Health Informatics

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The Incidence of Injuries and Their Determinants in Akaki Textile Factory A. A. Region
(Addis Ababa University, 1991-03) Senbeto, Elias; W, George. (PhD)
A descriptive and case control study was done to observe the incidence of injuries and their determinants in Akaki textile factory. There were a total of 143 accidents during the study period giving an incidence density of 200 per 1000 person years. This is very high in comparison to developed countries. The most frequent cause of injury was machinery (29.4%), and hit by/against objects (20 . 3%) . Most of the accidents occurred in the Weaving department (109.2 per 1000 exposed workers). From our study , we found out that most accidents occurred on Mondays {35. 7%) and on Fridays(17.5%). The most common time of accidents was from 8am to lOam . The most common parts of the body which were affected by accidents were finger (42%), lower leg(18.9%), hand (13.3%). The most frequent type of accidents were prick (32.9%), laceration (30.8%), and bruise (16.8%). From the result of our study, 87.4% of the interviewed workers were not wearing personal protective devices and 86.1% had not taken safety training. 1001 total man days was lost due to 143 accidents over a period of 12 weeks. More injuries occurred in those workers who were below the age of 30 years as compared to those above 30 year (p <.05), and more injuries occurred in those workers who were above 6lli grade (p<.05). Recommendations in how to reduce the rate of accidents are made.
Relationship Between Nutritional Status and mental Development of Children in Elka Na Mataramofa, East Showa
(Addis Ababa University, 1996-05) Mogga, Souci; Alemu, Tadesse (PhD)
Malnutrition is one of the major problem in the world particularly in developing countries and it is endem ic in Eth iopia. Different studies have showed that severe malnutri tion during in fancy negatively affects mental development. Most malnu tri tion begins in the second year of life, and most of it is chronic and mild to moderate in severity. This is why the current study is looking at even mildly malnourished children I - 4 years of age. To assess the mental development of children in relation to their nutr itional status, I II children 12 - 42 months of age from a single peasant association were taken in this study. From these chi ldren 49.5 % were under weight, 52.2% were stunted and 9.9% were wasted. The mean Bayley score was 88 and SO 13. Most (71.2%) scored 76 - 101. The mean Bayley score between those stunted and non-stunted showed a significant difference. Multiple linear regression also showed HI A significantly related to mental development. In addition to nutritional status, birth order and delivery events were shown to have strong relation to mental development. Therefore we recommend an extensive health education on nutrition, expansion of delivery services to the rural population and further research on mental development of children with emphasis on the effect of family interaction and chIld rearing pracfice on mental development.
Assessment of Utilization of Voluntary Counselingand Testing (VCT) Data for StrategicInformation in Addis Ababa
(Addis Ababa University, 2009-05) Atnafu, Birhane; Deyessa, Nigussie (MD, MPH)
BackgroundEvidence-based decision making in managing VCT services is imperative to strength the service.This ultimately roots in utilizing VCT data for strategic information.However, there has not beenprecise information pertaining to the VCTdata utilization for strategic information at healthcenter level.ObjectivesThestudywasconductedtoassessVCT data process performance, level ofutilizationand factorsaffectingits utilization in Addis Ababa city. MethodsFacility based cross-sectional study wasconducted from October, 2008 to May, 2009 in all 24health centers of Addis Ababa.A total of 134 health center employeesfrom all units/departmentsthat are involved in utilization VCT data were included in the study.Trained data collectorsadministered a pre-tested andstandardizedquestionnaire. In depth interviewwith keyinformants,oneVCT focal person from eachsub cityhealth desk,werealso conducted.Datawere enteredand cleaned using SPSS window version11.0. It was also employed for descriptive and logisticregression analysis.ResultsOverall, VCT data utilization rate was 22.4%. Data quality was good as data was reported withinreporting deadlines (89.6%), disaggregated (97.7%) and consistent (86.6%).Twenty three percentof healthcenter employeeswereable toanalyze VCTdata regularly.Health center employeeswho are older and those who analyze VCT data regularly were more likely to utilize VCT data forstrategic information,AOR (95%CI) =3.92(1.07, 13.26) andAOR (95%CI) =3.42(1.24-9.40),respectively. ConclusionLevel of VCT data utilizationis low at 22.4%.Process performance of VCT data in terms of dataquality wasgood;howeverin termsof data analysis was bad. Utilization was higher amongolderhealth professionalsand those who analyze VCT data regularly. RecommendationDue attention for data processing, in & on-service training on data processing with emphasis toutilization and involving young health personnel are recommended.
An Assessment of health information exchange between Clinicians and People Living with HIV/AIDS on Anti- retroviral therapy at Public hospitals in Addis Ababa
(Addis Abeba University, 2009-05) Assefa, Mekdes; Enquselassie, Fekre (PhD ,Ass.Prof.)
