Browsing by Author "Kassaye, Mesfin(PhD)"

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    Assessment of Quality of Service Delivery in Immunization in Western Gojjam, Amhara Region Ethiopia
    (Addis Ababa University, 1997-12) Teklu, Teshome; Kassaye, Mesfin(PhD); Taffa, Nigussie(PhD); Berhane, Yemane(PhD)
    Many developed and developing countries have achieved the 1990 uel target. However ,few countries, like Ethiopia, have neither achieved nor maintained it. The coverage in Western Gojjam in 1995\6 for three doses of DPT was below 40%, far below the coverage level expected to bring morbidity and mortality reduction. A cross-sectional health facility based study to assess the quality of immunization service delivery using qualitative and quantitative methods was conducted from March to May 1997 in 10 districts of Western Gojjam zone. All hospitals and health centres in the zone and randomly selected health stations were included in the study . Exit interview, observations of client-provider interaction, document review, inventory of equipment, interview with service providers, and focus group discussions with service providers and mothers were the techniques uti! ized. Though the geographical access is satisfactory, vaccine shqrtage, lack of incentives and transport facilities , delayed replacement of needles and syringes were among the structural factors that affect the quality of service delivery , while poor communication, lack of aseptic procedure, lack of proper screening, weak supervision, and absence of EPI target disease surveillance were weakness in the process of service delivery. More than 98 % satisfaction rate was reported by clients of the service during the exit interview on the dichotomous scale. But the finding was not consistent with the FGDs and the specific items addressed to assess the satisfaction. Therefore, it is concluded that quality of service delivery in immunization was not satisfactory and hence need improvement to have an effect on coverage and mortality and morbidity reduction targets
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    Reasons for Low EPI Coverage Rates in Three Woredas of South West Ethiopia
    (Addis Ababa University, 1994-05) Bekele, Worku; Farrow, James(PhD); Kassaye, Mesfin(PhD)
    Cross sectional surveys (EPI cluster survey and missed opportuni ty exit survey), interviews with health workers, focus group discussion, and observation of immunization activities, were conducted in three woredas of South Western Ethiopia to determine EPI coverage levels and to find out reasons for low coverage. The study was carried out from November 1993 to February 1994. It was found that the coverage rate was 42.1% for BCG, 24.4% for DPT3, 24.3% for OPV3, ?8.8% for measles, and 32.3% for maternal TT2. The study has indicated that religion, occupation, educational status and economic status of the parents and place of birth of the child have influence on starting or non starting of immunization of children while marital status of the mother and the number of under five children do not. Defaulting for childhood immunizations is 31.7% while it is 26.1% for maternal TT. Reasons for defaulting are: different obstacles (48.5%), lack of information (36.4%), and lack of motivation (9.2%). For maternal TT, starting of immunization was influenced by religion, occupational, educational and economic status of the couple, number of children under five and place of birth of child while it is not influenced by marital status of the mother. Missed opportuni ty exi t survey revealed that missed opportunity of immunization is 47.2% for women and 23.8% for children. Important reasons are lack of information (27.1%) and no offer from health workers (25%). vi Focus group discussion of caretakers, discussion with health workers and observation of EPI activities were undertaken by the principal investigator to clarify and strengthen the survey findings and these revealed that indeed there are problems, correction of which may lead to the intended goal of universal child immunization. Finally recommendations are made based on the study findings
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    Self-Medication and its Determinants in Butajira , Southern Ethiopia
    (Addis Ababa University, 1995-05) Gedif, Teferi; Kassaye, Mesfin(PhD)
    In developing countries including Ethiopia studies on drug utilization pattern at community level particularly on the issue of self-medication and drug hoarding are rare. study that was This community based cross-sectional supplimented by FGD (Focus Group Discussion) was carried out in Butajira, Southern Ethiopia, between September 1994- December 1994 to determine the extent and determinants of self-medication, the extent of drug hoarding at household level and to describe the community's criteria for therapy choice among modern drugs. The survey results showed that 1207 (6%) persons reported to have been ill in the past two weeks preceding the interview date; out of which 501 (42%) didn't take any drug or herbal medicine for their illness. Among 706 (58%) respondents who took drugs, 201 (28.5%) self medicated themselves and the majority 115 (57%) of selfmedications were carried out by using modern drugs. Determinants of self-medication with pharmaceuticals among adults were assessed using bivariate and mul ti variate analysis; being from meskan sub-ethnic group came out as a significant determinant { adjusted OR, 3.5 with 95 % CI (1.39, 8.83)}. Six hundred and eighty eight (14 %) of the studied households found storing drugs and 97% of these households were found storing traditional herbs. Colour, shape and dosage form are the criteria for therapy choice. In addition, injections are chosen as the most important remedy by most participants of the FGD. In conclusion, this study highlights medication is one of the maj or form of opt i ons in the studied community and it that selfhealth care is largely carried out with modern pharmaceuticals. Finally, the study recommended that health education on rational use of drugs using local native language and local meanings to pharmaceuticals is essential to avoid inappropriate use of drugs in self-medication. Studies to evaluate the effectiveness of drug information media¥ is also recommended.