Browsing by Author "Adiam Nega"

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    Assessment of Patient Satisfaction and Associated Factors in Telemedicine Service Providing Organizations in Addis Ababa, Ethiopia.
    (Addis Ababa University, 2023-06) Kenean Mitiku; Mesfin Addise; Adiam Nega
    Background: Telemedicine is the provision of health care services, clinical information, and education in all specialties over different sort of technologies including the Internet, mobile phones and electronic medical records. Assessing the level of patient satisfaction in Telemedicine program, allows continual improvement in the design, alternative, or choice of equipment, and program administration and management for the health service provider. Hence, this study is intended to fill this gap in evidence in the study area assessing patient satisfaction so that interventions can be taken to improve of Telemedicine service quality in Ethiopia. Objective: To assess level of patient satisfaction and associated factors among service users of Telemedicine service providing organizations in Addis Ababa, Ethiopia. Methods: Facility based, cross-sectional study design was conducted from April to May 2023 in Addis Ababa. A total of 410 patients were selected by non-probability voluntary sampling method from five service providing organizations that were selected randomly. Data was collected based on an online self-administered Telemedicine satisfaction questionnaire using pre tested structured questioner. For the analysis, SPSS version 25 was used. Ethical approval for this study was obtained from the Research Ethical Committee of SPH, AAU, Permission letter was written for the selected telemedicine organizations, during data collection informed consent was obtained from the participants, after the necessary explanation was given. Based on the mean value among the factors related questions asked. Bivariate and Multivariate logistic regression was done to identify factors that were associated with diabetic self -care practice. The odds ratio with 95% CI was used to determine the association. A statistical significance was declared at p value <0.05. Result: Among 373 respondents about 205(54.7%) were satisfied. Age ranging from 35- 44(AOR=0.341, 95%CI; 0.127-0.919), male gender(AOR=0.233, 95%CI; 0.128-0.425), hotline type of telemedicine(AOR = 0.607,95%CI;0.369-0.999), patients with no previous experience(AOR=0.287, 95%CI; 0.161-.513),patients who thought the service was inexpensive(AOR =0.422, 95% CI; 0.247-0.719) were significantly associated with overall telemedicine patient satisfaction. Conclusion: The study demonstrated more than half of the patients 57.4% were satisfied but still substantial amount (42.7%) of respondent were dissatisfied. Telemedicine patient satisfaction was found to be associated with age, gender, previous experience and cost perception.
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    The Effect of Social Marketing Strategies on Community Based Health Insurance Enrolment in lideta Sub City, Addis Ababa, Ethiopia.
    (Addis Abeba University, 2021-06) Haimanot Abay; Salle Workneh; Adiam Nega
    Background: Health insurance system is one of the means to enhance access to health care services and to protect individuals from catastrophic health expenditures. Social marketing strategies such as radio, television, print media, facility &community based sensitizations have been used to augment enrollment in to community-based health insurance (CBHI) schemes in Ethiopia. However, there is gap of evidence on the influence of existing social marketing strategies on CBHI enrollment in Ethiopia. Objectives: This study aims to assess the effect of utilization of social marketing strategies on households to join CBHI and associated factors with enrollment in Lideta Sub City, Addis Ababa. Methods: A cross sectional study was conducted among a sample of 422 randomly selected households of Lideta sub-city, Addis Ababa in two randomly selected woredas using structured questionnaires. Epi-data version-3.1 and SPSS version-25 were used for data entry and analysis respectively. Descriptive statistics were used and data were presented using tables and figures. A binary & multiple logistic regression models were used to determine the odds of enrollment for each predictor. The investigator obtained ethical clearance from Addis Ababa University ethical review committee. Results: The level of utilization of social marketing strategies for CBHI among households was 75.6% (69% enrolled and 31% not enrolled) with level of utilization of house to house sensitization (18.9%), local radio (11.1%), national radio (8.3%), and health facility based sensitization (5.7%). The most motivator of the households to join CBHI was house to house sensitization (37.81%). Multivariate Logistic regression revealed no significant association between social marketing strategies and enrollment, but only house hold income (AOR = 0.023, 95% CI; 0.006–0.092, p<0.001) and family size (household with ≥ 4 members) (AOR = 10.99, 95% CI; 3.19–37.83, p<0.001) were significant factors associated with enrollment. Conclusion and recommendations: In this study, the overall level of utilization of existing social marketing strategies was high but not significantly associated with households CBHI enrollment. Family size and average monthly income of households were significant determinants of enrollment and also most members were enrolled after being sick, indicating that sensitization at the health facility by health service providers was the common social marketing strategy. Thus, the study indicated evidence of adverse selections. The government may need to look for options to make the CBHI scheme contribution based on the economic status of households and compulsory.