Background Good quality of clinician-patient health information exchange promotes patient's knowledge and understanding, health outcomes, adherence to treatment plan, clinician and patient satisfaction and patient's trust on clinicians. Objective The main objective is to assess health information exchange between clinicians and PLWHA attending ART clinics at public hospitals in Addis Ababa. Method A cross sectional survey using quantitative and qualitative methods was utilized. Result 400 & 24 patients in the structured & in-depth interview respectively and 20 clinicians were involved in the study. The median communication score was 78%. Patients have assigned highest ratings for communication elements such as explanation on adherence (87.4%),talking understandably (87.2%), being greeted (80.8%), treated with respect (81%), & shown concern (80.2%). Involvement in decision making (54.8%) and explanation on availability of support and resources (50%) were rated low. Patients self reported better health status (P<0.0001), higher educational status (P<0.0001), longer duration of clinician patient relationship (P=0.006), lesser access to health information (p=0.019) longer visit length (P=0.019) & increased number of patients clinicians saw on daily basis (P<0.0001) were found significantly associated with better communication scores. Like wise better self reported health status (P<0.0001), longer duration of clinician patient relationship (P=0.002), increased number of patients clinicians saw on daily basis (P<0.0001) & older clinicians' age (P=0.027) were associated with better comprehension of health information. Better Health status (P<0.0001), longer visit length (P<0.0001), longer duration of clinician patient relationship (P<0.0001), longer clinicians' experience in care of patients on ART (P=0.029) & increased number of patients clinicians saw on daily basis (P<0.0001) were observed to be associated with patients' increased satisfaction with clinical communication. Clinicians’attitude on information exchange had no associated with communication variables studied. Conclusion Small proportion of patients have perceived the clinical communication to be close to the optimal score (100). However, majority of patients have reported being satisfied with and comprehending information provided during their clinical encounter. Clinician patient health information exchange was observed to be enhanced when patients report better state of health, happens to know clinicians over long period of time and cared by clinicians who see large number of patients on daily basis. Moreover patients were observed to be satisfied and rated the clinical communication higher when they are allowed to spend longer time during visits and have higher educational status respectively.
Assessment and development of radiological record system: the case of bethel teaching general hospital.
(Addis Abeba University, 2009-06) Woldeyohanni, Dawit Retta; Leulseged, Henock
The initial idea of the study is to assess and develop the radiological record system of Bethel Teaching General Hospital. The existing record keeping system of MRI department is manual, which has its own limitations. Based on these limitations, an electronic radiological record system is developed and implemented at the hospital. The record system of MRI department of the hospital is assessed before and after the implementation of the radiological record system. And within the department the service provider, data clerk/radiologist and patients are included in the study to see the effects brought by the radiological record system in service delivery. Report preparation time of MRI, Ultrasound, IVU and Mammography examinations are investigated before and after the system implementation. Furthermore patients’ feelings of the record system are described before and after the system implementation. There is a significant mean time difference ( d =1.887) for MRI report (p- value=0.000), ( d =1.300) for Ultrasound report (p-value=0.000), ( d =0.725) for reports of IVU and Mammography (p-value=0.000) before and after a system implementation. Therefore the result of the study showed that MRI, Ultrasound, IVU and Mammography report preparation mean time is shorter after the system implementation than before. But based on the response of patients the new radiological system didn’t improve their waiting time to get MRI, Ultrasound, IVU and Mammography reports. The radiological record system improved report preparation mean time. And also it is helpful in preparation of summary reports on daily, weekly, monthly, semi-annual and annual basis. Furthermore the system has the capacity to store long time patient data. In that case patient data could be used for education and epidemiological research purposes
Evaluation of the Effect of Electronic Medical Record (EMR) on Workflow in Outpatient Department Comparative Study
(Addis Abeba University, 2009-06) Mohammed, Hajira; Mitike, Getnet (MD, MPH)
Background: Uncertainty in clinical decision making is due to lack of complete, accurate and well documented patient data. Electronic Medical Record (EMR) is expected to improve the delivery of health care services and facilitate informed decision. Objective: - the objective of this study is to determine the effect of EMR on workflow in outpatient department there by assessing its effect on waiting time, patient satisfaction, physician-patient relationship and confidentiality and compare it with the manual system. Method: - comparative cross sectional study design was employed using both quantitative and qualitative approaches. The study was conducted in two private hospitals found in Addis Ababa namely Myungsung Christian Medical (MCM) center and Bethel Teaching General Hospital (BTGH). The calculated sample size for quantitative study was 768 (384 from each hospital) patients who were selected by systematic random sampling technique from OPD of each hospital. Qualitative data was generated from purposively selected physicians and front line workers (nurse, druggist, data clerks, etc) who have been working at OPD. The data was collected using structured questionnaire and semi-structured interview guide for the quantitative and qualitative methods respectively and analyzed using frequencies, percentages, mean, median, crude and adjusted odds ratio, P value of 0.05 was taken as a level of statistical significance. Result: The two hospitals were found to be comparable in almost all socio-demographic characteristics with the exception of age and religion. The mean waiting time for registration, service payment, searching MR etc in MCM were significantly lower than the time in BTGH. In addition, the overall mean satisfactions score of MCM 4.42 with SD=0.5 is relatively higher than that of BTGH (mean score 3.8 and SD=0.8). Regarding determinants of patient satisfaction, the presence of EMR, having knowledge about EMR, patient type and place of residence were found to have significant association with high level of satisfaction. In addition, waiting time has also association with level of satisfaction as the waiting time increases the level of satisfaction decreases. Conclusion and Recommendation: Electronic patient record handling significantly reduced the patient waiting time and increased patient satisfaction. Thus, promotion of the implementation of EMR both at private and government health institutions will lead to significant change in quality of care.
