Hospital and Health Care Administration
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Item Assessment of Occupational Exposure to Lead and Associated Factors among Workers in City Bus Garage in Addis Ababa, Ethiopia: a Comparative Cross-Sectional Study(Addis Ababa university, 2023-12-09) Tesema Merihatsidik; Kumie AberaOne of the most unusable chemical exposures that occurred in automotive garage areas was lead. Occupational exposure of garage workers to lead dust commonly poses acute and chronic health risks that can be prevented. In Ethiopia, there have been limited studies on lead exposure among garage workers. Moreover, it overemphasized that workers are more exposed than non-garage workers to lead exposureItem Assessment the Prevalence of Work Related Musculoskeletal Disorders and Associated Factors Among Coffee Processing Factory Workers in Addis Ababa City And Gelan- Sub City, Shagger City Oromia, Ethiopia.(Addis Ababa university, 2023-12-11) Legesse Getahun; Abegaze TeferiGlobally, work-related musculoskeletal disorders (WRMSDs) account for around 40% of the total compensated cost of occupational diseases and injuries. It has a huge impact on the public health problems and economic loss of the society. The extent and risk factors for musculoskeletal diseases associated with job among coffee processors have not been examined by researchers. The labor-intensive nature of the coffee processing industry puts employees at risk for musculoskeletal disorders. Objective: The study aimed to assess the prevalence and associated factors of work-relatedItem Validation of The Amharic Version of The Summary of Diabetes Self-Care Activity Scale Among Diabetes Patients in Addis Ababa Public Hospitals, a, Ethiopia(Addis Ababa university, 2023-12-21) Gashu Molla; Seid YimerMeasuring what it tends to measure makes a tool powerful and useful for decision-making. As the Amharic version summary of diabetes self care activity scale (SDSCA) construct doesn’t yet validated, there is an urgent need of validation of the tool for research and clinical practice purpose. This study aims to validate the Amharic version of the summary of the diabetes self-care activity scale (SDSCA) among diabetes mellitus patients in Addis Ababa public hospitals, AA, Ethiopia.Item Predictor of Gestation Weight Gain in Butajira,Ethiopia Community Basid Retrospective Study(Addis Ababa university, 2023-01-29) Getahun Eset; Shikur BilalGestational weight gain (GWG) can be defined as the amount of weight gain between conception and just before the birth of the infant; it is a unique and complex biological phenomenon that supports the functions of growth and development of the fetus (1). Gestational weight gain has been regarded as an indicator of maternal and fetal wellbeing (2). It comprises product of conception including the fetus, placenta and amniotic fluid comprise approximately 35% of total GWG, changes in maternal tissues uterus, breast, blood and to a similar extent, liver and intestinal mucosa), and changes in body composition with a significant increase in total body water, subcutaneous fat and protein reservesItem Assessment of Factors for Hiv Virologic Treatment Failure among Adult Patients on First-Line Art at Public Hospitals in Addis Ababa, Ethiopia(Addis Ababa university, 2022-10-17) Terefe Tizita; Addise MesfinCurrently treatment for HIV is sought to improve quality of life in HIV infected people by decreasing opportunistic infections, reducing disease progression to AIDS, and preventable deaths. Thus, knowing factors for virologic treatment failure is of a key importance in the treatment of HIV.Item Determinants of Survival, Survival time and Recurrence After Surgery among Colon Cancer Patients at Tikur Anbessa Hospital, Addis Ababa , Ethiopia , Retrospective Cohort Study(Addis Ababa university, 2023-10-23) Teklewold Sara; Getachew SefoniasColon cancer is cancer of the large intestine that originates from the colonic epithelial cells that line the lumen of the intestine. It is the fourth most common and fatal cancer worldwide. Globally there were nearly 1.2 million incident cases and over half a million deaths from colon cancer in 2020. In Ethiopia colon cancer is the 5th leading cause of death. Lack of timely seeking of medical help and organized screening practice for early identification of diseases combined with lack of access to curative and palliative care has become reasons for the high burden of premature death in the country. Understanding the survival time and determinants of survival is crucial in developing effective strategies to improve patient outcomes and reduce mortality rates in this settingItem Determinants of Survival, Survival time and Recurrence After Surgery among Colon Cancer Patients at Tikur Anbessa Hospital, Addis Ababa , Ethiopia , Retrospective Cohort Study(Addis Ababa university, 2023-04-11) Teklewold Sara; Getachew SefoniasColon cancer is cancer of the large intestine that originates from the colonic epithelial cells that line the lumen of the intestine. It is the fourth most common and fatal cancer worldwide. Globally there were nearly 1.2 million incident cases and over half a million deaths from colon cancer in 2020. In Ethiopia