Arebu Issa Bilal

Background: Ensuring the consistent availability of essential medicines is crucial for effective healthcare systems. However, Ethiopian public health facilities have faced frequent stockouts of crucial medications, highlighting systemic challenges such as inadequate forecasting, prolonged procurement processes, a disjointed distribution system, suboptimal data quality, and a shortage of trained professionals. This study focuses on the Ethiopian Pharmaceutical Supply Services (EPSS), known for its highly unstable and volatile supply chain, aiming to identify risks and mitigation strategies. Methods: Using a mixed-method approach involving surveys and interviews, the research investigates successful and less successful strategies, key success factors, and barriers related to pharmaceutical shortages. Results: Proactive measures such as communication, stock assessment, supervision, and streamlined procurement are emphasized as vital in mitigating disruptions, while reactive strategies like safety stock may lack long-term efficacy. The study highlights the importance of aligning supply chain strategies with product uncertainties, fostering collaboration, and employing flexible designs for resilience. Managerial implications stress the need for responsive structures that integrate data quality, technology, and visibility. Conclusions: This study contributes by exploring proactive and reactive strategies, elucidating key success factors for overcoming shortages in countries with unstable supply chains, and offering actionable steps for enhancing supply chain resilience. Embracing uncertainty and implementing proactive measures can help navigate volatile environments, thereby enhancing competitiveness and sustainability.

This study delves into the challenges of pharmaceutical forecasting within the Ethiopian public pharmaceutical supply chain, which is vital for ensuring medicine availability and optimizing healthcare delivery. t It aims to identify and analyze key hindrances to pharmaceutical forecasting in Ethiopia, employing qualitative analysis through semi-structured interviews with stakeholders. Thematic analysis using NVIVO 14 software reveals challenges including finance-related constraints, workforce shortages, and data quality issues. Financial challenges arise from funding uncertainties, causing delayed procurement and stockouts. Workforce shortages hinder accurate forecasting, while data quality issues result from incomplete and untimely reporting. Recommendations include prioritizing healthcare financing, investing in workforce development, and improving data quality through technological advancements and enhanced coordination among stakeholders.

Clinical pharmacy service has evolved steadily over the past few decades and is now contributing to the ‘patient care journey’ at all stages. It is improving the safety and effectiveness of medicines and has made a significant contribution to the avoidance of medication errors. In Ethiopia, clinical pharmacy service is in its initial phase, being started in July 2013. This study therefore aimed at assessing the status, challenges and way forward of clinical pharmacy service in the country. A cross-sectional survey was conducted in six regional states and one city- administration in September 2014. A total of 51 hospitals were included in the study. Both qualitative and quantitative methods were employed for data collection. A total of 160 pharmacy graduates, and 51 pharmacy heads participated in the study. Internal Medicine and Pediatric wards were the major wards where the graduates provide clinical pharmacy service. Almost 94% of the new graduates were found to be involved in clinical pharmacy service, but 47% of them rated their service as poor. The overall satisfaction of the graduates was close to 36%. Thirteen hospitals discontinued and two hospitals not even initiated the service largely due to shortage of pharmacists and lack of management support. About 44% of the surveyed hospitals documented the clinical pharmacy service provided using either developed or adopted formats. Lack of awareness by the medical fraternity, high attrition rate, lack of support from the management as well as from the health care team, readiness of the graduates to deliver the service, and shortage of pharmacists were identified by the key informants as the major stumbling block to deliver clinical pharmacy service. Clinical pharmacy service is initiated in most of the surveyed hospitals and a large proportion of the graduates were involved in the service. Although there is a great enthusiasm to promote clinical pharmacy service in the surveyed hospitals, efforts made to institutionalize the service is minimal. Thus, concerted efforts need to be exerted to promote the service through organizing awareness forums as well as revisiting the curriculum.