Development of Web-Based Database System for National and Regional External Quality Assurance of laboratory Service.
(Addis Abeba University, 2009-07) Assamnew, Bekalu; Lulseged, Henok ( MSc ); Belay, Getachew(MSc)
Background: External quality assurance is concerned with the evaluation of performance of a number of laboratories by external agencies. It’s aimed at assessing the general standard of performance, assessment of the effects of analytical procedures and assessment of individual laboratory performance and compare result between different laboratories. Objectives: the aim of this paper is to assess and produce a user friendly web based database system for the national and regional external quality assurance scheme that help in the improvement of patient care through increasing the quality of data, quality control of service (trainings), and more efficient laboratory monitoring and reporting system. Methods: A survey study was conducted to assess the external quality assurance scheme of laboratory service during March 2009 to April 2009. Different fact finding techniques (reviewing documents, reports, files etc, interview and questionnaire) has been used for assessing the current system and to discover the requirement of the system. An object oriented system development methodology was used to analyze and design the system. PHP, MySQL and apache were the tools used to develop the database and the web. Result: The laboratories use manual data collection means in about 90% of the cases. As compared to the previous method of data reporting and feedback generation, the newly developed web-based EQA has improved the performances by reducing the response time and loss of information. Only 27 % receive feedback timely, this is as a result of result submission system used and the time staffs needs to make the feedback report. Access to computers is 36.4% and internet (22.5%) in the laboratory. Internet access in the facility is a little higher but still in shortage (51.2%) and restricted to federal hospitals. In most of the cases the automated system have been recommend to use in the facility for their organized handling of information related activities and there has been indicated that this system will make their work easy, reduce workload, it is an accurate method, fast, time saving etc. Conclusion: The constantly increasing volume of data collected from different laboratories is creating difficulties in manipulation of all available information. The development of an integrated system is crucial. The web based database system developed as enormous potential in reducing time for the submission of result, the response time of feedback and workload on the N/REQAS staff.
Assessment of Knowledge, Attitude and Utilization of Information Communication Technology among Medical students and Health care providers at Tikur Anbessa Specialized Hospital
(Addis Ababa University, 2009-07) Adane, Melisachew; Lessa, Lemma(M.Sc); Shiferaw, Solomon(MD, MPH)
Background: The advancement in Information Communication Technology (ICT) provides greater ease of access and use to exploit the benefits of computing for medical education as well as quality health service delivery. However, there is no adequate information on the level of knowledge and utilization patterns of ICT among medical students and health care providers in Ethiopia. Objective: To assess the knowledge, attitude and utilization of ICT among students and health care providers in AAU, Medical Faculty and Tikur Anbessa Specialized Hospital, Addis Ababa. Methods: A cross sectional survey was conducted in AAU, MF and Tikur Anbessa Specialized hospital from February to March 2009, a total of 403 study participants were randomly selected from undergraduates, residents and health care providers based on their population size proportionally. The quantitative data were collected using self administered pretested questionnaire. The study was complimented with in-depth interview. Data were initially entered into EPi-6 dos version and exported to SPSS version 15.0 for analysis. Result: A total of 334 students and 59 HCPs participated in the study and about 25% of the respondents had satisfactory knowledge. Around 52% of the respondents had at least one computer at home and 74.8% of study subjects had Internet access mostly from Internet café(46.6%). Among study participants who had Internet access, 89.3% were users though 90.1% of them using it for e-mail service. About 83.2% of study participants had positive attitude towards ICT. The utilization rate of computer was 32.6% for all respondents. Computer possession [OR(95%CI) = 5.67(2.68, 11.99)], having computer training [OR (95%CI) = 2.26(1.12, 4.55)], knowledge on ICT [OR (95%CI) = 2.52(1.31, 4.84)], being intern [OR (95%CI) =5.01(1.71,14.69)] and resident [OR (95%CI) = 6.84(1.46, 31.99)] had significant difference in level of utilization among students in Addis Ababa University, Medical Faculty. Conclusions and recommendations: The study indicated that students and HCPs had low knowledge level and poor utilization status of ICT for academic purpose and service delivery needs. The findings indicate the need for improving the existing ICT course in the curriculum to be more skill oriented and also formal in-service ICT related trainings for the health care providers. Further, it is recommended that the medical faculty as well as MOH should consider improving the ICT facilities for students and health care providers with the aim of achieving universal access.