colon cancer is the 5th leading cause of death. Lack of timely seeking of medical help and organized screening practice for early identification of diseases combined with lack of access to curative and palliative care has become reasons for the high burden of premature death in the country. Understanding the survival time and determinants of survival is crucial in developing effective strategies to improve patient outcomes and reduce mortality rates in this settingItem Hesitancy in Human Papilloma Virus Vaccine uptake and its Associated Factors among Female Students in Jimma town, Oromia, Ethiopia(Addis Ababa university, 2023-10-09) Dera Meron; Gashaw ZeytuThe human papillomavirus (HPV) vaccination strengthens the body's defenses against the viral strains that cause cervical cancer. It has contributed to a reduction in cervical cancer-related morbidity and mortality, which is one of the great public-health success stories. Despite the fact that vaccination reluctance is one of the world's top ten health challenges, there is a shortage of evidence in Ethiopia to completely understand vaccination-related hesitancy behavior. The primary objective of this thesis was to assess hesitancy of HPV vaccine uptake and associated factors among female students, in Jimma Town, Oromia, EthiopiaItem Assessment of Long-Acting Reversible Contraceptive Methods use in Extended Postpartum Period among Women in Debre-Libanos District, North Shewa Zone, Oromia Region, Ethiopia, 2023(Addis Ababa university, 2023-06-15) Derbe Salsawit; Assegid MeselechThe first 12 month following delivery are known as the extended postpartum period, which is effective way for lowering maternal and child morbidity and mortality by preventing unplanned pregnancy and maximizing the birth space. The most effective method of birth control for preventing unwanted pregnancy during postpartum period is long-acting reversible contraceptive. Despite the efforts to increase the use of modern contraceptives, particularly long-acting reversible contraception in extended postpartum period has still low uptake in Ethiopia.Item Duration of Breastfeeding and Dental Carries among Young Children in Selected Health Facilities of Addis Ababa, Ethiopia(Addis Ababa university, 2023-06-11) Yemane Marta; Darge TeferaBreastfeeding has many health benefits for infants, including protection against dental caries. However, the effect of breastfeeding duration on caries risk is unclear, as different studies have found different results. This may depend on multifactorial risk factors of dental caries such as biological, behavioral and socioeconomic factors. However, there is limited evidence on the magnitude and the association between duration of breastfeeding and dental caries among children aged 12 to 36 months in Addis Ababa, Ethiopia.Item Quality of Antenatal Care Services and Factors Influencing Maternal Satisfaction in Public Health Facilities of Wolkite Town, Gurage Zone, Southern Ethiopia(Addis Ababa University, 2023-06-23) Cheru Temesgen; Ababi Zergaw(Dr.)Although antenatal care (ANC) coverage in Ethiopia is increasing, the quality of ANC remains low. It is believed that increasing number ANC contact by itself is not enough to change current maternal health status and that the quality of ANC service can have important impact in the heath of mothers and new born. Objective: To assess quality of antenatal care services and factors influencing maternal satisfaction in Wolkite town public health facilities Methods: The study was carried out in Wolkite town the administrative center of the Gurage zone located 155 km west of capital city of the country, Addis Ababa. A facility-based cross sectional study design was conducted. The study populations were all pregnant women who attended the service in data collection period. Sample size was 409. A pretested structured questionnaire was used. Data entry, coding, cleaning was done by Epi-Info and the analysis was done by using SPSS version 26. Binomial and multinomial logistic regression analyses were conducted to examine the association between the socio-demographic, obstetric factors, process aspects of quality and maternal satisfaction. Ethical clearance was taken from the school of Public Health of Addis Ababa University research ethics committee Result: Out of 409 sampled pregnant women attending ANC clinic 398 (97.3%) were responded. About 48% % of respondent were satisfied with ANC services. Residence (AOR = 5.839 95% CI 3.175, 10.739), pregnancy status (AOR = 6.216 95% CI 2.943, 13.127), frequency of ANC visit (AOR = 1.804 95% CI 1.056, 3.082), counseling on nutrition (AOR = 2.875 95% CI 1.709, 4.835), prevention of mother to child transmission (PMTCT) of HIV(AOR = 2.337 95% CI 1.427, 3.827) and birth preparedness and complication readiness (BPCR) (AOR = 2.426 95% CI 1.341, 4.389)and provision of iron (AOR= 2.816 95% CI 1.249, 6.350) had an association with maternal satisfaction. Conclusion: Generally, maternal satisfaction with antenatal care services in this study was low. Absence of clean latrine & adequate water supply was the main reason stated by respondents. Effort should be made to improve accessibility of safe and potable water supplyItem Quality of