Health Informatics

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Adoption of Electronic Medical Records among Health Professionals at Public Hospitals in Addis Ababa City Administration Health Bureau, Ethiopia.
(Addis Ababa University, 2012-12) Gebremariam, Semere; Lamenew, Workshet(MSc); Deyassa, Negussie(PhD)
INTRODUCTION:Wellness and health are central to live of all people of age group. Incorporating information communication like Electronic Medical Records on the health care industries is mandatory for the better improvement of patient care and safety, integrated research, for effective planning,monitoring and evaluation of disease etc. Electronic Medical Record implementation in public hospitals in Addis Ababa is on the infant stage not more than three years since its inception.Even though There is discrepancy in adoption among health professionals and is not utilized as needed due to different factors,most of the public hospitals have implemented it.So identifying the factors which affect the adoptionwill help to apply proactive measure and correction so as to increase the adoption of EMR among health professionals whom are working at the public hospitals. OBJECTIVE:This study aimed at identifying the factors that affect the Behavioral Intention and usage behavior of Electronic Medical Record and determine the utilization status among health professionals working in public hospital in Addis Ababa City Administration health Bureau. METHOD: A Cross-sectional survey was carried out among health professionals working at public hospitals in Addis Ababa using modified theory of unified acceptance and use of technology(UTAUT)model. Four hundred eight health professionals who had training on EMR were interviewed at the five public hospitals. RESULTS:The utilization of EMR among health professions working at the public hospitals was 51.7%permanence expectancy, Effort expectancy, social influence were factors influencing the behavioral intention of health professionals to adopt EMR and Behavioral intention was also significant influencing factor on actual usage behavior. Facilitating condition remains insignificant on the actual usage behavior of EMR among health professionals. CONCLUSION AND RECOMMENDATION:The utilization rate of EMR was 51.7%: Having no experience,misunderstanding on the relative advantage, perceiving complexity of the system, inadequate support of the top managers, low behavioral intent were factors associated with the behavioral intention and actual usage of EMR. This study indicates that the necessity of integrating health management information system with the daily health care activities and development of health information policy that can scale the utilization rate.
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.
Application of Data Mining Technique to Develop Chronic Disease Distribution Map using Drug Distribution Data in Ethiopia
(Addis Abeba University, 2013-04) Zerihun, Marara; Worku, Alemayehu(Dr.); Jemaneh, Getachewu
Background: Due to the great difference in population structure, geographic environment, food composition, ethnicity and lifestyle, it could be predicted that there may be significant differences of chronic disease forms and distribution in the various administrative areas. The amount of data getting generated in any sector these days is enormous. There are many data mining tools and technique to uncover hidden knowledge in the data. At the same time Ethiopian PFSA has huge and useful drug distribution data in their data base to investigate chronic disease distribution. Objective: The purpose of this study is to investigate distribution of chronic diseases in various administrative areas of the country based on chronic disease drug distribution data applying data mining techniques. Methods: Drug distribution data was collected from EPFSA. Data that are retrieved from the organization is from 2003 up to 2005 EC. Since annual data follow is high and distribution density is the same, two and half year’s data is enough to produce distribution map and identify increase in demand applying data mining technology. Any data beyond these years are redundant and over saturate the models. In order to optimize the desired outcome the researcher has followed Hybrid data mining process model. The model is selected because it is appropriate for academic research; it combines the best features of KDD and CRISP; and starts with problem domain understanding. Results: The study revealed that some drugs are more important at one hub than the other. Gullele hub received the hieghtest persontage of Athma (17.3%), Cardiac (38.5%), Diatetes (45.6%) and Hypertenion (28.99%). While Parkinson drugs are issued mostly to Mekele (15.5%)hub. The mining software revealed that some drugs are more important at one hub than the other in specified time. Conclusions: Issue date, issue number and expiry dates are selected as best attribute by the mining tool. Based on discussion with domain experts issue date is important for drug distribution while issue number and expiry date are not relevant to the drug distribution.
Application of Data Mining Techniques to Predict Urinary Fistula Surgical Repair Outcome: the Case of Addis Ababa Fistula Hospital, Addis Ababa, Ethiopia.