Assessment of Magnitude and Factors Affecting Health Information System (HIS) Use in Private and Public Health Facilities in Addis Ababa
(Addis Abeba University, 2009-07) Mengistu, Azeb; Mitike, Getenet(MD, MPH)
Background: Health information systems are critical to improving health system effectiveness and monitor and evaluate performance. However, the utilization of HIS at facility level has been frequently reported to be poor. Objective: To assess the magnitude and factors affecting Health Information System (HIS) use in both private and public health facilities in Addis Ababa. Method: a cross sectional, descriptive study was conducted in Addis Ababa. A structured questionnaire was filled by 124 health facilities and; in-depth interview with 11 health facilities were conducted A total of 124 health facilities were included in the study. Result: the health facilities were found to perform poor in terms of basic inputs to HIS; inadequate processes and; insufficient outputs. The use of HIS in the facilities is thus found to be very low (22.5%) although the government health facilities were performing relatively better. The absence of incentives to the use of HIS, the inability to participate HIS workers in the planning process, lack of local skills to manipulate the data, lack of information culture, low attitude and commitment of managers as well as staffs, lack of basic inputs to HIS, centralized decision making, lack of feedback and absence of technical support as well as supportive supervision were found to be the major factors affecting HIS use in the facilities. Conclusion and Recommendations: it can be concluded that the utilization level of HIS in health facilities under study is far below the standard expectations. It is recommended from this study that a common understanding should be reached between the facilities and the responsible organs so that facilities could know the use of the data they generate to local need rather than sending reports upwards.
Internet-Based technologies as source of Sexual and HIV/AIDS related health information among Addis Ababa University Students.
(Addis Abeba University, 2009-07) Worku, Elias; Beshah, Tibebe
Background: Internet-based sources are gaining recognition as a powerful and low cost method to deliver health related intervention information. In AAU, there is an increasing trend of network and internet services expansion to both students and staff, which greatly fosters the access to any kind of information including sexually and HIV/AIDS related heath information within the university. In order to plan for internet-based health information intervention and allocate the resources efficiently in the university, assessment of its level of availability, patterns and utilization is preliminarily required. Methods: A Cross-sectional survey study method was used to determine the utilization level among undergraduate students of AAU. Self-administered questionnaire was used to collect quantitative data from 929 randomly selected eligible students. Moreover, in-depth interview was conducted to 25 selected students to support the quantitative results. On site observation was also used. Cross tabulation, Logistic regression and Chi Square tools were used for quantitative analysis. And categorization and interpretation of interviewed data were applied to support the quantitative data. Results: Of the total 929 students selected, 86% (803) of them responded and 774 were analyzed. Of the total respondents, 86% (666) of them had ever used internet recently at least once, 39% (300) of them using it for general health information and only 22% (169) of them used it to access sexual and HIV/AIDS related health information. However, only 5% of them used digital technologies like compact disk to access sexually related health information. As their awareness, internet skill and access increased, so did their relative odds of utilization of the technologies for sexual and HIV/AIDS information, which is also significantly associated with their stream and interest to use the technologies. Conclusion: Although the actual utilization of internet-based and digital sources forsexual and an HIV/AIDS purpose is low, it can be a promising strategy to use it in delivering such contents of information effectively and efficiently by expanding its access.Moreover, most students are quite aware and interested to use it for accessing sexually and HIV/AIDS related health information.
Temporal urban growth analysis and potenial siteidentification fora highrising buildings in bahr dar city
(Addis Ababauniversity, 2009-12) Mebratu, Haimanot
The Urbanization level and the land use dynamics of Bahir Dar is assessed in the field of GIS and Remote sensing technology for excellent understanding of the emerging growth pattern using multi temporal dataset. And the results from a study about growth trends of the urban areas in Bahir Dar are described here. The period under consideration is from 1957 to 2005. It should be noted that the internal urban growth is evaluated in a separate manner and in the pre 1957 urban centers of Bahir Dar during 1957- 2005 built up area increases from 13 hectares to 33.68 hectares. In the 1957-1984 expansion areas during 1984-2005 built up area increases from 166 hectares to 210 hectares. In the post 1984 expansion areas 363 hectares of land is used for built up. With regard to the external growth of Bahir Dar two distinctive phenomena is visible from 1957 to 1984 the city expand ten times to its size of 1957 and from 1984 to 2005 again a three times growth from its size of 1984 is observed. In addition to the above urban growth analysis a suitability model for identifying potential developable land for high rising buildings has been carried out. This analysis is based on the physical and social parameters, besides in the present research all the empirical observations, the RS imagery and the GIS analysis have been used. This has been done in an integrated conceptual and operational frame work which adds an indicative bottom up perspective to the understanding of urban growth pattern
Exploring the Application of Geographic Information System in Health Organizations Working on HIV/AIDS Prevention Programs in Ethiopia.