Intrapartum and New Born Care in Public Health Care Facilities of Wolkite Town, Southern Ethiopia(Addis Ababa University, 2023-06-17) Berhanu Semra; Mesfin AddisseEven though, the world has made significant progress in reducing maternal and newborn mortality today, there are still far too many preventable and treatable maternal and newborn deaths globally. It is estimated that about six out of ten newborn problems and fifty percent of maternal mortality in developing countries are due to poor quality of care. However,in Ethiopia study on quality of intrapartum and newborn care is limited. Thus, the purpose of this study was to assess the quality of intrapartum and newborn care in public health facilities of Wolkite town in terms of three quality dimensions. Objectives: To assess the level of quality of intrapartum and newborn care in public health facilities of Welkite town, Southern Ethiopia, 2023. Methods: A facility-based cross-sectional study design was employed from March to April 2023 in 5 public health facilities for facility audit, among 342 mothers for exit interview and 185 mothers for observation. Consecutive random sampling method was applied. Data were collected by using document review, observation, and exit interview. Data was entered, coded and cleaned using Epidata version 4 and exported to Stata version 14 and SPSS version 25 for analysis. Descriptive and summary statistics were computed. Binary logistic regression was performed and variables which had p-values of ≤0.25 were selected and included in multivariable logistic regression analysis. Finally adjusted odds ratios with 95% confidence intervals and p-values < 0.05 were considered significant independent predictors of quality of intrapartum care. Result: The study revealed that the quality of intrapartum care in input and process components were 60% and 35.1% respectively. While, the quality of output as measured by maternal satisfaction was 42%, and 69.7% of newborns received good quality of care. Maternal education (AOR: 9.97, 95%CI: 1.52, 25.56), ANC visit (AOR: 6.32, 95%CI: 2.86, 14.00), transportation (AOR: 0.26, 95%CI: 0.15, 0.48) and process quality (AOR: 2.32, 95%CI: 1.27, 4.24) were independent predictors of maternal satisfaction with quality of intrapartum care. Conclusion and Recommendations: The quality of intrapartum and newborn care in the study area was minimal. Thus, efforts should be made by the government for improving facilities capacity and performance of health care providers in order to improve the quality of intrapartum and newborn care.Item Health Professionals‘ Psychological Distress and Associated Factors in the Post-Pandemic period of COVID-19 At Eka Kotebe General Hospital, Addis Ababa, Ethiopia(Addis Ababa University, 2023-06-21) Amira Kasim; Salle WorknehHumanity has battled a variety of pandemics. The Plague, Cholera, and Influenza are the most well-known of these pandemics and have caused the greatest number of fatalities. Now adays COVID-19 Is a global threat affecting all aspects of human life. Globally, the Pandemic affected how individuals‘ function, reorganizing professional work, requiring people to adjust to the constraints in place and limiting their ability to contact their loved once. Studies on this new pandemic have discovered that psychological distress in healthcare workers, such as anxiety, sadness, somatic discomfort, and burnout were experienced during the outbreak of the disease. However, the majority of studies have been done during the outbreak phase, while little has been done on job stress and psychological adaptability in healthcare personnel during the post-pandemic period. Objective: To assess Health Professionals‘ Psychological Distress and Associated Factors in the Post Pandemic period of COVID-19 at Eka Kotebe General Hospital, Addis Ababa, Ethiopia 2023. Methods: Institutional based cross-sectional study was done at EKGH. A sample of 416health professionals was included in this study using stratified simple random sampling technique. Self-administered questionnaire was used to collect information. After proper coding, data was entered into SPSS V.27 software. To evaluate the demographic traits and the trends in the concentration of the key variables, descriptive statistics were used. Multivariable logistic regression analyses were used to evaluate the significance of the association at P-value < 0.05. Result: 10.3% of the individuals reported experiencing psychological distress according to the IES-R scale. The two levels of psychological distress that the participants experienced the most frequently were mild (53.6%) and moderate (33.7%). The results of the multivariate logistic regression analysis showed that professionals with current medical illness (AOR= 4.9; 95%CI 2.39 to 10.2) and current substance users (AOR=3.8; 95% CI; 1.9 to 7.9) have statistically significant relationship with psychological distress. Conclusion: The findings of the current study confirmed the presence of psychological distress in the epidemic era and the concept that clinical circumstances like medical illness and current substance use affect health professionals' psychological distress as well as their ability to anticipate psychological distress during the post-pandemic period of COVID 19.Item Capstone Project on Reducing High Stock out of Medication in Kuyu General Hospital ,Kuyu Woreda,Oromia Region, Ethiopia.