(Addis Ababa University, 2012-06) Tefera, Minale; Jemaneh, Getachew; Mola, Mitike(Dr.)
Background: The likelihood of the occurrence of incontinence after successful surgical repair makes predicting urinary fistula surgical repair outcome important for decision making during operation and for further follow up and treatment. Objective: The purpose of this thesis is to apply data mining techniques to build a model that can assist in predicting surgical outcome of urinary fistula repair based on clinical assessments done just before surgical repair. Methodology: The six-step hybrid knowledge discovery process model is used as a framework for the overall activities in the study. 15961 instances that have undergone urinary fistula repair in Addis Ababa Fistula Hospital are used for both predictive association rule extraction and predictive model building. Apriori algorithm is used to extract association rules while classification algorithms J48, PART, Naïve Bayes and multinomial logistic regression are used to build predictive models. Support and confidence are used as interestingness measure for association rules while area under the WROC and ROC curve for each specific outcome is sequentially used to compare performances of models from the predictive algorithms. Results: Predictive association rules from Apriori have shown frequent co-occurrence of less severity of injury with cured outcome. The predictive model from PART-M2-C0.05Q1 scheme has shown an area under WROC curve of 0.742. Area under the ROC curve for residual outcome(ROC=0.822) from this algorithm is better than Naïve Bayes and logistic, while the areas under the ROC curves for the other outcomes are greater than the model from J48. Conclusion: Predictive model is developed with the use of PART-M2-C0.05-Q1. It is Residual better in detecting residual outcome than the logistic regression model. The predictiveassociation rules and predictive model built with the use of data mining techniques can assist in predicting urinary fistula surgical repair outcome.
Architectural Framework for Information Integration: Case of Organizations Working on Water, Hygiene and Sanitation in Ethiopia
(Addis Ababa University, 2013-05) Mulualem, Wondwossen; Lamenew, Workshet ; Enquselassie, Fikre(Dr.)
Water, Hygiene and Sanitation (WASH) is a subject of intersectoral interest that engages different governmental and non-governmental organizations. As it happens in the otherareas of public health, existence of parallel WASH activities makes the sector prone to theproblems of fragmentation, lack of consistency and other problems that plagued the sector. Such problems were felt at the national level by the Ethiopian government and, as the result,movement towards integrating all WASH activities in the nation was started by drafting aWASH implementation Framework (WIF) and Memorandum of Understanding whicheventually was signed by four governmental organizations. The WIF aims at integrating all aspects of WASH activities, including the information system, under one umbrella and the interest of this research lies on exploring the possibility for creating a framework for anintegrated WASH information system that can be shared by all stakeholders. The mainobjective of this research was to study the current status of WASH data creation,management and sharing practices among organizations working in the sector and proposean architectural framework that can be considered as a guide to setup an Integrated WASH information system. To this end, this research focused on the use of indicators as primary tools for data integration and attempted to study types of WASH activities performed and indicators used by target organizations, types of data they collect under each indicator,formats for data collection including the data attributes being used, standards being used for formulation of indicators and practice of sharing between organization working in the sector. Relevant data was collected mainly through semi-structured interviews and analysis of relevant documentations provided by the respondents. The result was eventually used to propose an architectural framework that can be considered as a starting point for practitioners working in the area. The framework was discussed with selected respondents for checking its validity and the overall reaction of the respondents was found to be positive.
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.
Assessing knowledge management practice at EFMoH and its affiliate organizations, Ethiopia
(Addis Abeba University, 2015-01) Amenashewa, Eskedar; Zergaw, Ababi(Dr.); Meshesha, Million(Dr.)