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    Improving Ethical Practice at Neonatal Intensive Care Unit in Buee Primary Hospital.
    (Addis Abeba University, 2020-05) Hiwot Alemayehu; Mesfine Addise; Adiam Nega
    Introduction: Ethics is defined as a moral philosophy or code of morals practiced by a person or group of people. There agreed ethical principles are autonomy, beneficence, non-maleficence, and justice, which are widely accepted in the neonatal practice.However, within the context of diverse values, beliefs and interests’ fundamental variations exist and they hugely influence the plans of new born management. There is limited information in Ethiopia regarding the practice of these ethical principles. The ethical principles of new born care are not clearly stated and not applied well by NICU staffs, in Buee Primary Hospital (BPH). The parents are not part of decision making and treatment of choice. Objectives: The objective of the project is to improve the practice of ethical principles at NICU in Buee Primary Hospital. Methods: Pre-post interventional study and descriptive qualitative approach was conducted to explore the practice of ethical principles at NICU in Buee Primary Hospital. The study populations are all health professionals working in the hospital. Key informant interview guide was conducted face to face by the investigator. The recorded audio note interviews were transcribed, and analyzed thematically using open code software version 4.2. Result: In the pre-intervention we conducted observation, document review and discussion to verify the root cause of the problem. In the- post intervention we developed implementation plan and the health professionals started to implement the plan. During this period, we evaluated the problem whether it has improved or not .Qualitative finding: The key informant interviews indicated gaps in the practice of ethical principles in NICU.The results of the selected strategies showed a significant improvement on the practice of low ethical principles in the unit. This was objectively measured using the observational checklist from 27% to 80% during the evaluation period of pre and post intervention. Conclusion and Recommendation: The results of this project suggested that a simple set of intervention was effective on improving the practice of ethical principles.The finding also proved the effectiveness of selected strategies, but it will be better to implement in a large scale in the hospital.
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    Improving Low Implementation Rate of Infection Prevention and Patient Safety among Nurses in Adama Hospital Medical College.
    (Addis Abeba University, 2019-06) Abraham Runicho; Gashaye Asrat; Adiam Nega
    Background: Infection prevention is very essential for the safety and wellbeing of patients, hospital staffs and visitors of the hospital.All health care professionals and Nurses in particular are often exposed to various infections during the course of carrying out their nursing activities. Therefore nurses should have sound knowledge and strict adherence to infection prevent practice in order to prevent hospital acquired infections. Objective: Improve the implementation rate of infection prevention and patient safety from 37%to 80% in Adama Hospital medical college by end of June 2019. Methods: pre-postintervention study design was used in a consultative approach to increase the implementation rate of infection prevention and patient safety in Adama hospital by creating awareness among nurses in providing practical on-service training. The sample size for the study was determined by using single population proportion formula considering 83% proportion of good practice and 16.7% of proportion of HCW who got any training on infection prevention and patient safety. The sample size selection was done by considering the rule of thumb and the selection of nurses considers proportional allocation to each department based on the size of nurses and then simple random sampling method was used. Data was calculated manually by using Microsoft Excel and manual calculators to calculate percentages. Data were collected from 83 sampled nurses’ though self-administered checklists and the collected data were counted, tallied and checked for quality and before data analysis. Result: The finding of this study shows that there was low implementation rate for infection prevention 37% during pre-implementation period and later increased to 80% after the intervention strategy has implemented. Conclusions: Nosocomial infections have been recognized as a problem affecting the quality of health care and a principal source of adverse healthcare outcomes. Increased hospital stay days due to prolonged wound healing in the hospital has increased costs of healthcare, economic hardship to patients and their families as evidenced this capstone project during the study period
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    Improving Outpatient and Inpatient Medical Recording Data Quality in Yerer General Hospital,2021
    (Addis Abeba University, 2021-07) Hanna Aboye; Mesfin Addise; Wondimu Ayele; Adiam Nega
    Background: Medical recording is an essential part of information use, dissemination, decision making for the health needs of the community health care system and quality service delivery. The medical recording quality is a serious issue to be addressed, especially in Africa which has been measured using different data quality dimensions, and the percentage result is below standard. In Ethiopia, the ministry of health (MoH) has focused on information revolution setting a five-year transformation plan, and has developed tools on a standard of data quality measurement. Those tools are used to measure the medical recording data quality in Yerer General Hospital for selected dimension. Objective: To improve medical recording of outpatient and inpatient data quality in Yerer General Hospital by the end of 2021 EC. Method: It is a pre post study, we carried out a pre intervention; with baseline assessment using an infinite sample size calculation and proportional simple random sampling of cards which was admitted to the hospital between end of 2018 to end of 2019 time frame, and post intervention was in 2021 January to measure the improvement. After the intervention, a finite population sample size was used and a proportional random sampling method was applied for those admitted from January 21 to February 21 2021. Result: Training on health management information system was given as an intervention after pre intervention result was observed .pre intervention total completeness of outpatient and inpatient MR was 79.12% and 51.59% respectively. On post intervention result it decreased to 57% and 41% respectively. Pre intervention total accuracy of outpatient and inpatient MR was 63.6% and 55.7% respectively. On post intervention result it increased to 80.73% and 81.67% respectively. The timelessness has improved the cards are returned to the medical recording room in 24 hours after intervention. Conclusion: The intervention has influence on improvement of Total accuracy and timeliness but decrease score of the Total completeness of medical recording in Yerer General Hospital. Recommendation: Continues trainings and follow up are required to strengthen quality department of Yerer General Hospital.
