Abera Kumie. "Healthcare Waste Management: The Current Issue in Menellik II Referral Hospital, Ethiopia." Current World Environment 12, no. 1 (April 25, 2017): 42–52. http://dx.doi.org/10.12944/cwe.12.1.06.

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Healthcare wastes generated in Hospitals from medical activities have not given sufficient attention. In developing countries, healthcare wastes are still handled and disposed indiscriminately creating an immense threat to the public health and the environment. This situation is much worse in Ethiopia where there is paucity of convincing evidence about healthcare waste generation rate and management system. A crossectional study was conducted in Menellik II hospital to evaluate the healthcare waste management system. Primary data on the healthcare waste management system was collected using observational checklist. Key informant interview guide was also employed on 11 selected informants to assess waste management practice and analyzed by thematic framework. The results revealed that there was no segregation of healthcare waste by type at the point of generation and disinfection of infectious waste before disposal. The main HCW treatment and disposal mechanism was incineration using low temperature, single chamber incinerator; open burning; burring in to amputation pit and open dumping on municipal dumping site as well as on the hospital back yard. Furthermore, there was negligence, attitudinal problem and low level of awareness about safe healthcare waste management. To diminish the risk of healthcare waste on public health and environment, a cost effective interventions include providing better medical waste management facilities, adherence to national regulatory and rising awareness of all concerned need to adopt in the hospital.

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Tiruneh, Bewket Tadasse, Gayle McLelland, and Virginia Plummer. "National Healthcare System Development of Ethiopia: A Systematic Narrative Review." Hospital Topics 98, no. 2 (April 2, 2020): 37–44. http://dx.doi.org/10.1080/00185868.2020.1750323.

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Israel Deneke Haylamicheal, Mohamed Aqiel Dalvie, Biruck Desalegn Yirsaw, and Hanibale Atsbeha Zegeye. "Assessing the management of healthcare waste in Hawassa city, Ethiopia." Waste Management & Research 29, no. 8 (August 4, 2010): 854–62. http://dx.doi.org/10.1177/0734242x10379496.

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Mebratie, Anagaw D., Ellen Van de Poel, Zelalem Yilma, Degnet Abebaw, Getnet Alemu, and Arjun S. Bedi. "Healthcare-seeking behaviour in rural Ethiopia: evidence from clinical vignettes." BMJ Open 4, no. 2 (February 2014): e004020. http://dx.doi.org/10.1136/bmjopen-2013-004020.

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Ayelign, Abebe, and Taddese Zerfu. "Household, dietary and healthcare factors predicting childhood stunting in Ethiopia." Heliyon 7, no. 4 (April 2021): e06733. http://dx.doi.org/10.1016/j.heliyon.2021.e06733.

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Kassie, Belayneh Ayanaw, Aynishet Adane, Eskeziaw Abebe Kassahun, Amare Simegn Ayele, and Aysheshim Kassahun Belew. "Poor COVID-19 Preventive Practice among Healthcare Workers in Northwest Ethiopia, 2020." Advances in Public Health 2020 (October 16, 2020): 1–7. http://dx.doi.org/10.1155/2020/7526037.

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Background. The novel coronavirus disease (COVID-19) pandemic outbreak affects the global social, economic, and political context and becomes a significant threat to healthcare providers who are among the exposed groups to acquire and transmit the disease while caring and treating patients. It is crucial to comply with prevention recommendations so as to stay safe and protected. Therefore, this study aimed to assess COVID-19 preventive practice and associated factors among healthcare workers in Northwest Ethiopia. Methods. An institution-based cross-sectional study was conducted among 630 healthcare workers in Northwest Ethiopia from March to April 2020. A multistage sampling technique was used to select study participants. A pretested and structured self-administered questionnaire was used to collect data. The data were entered using Epi Info 7 and analyzed using STATA 16 statistical software. Both bivariate and multivariable logistic regression analyses were employed to identify associated factors. Adjusted odds ratio (AOR) with 95% confidence interval was used to determine independent predictors of COVID-19 preventive practice. In multivariable analysis, a variable with a P value of less than 0.05 was considered as statically significant. Result. Among 630 healthcare workers participated in the study, the overall good preventive practice towards COVID-19 was found to be 38.73% (95% CI: 34.8, 42.5). Being a male healthcare provider (AOR = 1.48; 95% CI: 1.02, 2.10), having work experience of 6–10 years (AOR = 2.22; 95% CI: 1.23, 4.00), and having poor attitude towards COVID-19 (AOR = 2.22; 95% CI: 1.03, 2.22) were found to be significantly associated with poor COVID-19 preventive practice among healthcare workers. Conclusion. Overall compliance towards COVID-19 preventive practice among healthcare workers was found to be low. Multiple education and training platforms with focus on COVID-19 preventive measures and adequate personal protective equipment and supplies should be provided for healthcare providers.