Introduction: Knowledge management is the planning, organizing, motivating, and controlling of people, processes and systems in an organization to ensure that organizational knowledge related assets are improved and effectively employed. The study aims, to assess knowledge management practice, at the Federal Ministry of Health and its affiliate organizations in Ethiopia so as to design a mechanism for effective and efficient management of knowledge. Methodology: a descriptive cross-sectional study design employed to assess knowledge management practice in purposively selected organizations of Ethiopian Federal Ministry of Health and its affiliate organization by further correlating the existing knowledge management practices with the standard knowledge management practices that one institution need to have through structured self administered questions. The study included technical staffs in the target organization which would be selected randomly using lottery method from the total 99 case teams equivalent to one program staff from each case teams included in the study. Results: The study reviled that most of participants (78.2%) mentioned the organizations don‘t have knowledge management strategy and 92.2% of respondents mentioned there is no responsible person who can manage knowledge. Majority of the knowledge was existed in the form of tacit knowledge. The study also showed experiences of information technology in some of the organizations that need to be shared for other organizations where information technology infrastructure is important for knowledge sharing and capturing. Further the study indicated there is no statistical relation between socio-demographic factor and knowledge management practices in the organization which needs to be further studied. Conclusion: The study indicates the Federal Ministry of Health and its affiliate organizations needs to give emphasis on the importance‘s of knowledge management system to design and incorporate the strategies with other health sector . Recommendation:EFMoH and affiliate organization managers should create awareness about knowledge management, develop knowledge management strategy and guidelines and use mechanism for effective management of knowledge and tools which is suggested by this research.
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
Assessment and Improvement of Quality of Medical Laboratory Commodity Logistics Management Information Systems in Saint Paul’s Hospital Millennium Medical College
(Addis Abeba University, 2015-06) Bilal, Muhe; Betre, Mulugeta(Dr.); Teferra, Solomon(Dr.)
Background: Laboratory logistics management information system is the management of laboratory commodities in a systematic and standardized way by collecting, processing and utilizing timely logistics data to inform quantification, procurement, storage and distribution of laboratory commodities. Objectives: to assess and improve the quality of medical laboratory commodities of logistics management information system in St. Paul’s Millennium Medical College. Methodology: facility based cross-sectional descriptive study design was conducted from April, 2015 to June, 2015. The data’s were collected using self administered structured questionnaire for quantitative and semi structured interviewee questionnaires was implemented for qualitative findings. Intervention and problem solving mechanism was practiced. Scope of the project: maintaining LMIS to provide quantity and quality of the laboratory commodities that was served and satisfied the community without interruption of the services through the six basic rights of logistics. Significance of the project: is to provide reliable, accurate and manageable with specified period that easily monitored and controlled use of laboratory commodities of stock status. Result: in the selected facility there was a well-functioning logistics management information system for laboratory commodities. Among the total participants 15(83.3%) of the respondents did not have in-service training on LMIS. The frequency of stock out, under stock and over stock of laboratory commodities at the time of assessment were 35.7%, 23.8% and 9.5% respectively. Conclusion: the majority of study participants have no knowledge about LMIS and monitoring the stock status of laboratory commodity. Recommendation: In-service training should provide for laboratory professionals and integration of LMIS to laboratory information system should implement to minimize the gaps.
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 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.
Assessment of Quality of Referral System among Health Centers in Eastern Zone of Tigray, Ethiopia, 2019.
(Addis Abeba University, 2019-10) Gebremeskel, Fre; Addissie, Mesfin(MD, MPH); Asrat, Gashaye(BSc, MPH)
Background: Implementation of a well-managed and functional referral system leads to good health care quality. The referral system is an important public health issue. However, in Ethiopia, there is no available literature that assesses the quality of the referral system of Health Centers. So these results will help health managers as a baseline in decision making. Objective: To assess the quality of the referral system among Health Centers in Eastern Zone of Tigray, Northern Ethiopia, 2019. Method: Institutional based cross-sectional quantitative study was conducted. Eight Health Centers were selected using simple random sampling. A total of 422 sample size was calculated and allocated to each health center using probability allocation technique. Three data collection tool was used, data on the availability of inputs were collected through observation, patient interview questionnaire was used to assess patient satisfaction, and record review form was used to gather data from referral paper and feedback paper for the process part at the study period. Study participants were selected using the systematic sampling technique every kth value. Collected data were entered using epi info version 7 .2.0.1. Data were also cleaned and analyzed using SPSS version 25. Descriptive and, binary logistic regression was performed using SPSS version 25. Result: The response rate was 98.5%. Half (50%) of Health Centers had referral registry form, 22% of patients were provided ambulance, 63.6 % of patients were referred with referral paper and none of the health centers had a focal person (liaison). Concerning referral papers, 17 % of them were good in quality. Feedback to health centers was sent for 15% of referral; of those feedbacks 35 % were good in quality. Patient satisfaction was 47 % and there were no statically significant socio-demographic factors. Conclusion and recommendation: the quality of a referral system of Health Centers was poor. It needed to be strengthened by selecting a focal person at Health Centers, availing registry form and referral papers to health centers, and by strengthening feedback mechanism. Further study will be also helpful to assess the predictor of poor quality of referral system.