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    Improving Outpatient Medical Record Completeness in Enchini Primary Hospital, Oromia, Ethiopia
    (Addis Abeba University, 2019-06) Dereje Bokan; Mesfin Addissie; Adiam Nega
    Background: Medical records management is one of the components of health information system that documents information related to a patient generated during patient-to-health care provider encounters at a health care facility. A well-managed medical records system is critical to improve the provision of quality health care services to ensure safe medical practice, efficient and effective services and improve the patient’s experience and satisfaction with their medical encounter. Objective:-To improve outpatient medical record completion from 37% to 90% in Enchini Hospital at t he end of June 2019GC. Methods: A pre- post intervention design was used in this project to examine the completion rate of outpatient medical record. The pre-intervention assessment was conducted in the outpatient department of Enchini hospital. Base line data were collected between January and March 2019. The baseline data showed the completeness of outpatient medical records was low. Only 37% of the 50 audited patient folders were completed. A questionnaire was developed to assess knowledge gabs of all workers who were working at outpatient department such as nurses, general practitioners and medical record workers, whether supportive supervision was conducted by senior management team and availability of printing formats and materials. The root cause analysis was conducted to identify the root cause of the problem. Based on the verification, lack of awareness about outpatient medical record completeness was identified as a real root cause and a two day’s staff training on medical record completeness was conducted. Results: the outpatient medical record completion rate increased from 37% pre intervention to 89% post-intervention. Specifically, Summary sheet of all visit dates practice and International disease code practice were considerably improved by 90 and 80 percentage points respectively. Conclusion: The result of this project suggests that a simple set of intervention providing training on the awareness of medical record improves of outpatient medical record completeness. Recommendation: The hospital, the regional health bureau and FMoH need to give emphasis for the completeness of outpatient medical records as it contribute to good quality of healthcare.
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    The Role and Dynamics of Organizational Use Power on Employees’ Job Satisfaction: Comparative Study in Public and Private Hospitals in Addis Ababa, Ethiopia, 2014/2015
    (Addis Abeba University, 2015-06) Adiam Nega; Damen Haile Mariam
    Background: In an organization, power is an influential tool in order to achieve organizational goals and keep human resource on the right place. And like other resources it needs guideline over the entire activities in an organization. Therefore in order in order managers to achieve organizational goals and to contribute employees’ job satisfaction using the best type of power base have an influential tool to come up with the desired out come. And there is no study done in our setting on the role and dynamics of power on employees’ job satisfaction. Objective: The objective of this study is to assess the role and dynamics of power on employees’ job satisfaction in public and private hospitals in Addis Ababa. Methods: An institution based cross sectional study design was conducted on 586 health professionals, 454 from public hospitals and 132from private hospitals found in Addis Ababa from March to April 2015. Two population size using P-value 50% because there is no study done on the role of power on employees’ job satisfaction in our setting. Simple random sampling technique was used to select the hospitals. Qualitative study was also conducted in selected public and private hospitals to enrich the quantitative findings and to explore some of the major findings in detail. Results: Two hundred fifty six (56.4%)of public hospital professionals were dissatisfied with their job and one hundred ninety eight (43.6%)were satisfied with their job. Whereas in private hospitals ninety five (72%)of health professionals were satisfied with their job and thirty seven (28%)were dissatisfied with their job. The factors that affect employees job satisfaction were get training, comfortable working hours, conducive infrastructure and opportunity for further education. Those professionals who said manager use legitimate power were more likely to be satisfied with their job compared to those professionals who said manager did not use legitimate power [AOR: 1.88.95%CI: (1.31, 2.7)]. Those professionals who said manager use information power were more likely to be satisfied with their job than professionals who said manager use information power. [AOR: 1.72. 95%CI: (1.19, 2.49)]. Conclusion and Recommendations: Legitimate and information power have positive relationship to employees’ job satisfaction. Therefore policy makers must create conducive environment for the application of legitimate, expert, referent and information powers.
