Browsing by Author "Tesfaye, Hana"

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    Assessment of utilization of fee waiver system among beneficiaries in Addis Ababa, Ethiopia, 2017.
    (Addis Abeba University, 2017-05) Tesfaye, Hana; Tassew, Birhan (MPH)
    Back-ground: Fee waiver system is one component of health care financing reform; it is a system for granting access to health services for those who are unable to pay. Evidence shows that the implementation of fee waiver system have slower progress rates, and lack sufficient information on the privileges that come with the utilization of fee waivers. As a result, studying the utilization and factors that influencing implementation of waiver system is found to be crucial. Objective: The main objective of the study is to assess utilization and factors that influence the utilization and implementation of waiver system in Addis Ababa 2017. Method: A community based cross-sectional study design using both quantitative and qualitative methods, was conducted on 578 waiver beneficiaries and 15 key informants found in Addis Ababa from March to April 2017. The data were collected by using a structured interviewer based questionnaire for beneficiaries. Participants were selected using simple random sampling technique. Data were entered using EPI info version 7 and exported to SPSS version 20 for analysis. Descriptive statistics were used to summarize the data bi-variable and multivariable logistic regression was used to examine the relationship between outcome variable and independent variables. A cut of point P-value<0.05 was used to show the level of significance. Qualitative data were collected by using semi structured open ended questionnaire for key informants. Transcription and translation of each record were made by principal investigator using MS word and translated data were analyzed and categorized by triangulation by using thematic approach. Results: Among 578 beneficiaries who responded to the questionnaire, 438 (76%) of them had a health problem after being introduced to waiver privileges. Out of the latter, 367 (84%) had visited health facility. Of those who visited health facility, 273 (74%) utilized waiver privilege. The study showed that age, marital status, educational status, family size and visiting private health facility were significantly associated with utilization of waiver privilege. The key informant indicated that, fee waiver system implemented in public health institution but the system showed lack of effectiveness, because of lack of similar criteria, lack of training about the xii implementation and beneficiary identification, leakage, under-coverage and service related factor such as unavailability of medication, laboratory service and other resources. Conclusion; - Utilization of waiver privilege was seventy four percent. Among those who were utilizing the waiver system, availability of medication and other resources were found to be questionable. The system is also prone to the possibility of leakage and under-coverage. Addis Ababa city Administrators, Woreda administrators, and health facility medical directors monitor and evaluate the system. In addition, further public studies are needed. Key words; - fee waiver, waiver beneficiaries, utilization, under-coverage, leakage
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    Extraction and Characterization of Cellulose and Microcrystalline cellulose from Corn husk, Corn cob, and Lupine husk, and Evaluation of Microcrystalline Cellulose as Directly Compressible Pharmaceutical Excipient
    (Addis Abeba University, 2020-12) Tesfaye, Hana; Prof. Gebre-Mariam, Tsige; Dr.Joseph, Nisha M.
    In recent years there has been a worldwide interest on sustainable use of resources. Isolation of cellulose from agro-industrial wastes has gained a great deal of interest from scientists and researchers due to its high demand in paper, food, cosmetics, textile and pharmaceutical industries. In Ethiopia, corn husk (CH), corn cob (CC), and lupine husk (LH) are abundant lignocellulosic agricultural wastes. Thus, the objective of this study was to prepare and characterize native cellulose and microcrystalline cellulose (MCC) from corn husk, corn cob, and lupine husk and evaluate MCC as directly compressible pharmaceutical excipient. Cellulose fibers were isolated from corn husk, corn cob, and lupine husk with NaOH and peroxiformic acid treatments and MCC was prepared through the hydrolysis of native celluloses using 0.1-M HCl. The isolated celluloses and MCC were characterized by Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), scanning electron microscope (SEM), and Thermogravimetric analysis (TGA). The mechanical properties of both plain MCC tablets and mebendazolecontaining MCC tablets as a model drug were evaluated. The yields of cellulose from CH, CC, LH, were 42%, 33%, 36% and CH-MCC, CC-MCC, and LH-MCC, were 80%, 76%, and 78%, respectively. The degree of polymerization (DP) of CH-C, CC-C, and LH-C were 735.73, 667.29, and 576.75, respectively, while DP of MCC preparations ranged from 247.36 - 315.15. The FTIR spectra of cellulose from CH, CC, and LH were almost similar and MCCs were comparable to Avicel PH-101 spectra. The CI values of LH-C (75.39%) was slightly higher than CH-C (74.5%), CC-C (72.86%) and CI of LH-MCC (81.41 %) was lower than Avicel PH-101 (85.48%) and higher than CH-MCC (78.1%), CC-MCC (77.01%). The SEM pictures of cellulose showed micro-fibrillated structure, whereas MCC exhibited rod like shape and irregular aggregated particles. All samples of cellulose and MCC showed good thermal stability. All MCC powders showed monomodal normal particle size distribution. Both plain and mebendazole loaded CH-MCC, CC-MCC, and LH-MCC tablets showed acceptable crushing and tensile strength. The disintegration times and drug release profiles of all mebendazole loaded tablets prepared from CH-MCC, CC-MCC, LH-MCC, and Avicel PH-101 were comparable and within the acceptable Pharmacopeia range. Therefore, CH, CC, and LH could be promising locally available potential sources of cellulose and MCC.