(Addis Abeba University, 2020-03) Kebede, Nugusie; D, Anagaw(PhD); Hailesellasie, WarrisawBackground: Shortages and stock outs of essential medicines have been increasing and become a global problem. High stock out of medication in public hospital specially has high impacts on delivering health care services and reduces the community satisfaction on health services given by the public facilities. Drug stock outs cause unplanned treatmentinterruptions. Further, repeated drug stock outs interrupt treatment which causes treatment discontinuity, and if not controlled could lead to drug resistance and/or treatment failure. Objective: To improve availability of essential medication in Kuyu General Hospital from 64% to 85% by the end of June 2020. Methods: Pre-post intervention study was used to identify the percentage of essential medication available in Kuyu general hospital and factors contributing to stock out of medication in the hospital. During pre-intervention the percentage of medication stock out in the last three months was assessed from the documents and intervention strategies were developed to improve the stock out of medication in the hospital. Strengthen DTC committee by onsite training, preparing bin card for medication and ABC-VEN reconciliation for pharmaceutical in the hospital are strategic intervention that was implemented. Pre intervention assessment was done from Dec 25 2019 to February 15 2020 and post intervention assessment was done from March 2020 to June 2020.Data were analysed using frequencies and percentages were estimated and the results were presented using tables and figures. Result: Availability of medication in Kuyu General Hospital increased from 64% during pre-intervention to 80% after intervention. Bin cards were prepared for 83.33% of item and updated for 67% of item during pre-intervention and prepared for all item assessed and update for 93.33% of item after intervention. From ABC-VEN matrix analysis done 10.91% of items consumes 65.10% of hospital budget. Vital items took 46.20% of items procured. Conclusion: Strengthening DTC committee activity by providing training and using stock management tools such as bin cards properly can reduce medication stock out in the hospital. Recommendation: DTC committee, Hospital management and pharmacy staff should work closely to continuously improve availability of medication in the hospital.Item Improving Ethical Practice at Neonatal Intensive Care Unit in Buee Primary Hospital.(Addis Abeba University, 2020-05) Alemayehu, Hiwot; Addise, Mesfine(Ass. Prof.); Nega, Adiam(MPH)Abstract Introduction: Ethics is defined as a moral philosophy or code of morals practiced by a person or group of people.There agreed ethical principles are autonomy, beneficence, non-maleficence, and justice, which are widely accepted in the neonatal practice. However, within the context of diverse values, beliefs and interests’ fundamental variations exist and they hugely influence the plans of new born management. There is limited information in Ethiopia regarding the practice of these ethical principles. The ethical principles of new born care are not clearly stated and not applied well by NICU staffs, in Buee Primary Hospital (BPH). The parents are not part of decision making and treatment of choice. Objectives: The objective of the project is to improve the practice of ethical principles at NICU in Buee Primary Hospital. Methods: Pre-post interventional study and descriptive qualitative approach was conducted to explore the practice of ethical principles at NICU in Buee Primary Hospital. The study populations are all health professionals working in the hospital. Key informant interview guide was conducted face to face by the investigator. The recorded audio note interviews were transcribed, and analyzed thematically using open code software version 4.2. Result: In the pre-intervention we conducted observation, document review and discussion to verify the root cause of the problem. In the- post intervention we developed implementation plan and the health professionals started to implement the plan. During this period, we evaluated the problem whether it has improved or not.Qualitative finding: The key informant interviews indicated gaps in the practice of ethical principles in NICU. The results of the selected strategies showed a significant improvement on the practice of low ethical principles in the unit.This was objectively measured using the observational checklist from 27% to 80% during the evaluation period of pre and post intervention. Conclusion and Recommendation: The results of this project suggested that a simple set of intervention was effective on improving the practice of ethical principles.The finding also proved the effectiveness of selected strategies, but it will be better to implement in a large scale in the hospital.Item Improving Outpatient and Inpatient Medical Recording Data Quality in Yerer General Hospital,2021(Addis Abeba University, 