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Moye, Jennifer. "Healthcare Systems Meet Family Systems: Improving Healthcare for Older Adults and Their Families." Clinical Gerontologist 42, no. 5 (August 26, 2019): 461–62. http://dx.doi.org/10.1080/07317115.2019.1651485.

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Ferguson, J. K. "Preventing healthcare-associated infection: risks, healthcare systems and behaviour." Internal Medicine Journal 39, no. 9 (September 2009): 574–81. http://dx.doi.org/10.1111/j.1445-5994.2009.02004.x.

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Zenbaba, Demisu, Biniyam Sahiledengle, and Daniel Bogale. "Practices of Healthcare Workers regarding Infection Prevention in Bale Zone Hospitals, Southeast Ethiopia." Advances in Public Health 2020 (February 1, 2020): 1–7. http://dx.doi.org/10.1155/2020/4198081.

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Introduction. In Ethiopia, infection prevention to protect patients, healthcare workers, and visitors from healthcare-acquired infections is one of a number of nationwide transformational initiatives to ensure the provision of quality healthcare services. The aim of this research was to assess the practice of healthcare workers regarding infection prevention and its associated factors in Bale zone Hospitals. Methods. A cross-sectional study targeted 402 healthcare workers using simple random sampling to learn about their practices related to infection prevention. Data were collected in interviews using pretested, structured questionnaires. Returned questionnaires were checked for completeness and then data were entered into a database and analyzed using SPSS Version 20. Adjusted odd ratio (AOR) with a 95% confidence interval was calculated to determine the strength of association, and variables with a p value <0.05 in the final model were considered as statistically significant. Results. Three hundred ninety-four healthcare workers participated in the study. Of these; 145 (36.8%, 95% CI 32, 42%) of them were found to have self-reported good infection prevention practice. Good knowledge towards infection prevention (AOR = 1.84, 95% CI 1.02, 3.31), availability of personal protective equipment (AOR = 1.96, 95% CI 1.16, 3.32), and water (AOR = 4.42, 95% 2.66, 7.34) at workplace were found to have a statistically significant association with healthcare workers self-reported good infection prevention practices. Conclusions. In this study, slightly more than one-third of the healthcare workers reported to have good infection prevention practice. Good knowledge towards infection prevention, working in departments, availability of personal protective equipment, and water at work place were found to have statistically significant association with self-reported good infection prevention practices.

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Woldemichael, Abraha, Amirhossein Takian, Ali Akbari Sari, and Alireza Olyaeemanesh. "Inequalities in healthcare resources and outcomes threatening sustainable health development in Ethiopia: panel data analysis." BMJ Open 9, no. 1 (January 2019): e022923. http://dx.doi.org/10.1136/bmjopen-2018-022923.

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ObjectiveTo measure inequalities in the distributions of selected healthcare resources and outcomes in Ethiopia from 2000 to 2015.DesignA panel data analysis was performed to measure inequalities in distribution of healthcare workforce, infrastructure, outcomes and finance, using secondary data.SettingThe study was conducted across 11 regions in Ethiopia.ParticipantsRegional population and selected healthcare workforce.Outcomes measuredAggregate Theil and Gini indices, changes in inequalities and elasticity of healthcare resources.ResultsDespite marked inequality reductions over a 16 year period, the Theil and Gini indices for the healthcare resources distributions remained high. Among the healthcare workforce distributions, the Gini index (GI) was lowest for nurses plus midwives (GI=0.428, 95% CI 0.393 to 0.463) and highest for specialist doctors (SPDs) (GI=0.704, 95% CI 0.652 to 0.756). Inter-region inequality was the highest for SPDs (95.0%) and the lowest for health officers (53.8%). The GIs for hospital beds, hospitals and health centres (HCs) were 0.592(95% CI 0.563 to 0.621), 0.460(95% CI 0.404 to 0.517) and 0.409(95% CI 0.380 to 0.439), respectively. The interaction term was highest for HC distributions (47.7%). Outpatient department visit per capita (GI=0.349, 95% CI 0.321 to 0.377) and fully immunised children (GI=0.307, 95% CI 0.269 to 0.345) showed inequalities; inequality in the under 5 years of age mortality rate increased overtime (P=0.048). Overall, GI for government health expenditure (GHE) was 0.596(95% CI 0.544 to 0.648), and the estimated relative GHE share of the healthcare workforce and infrastructure distributions were 46.5% and 53.5%, respectively. The marginal changes in the healthcare resources distributions were towards the advantaged populations.ConclusionThis study revealed high inequalities in healthcare resources in favour of the advantaged populations which can hinder equal access to healthcare and the achievements of healthcare outcomes. The government should strengthen monitoring mechanisms to address inequalities based on the national healthcare standards.

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McGurk, Mark, and Fiona McClenaghan. "Complex facial reconstruction in the developing world." Bulletin of the Royal College of Surgeons of England 95, no. 8 (September 1, 2013): 254. http://dx.doi.org/10.1308/147363513x13690603819984.