Assessment of Service Quality and Satisfaction of Cervical Cancer Screening Recipients in Addis Ababa, Ethiopia, 2020.
(Addis Abeba University, 2020-12) Kumera, Matewos; Haileselassie, Warrisaw(MPH, PhD Candidate)
Background: Cervical cancer is the easiest gynecologic cancer to prevent with regular screening tests and follow-up. It is also highly curable when detected and treated early. For this quality screening service that can address the demands of clients will be of paramount importance for all women particularly those with age greater than 30 years are at risk for cervical. Objective: To assess service quality and client satisfaction towards cervical cancer screening, in Addis Ababa Ethiopia, 2020. Methods: Descriptive cross-sectional study was conducted using both quantitative and qualitative method, to assess quality of cervical cancer screening and client satisfaction. A facility based descriptive cross-sectional study design was used to assess service quality and client satisfaction towards cervical cancer screening. Data was collected by using a questionnaire developed based on Avedis Donabedian model that provides a framework for evaluating quality of health care and examining client satisfaction. The data collection instruments was coded and checked before entry. Health facilities were stratified on the basis of their geographical location, after which a simple random sampling technique was used. The sample size was determined manually for each specific objective using a single population proportion formula, the total sample size was 421 for quantitative study. Purposive sampling technique was used for a qualitative study and data were ultimately collected from 9 (nine) independent health facilities (Health care providers). Result: From 260 (62%) participant who were satisfied of cervical cancer screening service, 204(39.23%) were between age group of 30-49 years, 38 (7.31%) age of ≤29, and the rest 18 (3.46%)were ≥ 50 years old. Regarding the level of support from direct care giver 284 (67.5) of participants were very satisfied. Concerning the collaboration level of entire workers in the health care institution 252 (59.9) were very satisfied. In the majority of health facilities, the quality of cervical cancer screening services has been low. Conclusions: The present study found that more than half or 62% of cervical cancer screening recipients were satisfied with the overall service delivery. There is a good improvement in the satisfaction rate of the recipient of the service, but overall satisfaction of the cervical cancer screening service was lowest. This study shows that the quality of service at the cervical cancer screening center was low. The reasons for poor quality of service were lack of motivation on the part of health personnel, lack of effective follow-up and transparency on the part of the government, lack of willingness on the part of management to provide opportunities and motivate staff, lack of consistent quality assessment measures.This low standard has an impact on the use of the service.
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.
Assessment of Tobacco and Alcohol Images in Amharic Movie in Addis Ababa, Ethiopia
(Addis Abeba University, 2019-06) Alemayehu, Bedilu; Asefa, Demeke(MD., MA); Adugna, Zelalem (Msc.); Getachew, Sofonias(MPH)
Background: Tobacco and alcohol use are the most known addictive habit all over the world.These substances are the known cause of or predispose to several diseases mainly cancers. The uses of these substances are now spreading in Africa and Asia and it has emerged as the major public health problem in developing countries. Smoking among the youth has emerged as the new social and health problem. Generally, the school going adolescents in these countries are at risk of smoking cigarette. Alcohol is the most prominent substance and drinking alcohol was predominantly presented as normal social activity. The reasons for alcohol use were prosocial,although aminority were related to alcohol dependant and crisis manegmant.Mostly Direct advertisement is banned in almost all World Health Organization countries except seven. Television shows, movies, internet, magazines, music videos and other entertainment media can impact tobacco and alcohol use both positively and negatively. Perhaps the most intensively studied medium is cinema. Objective: This study aims to assess the tobacco and alcohol images, in Amharic video films in Addis Ababa, Ethiopia. Method: Ten minute descriptive content analysis. Ten minute interval content analysis of tobacco and alcohol use verbal, text and imagery information on the top 30 Amharic video films released on cinema and uploaded