(Addis Abeba University, 2010-06) Tadesse, Girma; Lensa, Lemma
Background: Understanding issues ranging from medical epidemiology to healthcare access requires a comprehensive understanding of their geography. In health organizations, GIS provides powerful tools for geographic and spatial analysis, and it allows visualizing data that may have gone unnoticed in spreadsheets, charts, and other reports. Despite the availability of a number of functionalities of GIS technologies with convenient cost, their applications to the health sector in preventing HIV/AIDS is not explored. Objectives: To assess the extent of GIS applications and identify barriers to its adoption, diffusion and utilization in HIV/AIDS prevention programs. Methods: Organization based survey was carried out in Addis Ababa between March and May; 2010.The study participants are organizations working on HIV/AIDS programs at national level. The study employed quantitative and qualitative methods. The data are entered, cleaned and analyzed using SPSS version15 statistical software. Result- Current GIS use among organizations working on HIV/AIDS prevention programs, 18(26.9%) are using GIS technology for program planning and management. Lack of GIS awareness (42.9%), GIS skill (18.4%)and clear GIS strategy (16.3%) are major barriers to the adoption and utilization of GIS among organizations included in the study. Lack of GIS skill (OR=0.07, 95 % CI (0.01, 0.71)) and awareness on GIS use (OR= 0.15, 95% CI (0.04, 0.48)) found to have associations with the current use of GIS in an organization. Conclusion- The study discovers that the uptake of GIS technology in the HIV/AIDS prevention programs is very low. The main reasons identified are Lack of GIS awareness, skill, strategy and poor data sharing experience among organizations. To improve the adoption and use of GIS in the health sector, I recommend organizations to create GIS awareness, develop GIS skill and enhance data sharing with and within the health sector, and investigate further the adoption and use of GIS technology in the health sector in general.
Determinants of Unintended Pregnancy Among Currently Married Women in Gozamen woreda, East Gojjam of Amhara, Ethiopia
(Addis Ababa University, 2010-06) Teshome, Haimanot; Hailemariam, Assefa (PhD)
Context: - It is a universally accepted fact that unintended pregnancy and births could have negative consequences for women, children, families and societies at large. The current study aimed to examine the level and determinants of unintended pregnancy among selected women in Gozamen woreda in the Amhara Region. Methods: - A cross-sectional study involving a sample of 576 currently married women of reproductive age, whose most recent pregnancy occurred within the last five years prior to the survey was carried out in three kebeles, selected from the study area. All pregnancies regardless of outcome are included in the study Data was collected from 554 respondents using a structured questionnaire.A multistage sampling technique was used to reach the respondents. Both quantitative and qualitative methods were employed. Descriptive and multivariate statistical techniques were used in the analysis of the data. Results: - About two out of five women (40.8 percent) reported that their most recent pregnancies were unintended. High percentage of unintended pregnancy (87.2%) was among respondents who were not using modern method of contraception prior to their most recent pregnancies. Results of the multivariate analysis indicated that several demographic, socio-economic and family planning factors influence whether a pregnancy is intended or unplanned. Women aged 35 and above (OR: 6.644), those who didn’t use contraceptive prior to the recent pregnancy (OR :2.047 ), those with no knowledge of modern contraceptive methods (OR : 4.068) and those married to husbands who do not approve contraceptive methods (OR: 3.962) had a higher chance of experiencing unintended pregnancy. Furthermore, those married at the age of 18 and above (OR: 0 .321), respondents who have exposure to media (OR: 0.404), women with at least primary education (OR: 0 .169), those women working outside home (OR: 0.387) and those married to husbands working in the non-agricultural sector (OR: 0.172) had lower chance of experiencing unintended pregnancy. Conclusion and recommendation: - Unintended pregnancy was found to be a major reproductive health problem in the study area resulting from the high unmet need for family planning and thus deserves priority attention. Policymakers and program planners need to design programs and services carefully to reduce unintended pregnancy in the region, especially, services should focus on helping those groups of women who are identified in the analysis as being at increased risk of unintended pregnancy- illiterate, ,older women aged 35 and above, those who got married at early age ,those who have less knowledge and practice of contraceptive methods and those who have five or more living children and women in rural areas
Assessing factors that affect the implementation of electronic medical records (EMR) system in government owned hospitals in Addis Ababa.
(Addis Abeba University, 2010-06) Dirirsa, Yoseph; H/Mariam, Damen(Prof.)