The trend of cosmetics utilization has increased globally; however, the exact amount of usage is not researched well. Lack of population awareness on proper use of cosmetics, particularly in developing countries, causes a prominent health challenge. Therefore, this study was conducted to assess the cosmetics utilization practices in Jigjiga town, Eastern Ethiopia. A community based cross-sectional study, using a semi-structured questionnaire, was used to assess factors associated with cosmetics use. Of the 559 participants, 93% used at least one type of cosmetics in the two weeks prior to the survey. The most commonly used products were body creams and lotions (68%), shampoos and conditioners (35%), and deodorants and perfumes (29%). Being single, female, and in the age group of 18–20 years increased the odds of cosmetics utilization. However, being in primary school and being self-employed showed a less likely use of cosmetics. Two hundred forty-seven (44%) of the interviewed household members reported that they use traditional herbal cosmetics. A higher likelihood of traditional herbal cosmetics use was observed in the age group of 18–20 years. This study indicated that the community in Jigjiga town use different types of cosmetics. Education, occupation, marital status, age, and gender were all important factors that determined the use of cosmetics in the study area.

Introduction Non-medicated cosmetics use is very common among the Ethiopian population. However, little is known about these products’ related adverse events. The aim of this study was to assess the prevalence and determinants of cosmetics-related adverse events among Jigjiga Town residents, Eastern Ethiopia. Methods A community-based cross-sectional study design was conducted in May and June 2014. Semi-structured interviews were used to collect cosmetics use pattern and related adverse events. For assessing determinants, logistic regression was used and statistical significance was set at p < 0.05. Results Overall, 600 participants were approached with a 93% response rate. Ninety-three percent (n = 521) of them reported the use of cosmetics at least once within 2 weeks prior to this study, and of these, 229 (44%) used traditional herbal cosmetics along with modern cosmetics. A total of 342 (61%) reported experiencing adverse events of which the most common reported were: allergic reactions, 149 (36%); the appearance of acne, 66 (16%); and hirsutism, 52 (12.5%). The occurrence of cosmetics-related adverse events were significantly associated with the number of cosmetics used per day, the frequency of use, mixing of different types of cosmetics together, and mixing of cosmetics with water or saliva. Conclusion A higher proportion of cosmetic users reported experiencing at least one adverse event. The number of cosmetic products and frequency of use were important predictors for experiencing adverse events. This implies the need to consider safety concerns related to cosmetic use. Approaches to address such issues may include awareness creation programs and promoting the concept of cosmetovigilance among cosmetic sellers, users, and other stakeholders.

About one-third of the world’s population lack access to essential medicines and this is further compounded by inappropriate prescription, dispensing, sale and use of the available medicines. The objective of the study was to assess the patterns of medicine use among health facilities in eastern Ethiopia using World Health Organization’s Prescribing, Patient Care and Health facility indicators. A cross sectional study was carried out in eight randomly selected health centers and data were collected retrospectively as well as prospectively. Prescribing indicators were assessed retrospectively using 636 prescriptions selected by systematic random sampling technique among prescriptions filled between September 2013 and September 2014. Patient care indicators were assessed prospectively by interviewing 708 patients from the health facilities. Health facilities were assessed through observation. Data were entered and analyzed using Statistical Packages for Social Sciences version 20. P-value less than 0.05 at 95 % confidence interval considered for significance of relationships for associations in statistical tests. The average number of medicines per prescription was 2.2 with standard deviation of 0.8. The proportion of medicines prescribed by generic name was 97 and 92 % of the prescribed medicines were included in List of Essential Medicines for Ethiopia, Prescriptions containing antibiotics and injections constituted (82.5 and 11.2 %) respectively. Of the total of 1426 medicines prescribed, 49.6 % were antibiotics, with amoxicillin (33.3 %) and co-trimoxazole (16.0 %) being the most commonly prescribed agents. The average consultation and dispensing times were 5.6 and 2.7 min, respectively. Among the medicines dispensed, 64.0 % were adequately labeled and the proportion of patients with adequate knowledge about medicines was 69 %. The prescribing and dispensing practices in the health facilities are fairly good and are not that far from the standard WHO requirements. However, there is a need to do more on some issues, including prescribing practice of antibiotics, average number of medicines per prescription, and patients’ dosage form knowledge.