in you tube channel from January 1 2018 to December 31 2018 was conducted in Addis Ababa the Data was collected by using film editors who have no interest of conflict with the investegated films and quantified the images of tobacco in each film in 10 minute intervals and by assessing the legal documents of Ethiopian media proclamations, and also the government proclamations of alcohol and tobacco control. RESULT: Of the 30 films investigated, 771 frequency of alcohol and tobacco images have occurred in which 630 (81.8%) contained at least one reference to alcohol, and 141 (18.2%) contained at least one type of tobacco image appearance. And the other result of this investigation show that user of the alcohol and tobacco were the main characters 427 (55.4%), co-characters 260 (33.7%) and supportive characters 84 (10.9%). The types of tobacco types viewed were cigarette 105 (75%), Shisha 16 (11.4) and others 19 (13.6%). The brand of tobacco that appeared was Niyala 10 (55.6%). Marlboro 8 (44.4%) and The type of alcohols used Beer 210 (41.3%), whiskey 89(17.5), wine 59 (11.6%), areque 29 (5.7), and unknown 61(12%) has been viewed. Conclusion: Movies contribute to indirect tobacco and alcohol use promotion, FMOH and EFDA (Ethiopian Food and Drug Administration) with all relevant stakeholders should restrict tobacco and alcohol related information in films to prevent the youth from tobacco use exposure.
Assessment of Utilization of Routine Health Information for Pharmaceutical Procurement and Associated factors in Public Hospitals in Gamo and Gofa zone,SNNPR,Ethiopia.
(Addis Abeba University, 2021-02) Bassa, Bereket; Addissie, Mesfin (MD, MPH); H/Silassie, Worissaw (MPH, PhD candidate)
Background: Availability of pharmaceuticals is a major issue in health care logistics as they play a critical role in improving delivery of health care services as well as gaining trust of clients. Utilizing routine health information is a mechanism that helps to achieve universal healthcare coverage by ensuring availability of essential pharmaceuticals by avoiding wastage and shortages. Objective: To assess utilization of routine health information for pharmaceutical procurement and associated factors in public hospitals in Gamo and Gofa zone, SNNPR, Ethiopia, 2020. Methods: Institution based cross-section study design using quantitative method was conducted in Gamo and Gofa zone public hospitals. By using simple random sampling method, 272 respondents were selected from simple randomly selected five public hospitals (two general and three district) and one Ethiopia pharmaceutical supply agency Arba Minch branch Structured selfadministered questionnaire was used after giving training for data collectors.The supervisor and data collectors were trained health information technician in each hospital. The collected data were checked for its completeness and consistency, then entered into Epi.Data 3.1 and exported to SPSS version 20 for further analysis. Result: Among the respondents, 192 (72.2%) were males and 112 (42.1%) respondents were pharmacy professionals. 186 (66.9%) were claimed to utilize routine health information and among those using routine health information, 130(69.9%) were uses the information for pharmaceutical procurement. In binary logistic regression analysis of utilization of routine health information for pharmaceutical procurement is statistically significant with variables (p-value<0.05, CI 95% and 0.05 margin of error) monitoring pharmaceutical procurement process, evaluation of pharmaceutical procurement, pharmaceutical procurement based on Ethiopia essential drug list, provision of training for pharmaceutical procurement committee and suppliers deliver right pharmaceutical at right time. Conclusion and recommendation The study revealed that 69.9% used routine health information for pharmaceutical procurement, 70.7% pharmaceutical procurement were transparent and 51% of the reason for stock out was lack of integration of routine health information unit with pharmacy unit. Routine health information utilization for pharmaceutical procurement affected by different factors, 31.6% were lack motivation, 39.1% of procurement were not according to standards and regulation of federal minister of health. Federal minister of health, regional health bureau, and zonal health department strengthen monitoring and evaluating routine health information utilization for pharmaceutical procurement. The public hospitals encourage sock rotation and inventory management.
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.
Awareness and Adherence to Health Care Facility standards among Health Workers in Private Medium Clinics in Addis Ababa, Ethiopia.