2021-07) Aboye, Hanna; Addise, Mesfin(MD, Ass. Prof.); Ayele, Wondimu(Ph.D.Ass. Prof.); Nega, Adiam(BSc, MPH)Background: Medical recording is an essential part of information use, dissemination,decision making for the health needs of the community health care system and quality service delivery. The medical recording quality is a serious issue to be addressed, especially in Africa which has been measured using different data quality dimensions, and the percentage result is below standard. In Ethiopia, the ministry of health (MoH) has focused on information revolution setting a five-year transformation plan, and has developed tools on a standard of data quality measurement. Those tools are used to measure the medical recording data quality in Yerer General Hospital for selected dimension. Objective: To improve medical recording of outpatient and inpatient data quality in Yerer General Hospital by the end of 2021 EC Method: It is a pre post study, we carried out a pre intervention; with baseline assessment using an infinite sample size calculation and proportional simple random sampling of cards which was admitted to the hospital between end of 2018 to end of 2019 time frame, and post intervention was in 2021 January to measure the improvement. After the intervention, a finite population sample size was used and a proportional random sampling method was applied for those admitted from January 21 to February 21 2021. Result: Training on health management information system was given as an intervention after pre intervention result was observed .pre intervention total completeness of outpatient and inpatient MR was 79.12% and 51.59% respectively. On post intervention result it decreased to 57% and 41% respectively. Pre intervention total accuracy of outpatient and inpatient MR was 63.6% and 55.7% respectively. On post intervention result it increased to 80.73% and 81.67% respectively. The timelessness has improved the cards are returned to the medical recording room in 24 hours after intervention. Conclusion: The intervention has influence on improvement of Total accuracy and timeliness but decrease score of the Total completeness of medical recording in Yerer General Hospital. Recommendation: Continues trainings and follow up are required to strengthen quality department of Yerer General Hospital.Item Improving Referral Feedback in Daye Primary Hospital, Sidama Region, Southern Ethiopia(Addis Abeba University, 2021-07) Tuke, Eshetu; Tassew, Berhanu(Bsc, MPH)Background: Referral is a two way process and ensures that a continuum of care is maintained to patients or clients. Referral system is a process by which a health provider transfers the responsibility of care temporarily or permanently to another health professional or social worker or to the community in response to its inability or limitation to provide the necessary care. It is done from the community to the primary care health service and to hospitals and within hospitals and vice versa. It also involves not only direct patient care but support services such as transport and communication. And once the care is completed, the receiving unit shall return the patient back to referring unit with timely referral feedback. This system is not practiced in Daye primary Hospital and uniformly. The objectives: To improve referral feedback in Daye primary hospital, in Sidama regional state, southern Ethiopia. Method: A pre-post intervention study to patients who were referred to Daye primary Hospital received referral feedback when referred back to the referring unit. A chart audit was conducted to calculate the percentage of completion of referral feedback forms and checklist was prepared to collect the information during chart auditing. The sample size was 62 chart audits referred in during pre intervention and post intervention. The reliability of the items in the check list was tested and revised. During the actual data collection process check the data collectors by randomly taking medical records with the checklist. Ethiopian hospital key performance indicator/KPI/ formula was used to analyses the difference between the pre-post intervention change in percentage the pre-post intervention change in percentage of referral feedback given (KPI 39) . Result: Pre intervention revised documents 62 medical records contained completed referral feedback from upon discharged (0%). A total of 68 referred patients were registered. All patients had referral paper (100). Fifty three of the discharged patient’s documents contained the completed and gave referral feedback forms (77.9%) to refer health facilitiesItem A Pre-Post Interventional Study on Improving the Implementation Status of Nursing/Midwifery Care Standard Practice At Haramya Hospital, Oromia Regional State, Ethiopia(Addis Abeba University, 2020-08) Abdulla, Abdulbasit Aliyi; Asrat, Gashaye (BSc, MPH); Tassew, Birhan(BSc, MPH)Background: The nursing/midwifery care standards help to ensure that patients are receiving high quality care. The standards support implementation of the basics of nurses‟/midwives‟ profession. Despite the importance of nursing care standards, implementation of the standards is lacking in most of the developing countries, including Ethiopia. Similarly, the baseline assessment of