Browsing by Author "Beedemariam, Gebremedhin"

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    Assessment of Pharmacy Workforce in Ethiopia
    (Addis Ababa University, 2011-03) Beedemariam, Gebremedhin; Gedif, Teferi (PhD)
    Background: Human resources for health have long been recognized as the cornerstone for the success of the health sector programs. In this regard, proper planning of the development of human capital based on evidence related to the number of working force available, factors that contribute to the attrition of the available health professionals and international standards, is crucial. Although most developed countries have a well documented data of health workers in general and pharmacy workforce in particular, the developing world like Ethiopia are severely lagging in developing an evidence related to its education and work-force development. The country lacks an adequate national pharmacy workforce data. As a result, fundamental questions regarding the status of the pharmacy workforce, its level of performance and the problems they face remain largely unanswered. So, the results of this unique national survey allow critical evaluation of the national pharmacy workforce which should be considered in the national health care policies and workforce planning that impact the health, labor and education policies. Objective: To assess pharmacy work force in Ethiopia. Methodology: A national census and descriptive cross-sectional survey of the pharmacy workforce in Ethiopia was conducted between June and September, 2010. A complete enumeration of pharmacists was conducted in all pharmaceutical sectors across the country. On the other hand, other variables related to pharmacists‘ job satisfaction and work-life change were assessed taking cross-section of the pharmacists by applying stratified sampling method. Six regions/city administration (Afar and Benshangul Gumuz from the historically disadvantaged regions and Addis Ababa, Amhara, Oromia, and Tigray from the other regions/city administration) were involved in the study. Both qualitative and quantitative methods were employed in data collection. The quantitative data was collected by self administered questionnaire, census form and structured data abstraction format. The qualitative data was collected by in-depth interview with key informants from the Regional Health Bureaus, Federal Ministry of Health and pharmacists from different batches. Results: The total number of pharmacists in the country was 1898 (2.38 pharmacists per 100,000 population). Pharmacists were found unevenly distributed between regions, private and public sectors. The maldistribution of pharmacists was evident that pharmacists‘ density per 100,000 IX population ranges from 0.66 in Afar to 29.88 in Addis Ababa. To attain WHO recommended ratio and African countries average pharmacists density, currently Ethiopia needs to have a total of 39,918 and 6,387 pharmacists, respectively. The forecasted demand of pharmacists for 2024/25 fiscal year based on both the lower and middle income countries scenario, and the lower, middle and higher income countries scenario is estimated to be within the range of 28,278 to 30,003 pharmacists. The fourteen years (1993-2006) annual average Pharmacists‘ loss rate was found to be 6.5%. Pharmacists appeared to be less satisfied with their work, with overall mean job satisfaction score of 3.0 (SD = 1.11) in a scale of 1-5. Relation with colleague and fellow professionals was an item with the highest mean job satisfaction score (3.74 ± 1.06), while remuneration (with mean score of 2.55, SD = 1.22) ranked least by pharmacists. Pharmacists working in hospital pharmacy, level IV cities/towns, and younger pharmacists were significantly less satisfied than pharmacists on the other category. Out of 393 pharmacists interviewed, 37.7%, 11.2% and 12.1% of them reported that they were highly likely to leave their current area of practice, reduce hours of work, and leave the profession within the next two years, respectively. Conclusion and Recommendation: This study has shown that the country suffers from shortage of pharmacists, particularly the emerging regions. The double digit economic development of the country contributes to increase the demand for pharmacists and the forecasted need for 2024/25 fiscal year is about 28,278 to 30,003 pharmacists. The introduction of new curriculum is also expected to boost the country‘s demand for more number of pharmacists. This shortage of pharmacists could undermine equitable access and availability of medicines to the communities in the country and therefore deter the reduction of morbidity and mortality. Hence, the government should give due attention to maximize patients‘ benefit from the underutilized pharmacy profession. Key words: Pharmacy, Ethiopia, Pharmacist density, Job satisfaction, Plan to change work-life
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    Asthma Treatment Outcome and Factors Associated with Uncontrolled Asthma among Adult Asthmatic Patients Attending Ambulatory Care Units of Selected Public Hospitals in Addis Ababa, Ethiopia: A Cross-Sectional Study
    (Addis Ababa University, 2019-07) Tsegaye, Tesfaye; Dr.Messele, Bruck; Beedemariam, Gebremedhin; Dr.Bayisa, Tola
    Background: Asthma is a major health challenge globally where majority of the patients have uncontrolled disease status. To this effect, development of various management protocols and considerable effort have been develop in broad understanding of important behavioral, social and administrative aspects of asthma care. However, lists of socio-demographic factors, disease characteristics factors and medication related conditions were revealed as risk factors for uncontrolled asthma. Objective: To assess asthma treatment outcome and factors associated with uncontrolled asthma among adult asthmatic patients attending ambulatory care units of selected public hospitals in Addis Ababa, Ethiopia. Methods: A cross-sectional study was conducted in selected public hospitals of Addis Ababa (Saint. Paul's Hospital Millennium Medical College and Menelik II Referral Hospitals) between March 1 to June 30, 2018. A consecutive sampling technique was employed to enroll asthmatic patients taking anti-asthmatic medications for at least three months. Pretested interviewer administrated questionnaire adopted from Global Initiative for Asthma Guideline, Medication Adherence Rating Scale and Beliefs about Medicine Questionnaire tools were used to collect the required data through chart review and patient interview. Asthma treatment outcome was categorized as controlled, partially controlled and uncontrolled. Descriptions of variables were done using frequencies and proportion while multivariate logistic regression analysis was employed to identify factors associated with uncontrolled asthma. The strength of association was presented by odds ratio with 95% CI and variable with p < 0.05 were considered as statistically significant. Data were entered and analyzed using SPSS version 20.0. Results: A total of 230 (response rate of 98.2%) study participants were interviewed. More than half (65.2%) of respondents were females and their mean age was 54±15.1 years. About 116 (50.4%) patients had uncontrolled asthma status. Moderate persistent (40%) and mild intermittent (21.7%) asthma was ascribed by high proportion of asthma severity. Patients on salbutamol puff as needed + beclomethasone puff BID (43.5%) followed by salbutamol puff as needed + beclomethasone puff BID + prednisolone (23.9%). Cold weather [AOR=2.16; 95%CI:1.00-4.63], exacerbations of asthma in the last 12 months [AOR=2.37; 95%CI:1.26-4.45], moderate persistent [AOR=3.62;95%CI:1.50-8.69], severe persistent [AOR=2.90;95%CI:1.03-8.20], patients on salbutamol puff with beclomethasone [AOR=5.95;95%CI:2.00-17.72] and patients on salbutamol puff with beclomethasone and prednisolone [AOR=15.50;95%CI:4.62-52.36] were found to be significantly associated with uncontrolled asthma. Adherence rate to controller anti-asthmatic medications was found to be 79 (44.9%). Conclusion: The study showed that more than half of asthmatic patients had uncontrolled asthma status and the rate of non-adherence towards controller medication was high, which warrants that health care providers should focus on medication adherence and strengthening asthma care education program.