(Addis Abeba University, 2019) Gudina, Ashebir; Nega, Adiama(MPH); Addissie, Mesfin (MD,MPH)
Background: Health workers adherence to health care facility standards are complicated processes. So when health professionals comply with standards, they must first become aware of the standards, then intellectually agree with them, and then decide to adopt them in the care they provide, then regularly adhere to them at appropriate times.. Health workers can simply not be familiar with standards because they have not been communicated clearly. Commonly, providers are aware of standards but may hold beliefs or attitudes that inhibit them from adhering to standards.Nevertheless,evidence on awareness and adherence to healthcare facility standards among health workers working in private health facility in low income countries is poor. Objectives:The aim of this study was to assess level of awareness and adherence to healthcare facility standards among health workers in selected private medium clinics in Addis Ababa. Methods:A Facility based cross-sectional descriptive study design was used to conduct the study and the study units were selected using simple random sampling technique. Descriptive statistics including frequencies and percent were used in order to summarize variables. To determine the association between each variable binary logistic regression model was used and variables with p-value less than 0.05 were considered as statistically significant. OR and CI was used to see the strength of the association between the independent variables and awareness and adherence. Result; A total of 250 participants were included in the study which makes the response rate 89.6% with mean age of 26.82 years. The majority which 62.8% of them were female, 67.2 % were heard about Ethiopian medium clinic standards, even though 98.4% of them had no on job trainings onit. Further, 22.4% and 44.8% of the study participants had good level of awareness and adherence respectively. Factors such as being the age interval of 21-25 years (AOR 0.19, 95%CI (0.06, 0.60))and 26-30 years of old (AOR 0.06, 95% CI (0.01, 0.32)) had statistical significance association with level of adherence as compared to 20 years and below age group. But not participated in informing about Ethiopian medium clinic standard (AOR 1017.49, 95% CI (35.99, 28768.10)) was the only variable which had statistically significant association with level of awareness. Conclusion and recommendation; the current study result indicated that almost more than half of participants had poor level of awareness and adherence toward Ethiopian medium clinic standards.Therefore, providing continuous pre-recruitment and on job educational training on Ethiopian medium clinic standared by the health institutions is essential.
Constructing a Predictive Model for Occurrence of Tuberculosis: The Case of Menelik II Hospital and St. Peters TB Specialized Hospital.
(Addis Ababa University, 2013-05) Mulugeta, Teketel; Yifru, Martha(PhD); Betre, Mulugeta (MD, MPH)
ABSTRACT Background: Tuberculosis is a disease of poverty affecting mostly young adults in their most productive years. In Ethiopia, TB is a disease of major public health problem. Early identification and isolation of TB cases is critical to prevent further transmission, morbidity and mortality caused by TB. Data mining has a potential to indentify hidden knowledge from huge datasets. It is possible to use data mining algorithms for analysis and predicting the TB status ofpatients. Objective: The goal of this research was to apply data mining techniques for predicting the TB status of patients. Specifically, identify the determinant attributes of TB status of patients, build best prediction model and finally develop a prototype graphical user interface. Methodology: A hybrid data mining process model that involved six steps is followed. This study considers a total of 10,031 records from Menelik II and St. Peters TB specialized hospitals patients’ data and 15 attributes for predicting the TB status. Descriptive data analysis,visualization and statistical summary were implemented to gain understanding of the data. Handling of missing values and data transformation were done to prepare the dataset for experimentation. The mining algorithms used are decision tree, naïve bayes, support vector machine and artificial neural network. To evaluate the models performance 10-fold cross validation and confusion matrix are used. Results: The result of the experiments with all and selected attributes showed that performance of J48, Sequential minimal optimization and Multilayer perceptron were better with all attributes than best selected attributes, whereas naïve bayes classifier performance increased with selected attributes than all attributes. The results of the experiments show the performance of mining algorithms decreases as the amount of training increases. The best selected model to predict the TB status of patients in this study was generated by J48 decision tree with all attributes. The accuracy of this model is 95.24%. Graphical user interface prototype was designed using the ten rules from J48 decision tree. Conclusion: The results achieved from this research indicate that data mining is useful in bringing relevant information from large and complex patients’ dataset, and we can use this information for predicting TB status and decision making. The most important attributes that determine the TB status of the patients are shortness of breath, chest pain, cough, weight loss,loss of appetite, night sweats and HIV test results.

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