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Ethiopia is a country of over 91,000,000, making it the second most populous in Africa. doctors are 1 in 36,000 of the population (compared with 1 in 400 in the UK) and 43 per cent are based in the capital, Addis Ababa, which comprises only 5 per cent of the population. As a result, healthcare in rural areas is practically nonexistent. Ethiopia is one of the many developing countries that welcome surgical missions in order to meet the demands of complex patients who would otherwise be unable to access healthcare. In 2001 Project Harar was set up with the aim of funding surgical missions to provide facial reconstruction for children and young people suffering from facial deformity in Ethiopia.

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Sahiledengle, Biniyam, Yohannes Tekalegn, and Demelash Woldeyohannes. "The critical role of infection prevention overlooked in Ethiopia, only one-half of health-care workers had safe practice: A systematic review and meta-analysis." PLOS ONE 16, no. 1 (January 14, 2021): e0245469. http://dx.doi.org/10.1371/journal.pone.0245469.

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Background Effective infection prevention and control measures, such as proper hand hygiene, the use of personal protective equipment, instrument processing, and safe injection practicein the healthcare facilitiesare essential elements of patient safety and lead to optimal patient outcomes. In Ethiopia, findings regarding infection prevention practices among healthcare workers have been highly variable and uncertain. This systematic review and meta-analysis estimates the pooled prevalence of safe infection prevention practices and summarizesthe associated factors among healthcare workers in Ethiopia. Methods PubMed, Science Direct, Google Scholar, and the Cochran library were systematically searched. We included all observational studies reporting the prevalence of safe infection prevention practices among healthcare workers in Ethiopia. Two authors independently extracted all necessary data using a standardized data extraction format. Qualitative and quantitative analyseswere employed. The Cochran Q test statistics and I2 tests were used to assess the heterogeneity of the studies. A random-effects meta-analysis model was used to estimate the pooled prevalence of safe infection prevention practice. Results Of the 187 articles identified through our search, 10 studies fulfilled the inclusion criteria and were included in the meta-analysis. The pooled prevalence of safe infection prevention practice in Ethiopia was 52.2% (95%CI: 40.9–63.4). The highest prevalence of safe practice was observed in Addis Ababa (capital city) 66.2% (95%CI: 60.6–71.8), followed by Amhara region 54.6% (95%CI: 51.1–58.1), and then Oromia region 48.5% (95%CI: 24.2–72.8), and the least safe practices were reported from South Nation Nationalities and People (SNNP) and Tigray regions with a pooled prevalence of 39.4% (95%CI: 13.9–64.8). In our qualitative syntheses, the odds of safe infection prevention practice were higher among healthcare workers who had good knowledge and a positive attitude towards infection prevention. Also, healthcare workers working in facilities with continuous running water supply, having infection prevention guideline, and those received training were significantly associated withhigher odds of safe infection prevention practice. Conclusions Infection prevention practices in Ethiopia was poor, with only half of the healthcare workers reporting safe practices. Further, the study found out that there were regional and professional variations in the prevalence of safe infection prevention practices. Therefore, the need to step-up efforts to intensify the current national infection prevention and patient safety initiative as key policy direction is strongly recommended, along with more attempts to increase healthcare worker’s adherence towards infection prevention guidelines.

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Manirabona, Audace, Lamia Chaari Fourati, and Saâdi Boudjit. "Investigation on Healthcare Monitoring Systems." International Journal of E-Health and Medical Communications 8, no. 1 (January 2017): 1–18. http://dx.doi.org/10.4018/ijehmc.2017010101.

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Wireless Body Area Networks (WBANs) services and applications have emerged as one of the most attractive research areas and have become more and more widespread especially for healthcare use. Lots of researches have been carried out to specify innovative services and applications using healthcare monitoring systems (HMS). However, the WBAN requirements vary from one application/service to another. Furthermore, HMSs are expected to reduce healthcare costs by enabling the continuous remote monitoring of patients' health even during their daily activities and thus reduce the frequency of the patient's visits at hospital. From a medical point of view, the WBAN will emerge as a key technology by providing real-time health monitoring and diagnosis of many life-threatening diseases. In this paper, the authors outline the WBAN applications and services requirements for healthcare and review them with emphasis on their strength, limitations and design challenges. In addition, HMS architecture and its applications are deeply studied and some case studies are discussed.

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Wynekoop, Judy L. "Office Computer Systems in Healthcare." Journal of Organizational and End User Computing 8, no. 1 (January 1996): 22–30. http://dx.doi.org/10.4018/joeuc.1996010103.

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Safdari, Reza, Jebraeil Farzi, Marjan Ghazisaeidi, Mahboobeh Mirzaee, and Azadeh Goodini. "Healthcare intelligence risk detection systems." Open Journal of Preventive Medicine 03, no. 08 (2013): 461–69. http://dx.doi.org/10.4236/ojpm.2013.38062.

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Journal articles on the topic 'Healthcare systems in Ethiopia'

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