Background: To provide health services for the increasing Ethiopian population the government has increased the number of health facilities. To offer efficient and effective health services, however, patients’ medical record keeping or management system is very important. In line with this, some developed countries have undertaken the transition to Electronic Medical Records (EMR) system. Despite this fact, however, Ethiopia has not gone far in this aspect, and most hospitals are still documenting on paper based medical records, which is time consuming and sometimes even difficult to find. As a result, there is time when physicians are treating patients without having patients’ background information of their past medical treatments. Therefore, it is very important and timely to look into why our hospitals are not using Electronic Medical Records (EMR). Objective: The general objective of the study was to assess factors that affect implementation of EMR in government owned hospitals in Addis Ababa. Methods: A cross-sectional study design were used and health professionals and key informants in ten government owned hospitals and the only two nongovernmental hospitals that have fully implemented EMR, were assessed using questionnaire and interview on issues of health professionals attitude, budget, trained manpower, management commitment, availability of technology and other related to EMRimplementation. A Simple random sampling technique was used to select health professionals, depending on the population sizes of their hospitals and all key informants were selected purposively. Accordingly, a total of 399 health professionals and 12 key informants from each hospital have participated in the study. Data analysis was done using chi-square test, mean, t-test and odds ratio. EPI-INFO version 3.3 and SPSS version 11.0 was used to enter, clean, and analyze the data. Results - The majority 328 (92.1%) of health professionals in government hospitals support implementation of EMR in their hospitals. Among the variables analyzed, respondents’ age, sex, occupation, education status, having computer training,experience, type of organization and level of communication between employees and management were not found to significantly (p>0.05) affect health professionals attitude to support EMR implementation. Among government hospitals selected for this study only one hospital is in testing stage to implement EMR, while the remaining nine hospitals have not implemented EMR. Among the factors analyzed, except lack of budget, all were not found to significantly affect the implementation of EMR. Conclusions - From the findings of the study it is concluded that except lack of budget, other factors like employees’ attitude, management commitment, technology and lack of trained manpower were not found to be significant factor to affect the implementation of EMR in government hospitals. If budget is secured it is possible to implement EMR in government hospitals. Recommendations - Based on the findings of the study providing sufficient budget to EMR implementation, hospitals to generate income, financial subsidy or donating to implement EMR, strengthening the existing programs on EMR implementation, effective trainings and discussions with users and supporting domestic EMR software suppliers are recommended.
Assessment of the Feasibility of using Text Messages among Art Follow-up Patients to Improve Drug Adherence in Selected Art Units in Addis Ababa City Administration.
(Addis Abeba University, 2010-06) Hailu, Tsega; Fantahun, Mesganaw (MD, MPH, PhD)
Abstract Back ground: PLWHA on ART follow –up individuals may or may not have mobile phones,ability to use text messages and willingness to receive text message reminders to take their drugs. But the extent of theses desires and how it varies by individual, social, health and demographic characteristics is not well understood. Objective: to assess the feasibility of using text messages among ART follow up patients to improve drug adherence in selected ART units in Addis Ababa city administration. Method: The study was undertaken from March to April 2010, using quantitative cross-sectional study supplemented by qualitative in-depth interview on a sample of 461 PLWHA on ART follow up care for quantitative and 14 respondents for qualitative. Study subjects were selected using stratified random sampling method. A pre- tested structured questionnaire was used to collect data; Data were entered, cleaned, and analyzed using SPSS version 16 Result- One hundred twenty five (82.8%) male and ninety-three (79.5%) female over all 218 (81.3 %) of the total respondents PLWHA on ART follow-up in Addis Ababa were willing to receive (SMS) text message reminders. Of those who have willingness to receive text message reminders had disclosure of HIV status to their partner or family with (adjusted OR: 0.03, 95%CI:( 0.01-0.08) times more likely willing to receive SMS text message reminders than those who did not disclose their HIV status. In addition, respondents who attended elementary school (adjusted OR: 8.21, 95% CI: 1.59-42.33) times more likely to receive text message than those who do not attended school and those who secondary school (adjusted OR: 58.65, 95% CI:12.18-280.12) times more likely to receive text messages than those who did not attended school. One hundred forty eight (68.2%) of PLWHA on ART follow-up individuals wanted to receive text message reminders of time to take their drugs Conclusion: High proportion of HIV positive individuals on ART follow-up wanted to receive text message reminders, of time to take their drugs. Their willingness to receive text message reminders of these people has implication to introduce or adoption (SMS) text message technology with designed special computer software program that automatically sends special message service ) $ * to improve drug adherence.
Knowledge, Attitude and Practice of Healthcare providers on Health Management Information System in Health Centers in North Shoa Zone, Oromia Region 2010 .
(Addis Abeba University, 2010-07) Kifle, Tegegn; Tesfaye, Fikru(PHD, Ass. Prof.)