nursing standards in this study at Haramaya hospital was poor.Thus, it was critically important to improve the implementation of the Nursing/midwifery care standard practice in Haramaya general hospital. Objectives: To improve the implementation status of Nursing /midwifery Care Standards from 52.5% to 81% in wards of Haramaya Hospital, by the end of August 2020. Method: A facility based pre & post interventional study was conducted from March to August 2020 in Haramaya Hospital. A nationally tested and accepted instrument, the Ethiopian Hospitals Reform Implementation Guideline tool, was used to measure the performance on nursing/midwifery standards of care.The sampled nurses/midwives were allocated proportionally from all wards in the hospital. Data related to factors that hinder implementation of the nursing /midwifery standards was collected consecutively by data collectors using checklist and nursing standards through observational methods. Data quality was controlled through supervision and training of data collectors. Result: Among the total 88 the same respondents (44 before & 44 after), mean age was 27.23 years (SD=4.2) and the implementation status of nursing/midwifery care standards was 52.5% in pre-intervention & 78.4% after-intervention. This change was statistically significant at (df =44,P<0.001). Of the total of 80 patient cards documentation review (before 40 & 40 after intervention) the average implementation status of the standards in nursing/midwifery process & Medication administration record was 10.3 (50%) in pre-intervention & 28.5 (72.3%) after intervention. Conclusion and recommendation: The implementation status of the nursing /midwifery care standard practice is still below the expected criteria and it needs further intervention to increase its utilization. Knowledge, recognition & motivation are possible contributing factors for the improving of nursing/midwifery care standard practices those who are working at medical, surgical, & gynecology wards.Item Medical Equipment Management in Ayder Referral Hospital,Mekelle,Ethiopia.(Addis Abeba University, 2012-04) Mitiku, Mengistu; Addisse, Mesfin(MPH, PHD); Linnander, EricaAbstract Problem statement: In Ayder referral hospital, there is no well-organized system for the management of medical equipment. Objective: The overall objective of the project is to improve medical equipment management by increasing the percentage of EHRIG standards pertaining to medical equipment management met and by increasing medical equipment repaired by the end of April, 2012. Result: The percentage of functional medical equipment showed at improvement from 72(72.7%)to 82(83.8%). Compliance with EHRIG standards for medical equipment management (operational standards met)increased from 3 to 5 out of 9(33.3% to 55.6%). Conclusion: Sustainable provision of trainings on medical equipment operation and handling can result in a significant improvement in medical equipment functionality. Moreover, establishing medical equipment maintenance work agreements has a great impact in the management of medical equipment and also adherence to the Ethiopian hospitals reform implementation guideline can bring about improved management of medical equipment in health facilities. Recommendation: Full implementation of the Ethiopian hospitals reform implementation guideline strategies should be made and it is better to establish medical equipment maintenance work agreements with experienced companies.Item Tracer Drugs Stock Out in Durame Hospital SNNPR Ethiopia(Addis Abeba University, 2012-05) Adinew, Eshetu; Kumie, Abera( Dr. ); Mantopoulo, JeannieIntroduction: Although availability of tracer drugs was the most important objectives of national drug policy, the unavailability of tracer drugs remains to be a major problem for poor countries. Objective: Toimproved tracer drugs availability in the Durame hospital drug stores Design: Pre–post intervention study during August 2011 to March 2012, using tracer drug stock out registration form and physician inventory. Setting: Durame Primary hospital in Ethiopia. Participants: Pharmacist and pharmacy technicians, hospital administrator (CEO), clinical staff and DTC members. Implementation: The intervention included the following components:(1) Developing tracer drug monitoring form (2) enhanced DTC training on drug management, (3) Improving drug procurement, and (4) Improving communication between Pharmacy staff and Physicians. Communication is the most important to provide quality of health care for the client. The work plan progresses of implementation were monitored by check list. Main Outcome Measure: We measured tracer drugs stock out and availability. The tracer drugs stock out rate reduced significantly from 167 stock out days (34%) to 31 (6%) (P, <0.02) based on pre- and post-intervention comparisons. Lessons Learned: Our findings indicate that a well-organized tracer drugs monitoring management system should be effective in improving patient outcome in hospitals in low-income countries despite the lack of resources.Longer follow-up is required to assess the sustainability of the hospital improvements accomplished.
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