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    The Experiences of Institutional Review Committees in Conducting Post-approval and Site-Monitoring of Research Projects in Ethiopia: A mixed-method Research
    (Addis Ababa University, 2024-06) Girum Tamiru; Damen Haile Mariam; Adiam Nega; Awgichew Kifle
    Background: Research showed a high magnitude of research misconduct in Africa. Despite the need, ethics committees in Africa seldom monitor studies after approval. Moreover, research showed inconsistencies in post-approval monitoring by ethics committees and a lack of data supporting the practice. Thus, the study aimed to explore the experiences, opportunities, and challenges of post-approval and site monitoring of studies by ethics committees in Ethiopia. Methods: A concurrent mixed-method study involving an institution-based cross- sectional, descriptive qualitative study, and a document review of on-site monitoring was done on the fourteen institutions. The quantitative survey was done on 84 members using a self-administered structured questionnaire and 14 in-depth interviews were conducted with purposively selected members from each institution. Moreover, a review of site monitoring reports was done using a checklist. The survey data and document review were analyzed descriptively and the in-depth interviews were analyzed thematically and integrated using MAXQDA software. Results: Less than half of the members, 39 (46.4%), indicated they had prior on-site monitoring experience and over 84% of the members had previous experience of ongoing review of protocols. The most frequent challenges were a lack of system, resources, and contextual difficulties. The data revealed procedure infractions and deviations during site monitoring, along with the corresponding measures. In addition, the capacity, availability of universities and research institutes, and the existence of trigger factors all presented opportunities for continued follow-ups. Conclusions and Recommendations: The common passive way of monitoring of studies by ethics committees is inadequate to protect the study participants. Given the presence of such research flaws, it is imperative to strengthen the capacity of the ethics committees and more emphasis should be given to active monitoring of studies by ethics committees and all research stakeholders should support the monitoring activities.
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    To Assess and Improve the Low Bed Occupancy Rate in Mida Weremo Primary Hospital, Amhara, Ethiopia 2019
    (Addis Ababa University, 2019-07) Petros Anberbir ; Adiam Nega; Birhan Tassew
    Introduction: Low bed occupancy rate (BOR) is the one of the biggest problem of the hospital. As a result it brings the indication of low quality health care services, customer and staff dissatisfaction and poor revenue generation. In this study measured and improved bed occupancy rate focused on installing operation care materials and start operation care service and provided post operative care at surgical ward in Mida Weremo primary hospital in Amhara /Ethiopia. Objective: To assess and improve low bed occupancy rate from 33.2% to 75% by the end of May 2019 G.C Methodology: A pre-post intervention study design was used to improve the low bed occupancy rate in Mida Weremo Primary Hospital. Data was collect from the admission and discharge registration log books including all patients admitted pre and post intervention by using the check list from each ward by data collectors. Total of 331 admitted patients were enrolled in study. Data was analyzed by using the following formula to calculate the BOR Formula of BOR= Total number of patient days for a given period (length of stay) x 100 Available beds (bed complement) x the number of days in the period. Result: Socio-demographic section of the study most admitted patients are male (59.3%) and Christian (82.7%). The mean ± SD age was 33.7 ± 27 and 32.4 ± 24.4 in the pre intervention and post intervention respectively. During the pre intervention study the BOR was 32.3%, 32%, 36% and 30.1% on September, October, November and December respectively. Operation service was started at the month of January. In this pre-post study BOR when we see the progress of BOR in each month with in the intervention periods 55.8%, 63.3%, 74.1% and 86.6% on February, March, April and May respectively. Conclusion: The fact that the hospital hasn’t started giving operation and post operation care service was attributed for low BOR and initiating this service was the main change idea. During post intervention period BOR was increased from 33.8% to 70% in this intervention period. Recommendation: It was recommended to hospital manager to give more attention and that the departments should record and report the necessary data accurately. It was also recommended to give more emphasis and do more researches on this field.