Background: The HMIS is a tool which could be used to improve health services. Nations all over theworld are demanding to improve their healthcare service delivery quality through HMIS. Currently HMIS is coming up as one of the hot issues initiated to be reformed and implemented in Ethiopia. The purpose is to revitalize the health service provision through evidence-based decision-making. Objective: To assess the situation of Healthcare providers working in health centers of North Shoa Zone, Oromia region in relation to HMIS Methods: A cross-sectional survey was conducted among all 301 HCPs in Oromia region, North shoa Zone, in all health centers in March 2010.The quantitative data were collected using self- administered based pre-tested questionnaire. The study was consolidated with in-depth interview. EPI6 was used for data entry and cleaning and exported to SPSS version 16 statistical package for coding and analysis. Descriptive analysis was done to calculate the knowledge, attitude and practice scores. To show the association between dependent and independent variables, odds ratio with 95% confidence interval was employed. Logistic regression analysis was done to control confounding effects amongst variables. Results: 296 questionnaires were returned making the response rate 98.3%. The overall knowledge and attitude on HMIS basic concept was found to be relatively good. But not seem to correspond with practice as it is comparatively very low. About 70.61% of the respondents were found to have good knowledge. The favorable attitude score was also found to be 81.08%. Concerning the practice, only 20.6% of the respondents were found to have good practice and significantly associated with unmarried marital status [COR=3.22(95%CI=1.80, 5.75)] and [AOR=2.67(95%CI=1.28, 5.59)].From professional category, degree holders had better practice of HMIS [COR= 2.93(95%CI=1.37,6.24)] and [AOR=2.93(95%CI=1.06,8.11)]. According to the in-depth interview result, lack of trained and full time HMIS workers, unstandardized data collection and reporting tools were underlined as the main factors for malpracticing of HMIS at the health centers. Conclusion:Although the practice of HMIS neglected, the knowledge and attitude status of the HCPs on basic HMIS concepts was relatively found to be good. As a result, the HMIS status in general was found to be very poor in the study area. Recommendation: Motivation and Training of HCPs on HMIS, provision of standardized data collection,and reporting tools, allocation of properly trained and full day HMIS workers with sustainable supportive supervision at each health centre were recommended to be given due consideration.
Trauma Severity Scoring and its immediate outcome Measure among Patients with Trauma incident attending by Emergency Medical Services, the case of Tikur Anbessa and Yekatit12 Hospitals.
(Addis Abeba University, 2010-08) Mengistu, Zuriyash; Azaj, Aklilu(Dr.); Teferi, Dereje(Dr.); Belachew, Ayele(Dr.)
Trauma is the leading cause of morbidity and mortality all over the world Trauma can be a threat to life through damaging different body part that involve the most active group of society and can result in prolonged compensation.The severity of trauma and immediate outcome of trauma measure can enable to evaluate health care intervention for an emergency trauma patient.In this research, retrospective patient care record review design is used for trauma patients who attended the emergency department of Tikur Anbessa and Yekatit 12 Hospital. The research is conducted from August 2009 to June 2010, and the record review and data collection period was from March to April 2010. All identified trauma patient care record about patient with altered level of consciousness who attend emergency medical service throughout the previous year and those who fulfill inclusion criteria was reviewed. Data was analyzed using SPSS 15.0 statistical package.Indescriptive statistic frequency, median, and standard deviations were computed. The TRISS methodology was used to score trauma severity and to compare the data outcome. Among 328 trauma patients 72.9% were males and 27.1% were female. The median age was 30 years. 86.0 of them were below 54 years. From the total patient care record review the median of ISS and RTS were 25 and 7.84 with range 16 – 75 and 0.00 – 7.84 , and standard deviation of 12.60 and 1.54 respectively. Sustained penetrating trauma were accounted for 30(9.1%) of the total trauma incidents and sustained blunt trauma were accounted for 298(90.9%) of total trauma incidents. The majority of the trauma patients (49%) were sustained road traffic accident followed by strike by blunt object (18%)and fall > 5 meter (15%). Out of the total 328 trauma patients 18.3 % of them were died. The area under the curve at the ROC analysis was 0.967 for TRISS, 0.127 for ISS, and 0.903 for RTS (P < 0.0001 for each). Regarding actual survival status against TRISS, the use of a cut-off point of greater than 67.3 provided a sensitivity of 97.39% and a specificity of 65%. The overall severity rate, mortality rate and Hospital length of stay were higher in these two Hospitals with larger involvement of young adult and male. Head and groin region accident was more commonly altered anatomical region.
The Use of Mobile Phone for HIV/AIDS Patients Clinical Attendance and Follow-up in Art Providing Hospitals in Addis Ababa,Ethiopia
(2011-06) Yusuf, Abdi; Bekele, Rahel (PhD)
Background: HIV/AIDS is a lifelong disease and the treatment and follow-up of PLWHA over time requires daily administration of antiretroviral drugs as well as monitoring of clinical progression and lab results to prevent multi-drug resistance. Mobile phone technology has a potential to address many health challenges facing resource-poor countries including the barriers HIV patients encounter when accessing ART. The magnitude of mobile phone utilization and factors affecting utilization of mobile phone among patients attending ART clinic for health-care services particularly in management of HIV/AIDS patient clinical attendance, follow up and adherence is not well assessed in Ethiopia and Addis Ababa. Objective of the study: The overall objective of this study was to assess utilization of mobile phone and factors affecting utilization of mobile phone for HIV patients’ clinical attendance and follow up at public hospitals in Addis Ababa Methodology: A cross sectional study employing both quantitative and qualitative methods was utilized. And structured questionnaires and in depth interview were used to collect data. Epi info16 and SPSS statistical software package were used for data entry and analysis respectively. Descriptive statistics using frequency and summary statistic were used to describe the respondents. And logistic analysis for the quantitative study and content analysis for qualitative study were used to analyze data. Result: A total of 422 patients were participated in the study. Of those 85.5% had access to mobile phones, about 48.3% have no information about the service provided in ART, 37.4% were receive calls and 23.0% were had history of calls to adherence supporter. The utilization rate of mobile phone was 46.8% for all respondents. Miss appointment date [OR, 7.51 (95% CI 3.58, 15.77)], know about the service providing [OR, 9.25 (95%CI 4.89, 17.47)] and current adherence status [OR, 3.35 (95%CI 1.28, 8.80)] were found significant association with mobile phone utilization. Conclusion: Our study shows that information about the availability of the service; adherence status and missed appointment date were the major predictors of mobile phone utilization for patient clinical attendance and follow up. We recommend that the system should be integrated with the general ART service and responsible bodies should allocate budget for mobile phone service and motivate adherence supporters.
Predicting the Pattern of Under-five Mortality in Ethiopia Using Data Mining Technology: The Case of Butajira Rural Health Program.
(Addis Ababa University, 2012-06) Tekabe, Be’emnetu; Jemaneh, Getachew; Tefera, Worku
Introduction:The under-five deaths in Ethiopiarepresent 48% of all mortality. More than halfof the under-five deaths occurred during the first year of life, and 53% of these before 2 monthsof age.Data miningis a collection of techniques for efficient automated discovery of previouslyunknown, valid, novel, useful and understandable patterns in large databases. Objective:The main objective of this study is to explore the potential applicability of datamining to predict the determinants, levels and pattern of under-five mortality in Ethiopia,particularly for the Butajira rural health program sites. This can greatly support for policymakers, planners, and healthcare providers working on the control of under-five childrenmortality in Ethiopia. Methods andMaterial:The methodology used for this research was a hybrid six-step CiosKnowledge Discovery Process. The required data was collected from Butajira rural healthprogramdatabase covering the period 1987-2008. The researcher used two popular data miningalgorithms (C4.5 J48 Decision Trees and Naïve Bayes Classifier) to develop the predictivemodel using a larger dataset (11,600 cases). The researcher also used a 10-fold cross validationand 90% split test mode fordataminingmethods of the two predictive models for performancecomparison purposes. Results:The results indicated that the decision tree (J48algorithm) is the best predictor withpruned parameter of the tree of 90% split test mode; it has 97.49% accuracy on the holdoutdataset (this predictive accuracy is better than any reported in the literature), Naïve BayesClassifier came out to be the second with supervised discretization has 96.67% accuracy. Conclusion:The results from this study were very capable and confirmed the belief thatapplyingdata mining techniques could indeed support a predictive model building task thatpredicts the pattern of under-five mortality in Ethiopia; particularly for Butajira rural healthprogramsitesarepossible. In the future, more classification studies by using a possible largeamount ofButajira rural health programdemographic and surveillance sitesdataset records withepidemiological information and employing other classification algorithms, tools and techniquescouldyield better results.
Application of Data Mining for Predicting Adult Mortality.
(Addis Abeba University, 2012-06) Hailemariam, Tesfahun; Meshesha, Million(Dr.); Worku, Alemayehu(Dr.)
Background: The fast-growing, tremendous amount of data, collected and stored in large and massive data repositories, has far exceeded human ability for comprehension without powerful tools. As a result, data collected in large data repositories become seldom visited. This in turn, calls the application of data mining technology. Every year, more than 7·7 million children die before their fifth birthday. However, over three times those of nearly 24 million adults die every year. Less attention has been given to adults which are the most productive phase of life for both economic and social ramification of families and countries. Objective: The general objective of this research is to construct adult mortality predictive model using data mining techniques so as to identify and improve adult health status using BRHP open cohort database. Methods: The hybrid model that was developed for academic research was followed. Dataset is preprocessed for missing values, outliers and data transformation. Decision tree and Naïve Bayes algorithms were employed to build the predictive model by using a sample dataset of 62,869 records of both alive and died adults through three experiments and six scenarios. Result: In this study as compared to Bayes, the performance of J48 pruned decision tree reveals that 97.2% of accurate results are possible for developing classification rules that can be used for prediction. If no education in family and the person is living in rural highland and lowland, the probability of experiencing adult death is 98.4% and 97.4% respectively with concomitant attributes in the rule generated. The likely chance of adult to survive in completed primary school, completed secondary school, and further education is (98.9%, 99%, 100%) respectively. Conclusion: The study suggests that education plays a considerable role as a root cause of adult death, followed by outmigration. Further comprehensive and extensive experimentation is needed to substantially describe the loss experiences of adult mortality in Ethiopia.

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