Zelalem Tilahun Mekonen

Response to Letter in regards to Logistics Management Information System (LMIS) for Health Commodities at Public Health Facilities in Amhara National Regional State of Ethiopia: A Data Quality Evaluation Survey [Letter]

Introduction: Ensuring equitable access to essential medicines is a major global health challenge, particularly in low- and middle-income countries. Effective supply chain management and Logistics Management Information Systems (LMIS) are crucial for addressing these challenges. Despite substantial efforts, significant LMIS implementation issues continue, especially in Ethiopia.Objectives: The study aimed to evaluate the performance of health commodities logistics management information systems at public health facilities in the Amhara Region, Ethiopia.Methods: The study conducted in public health facilities of the Amhara region in Ethiopia used a quantitative methods approach. The region is supplied by four Ethiopian Pharmaceutical Supply Service hubs. A total of 102 facilities, selected through stratified random sampling, were included in the study. Data were collected through record review and and observation using data abstraction checklists to evaluate the LMIS forms availability, utilization, supply, and report timeliness.Results: Infrastructure challenges were noted, including inconsistent power supply and limited internet access, with only 42.2% having internet connectivity. LMIS performance varied, with high availability and utilization of forms like the IFRR and RRF but lower rates for some forms and digital systems. Reporting and feedback mechanisms were generally adequate, though only 37.3% of facilities received periodic written feedback from higher levels of the healthcare system.Conclusion and recommendation: The evaluation of the LMIS in Amhara Region’s public health facilities shows notable achievements in the widespread use of LMIS forms and reporting systems. However, ongoing challenges such as unreliable infrastructure, poor internet connectivity, and insufficient human resources impede effective LMIS performance. Addressing these issues, digitalization of the LMIS, strengthening feedback mechanisms, and supervisory support will enhance LMIS performance and improve health outcomes.

The healthcare supply chain relies on real-time logistics Management Information System (LMIS). Despite Ethiopia’s adoption of a digital LMIS in 2009, ongoing evaluation of software, infrastructure, and sustainability remains essential for improving performance from users’ and health system’s perspectives. The study aimed to evaluate the performance of the facility version of digital LMIS at public health facilities in the Amhara Region, Ethiopia. An institution-based cross-sectional study was used. Out of 102 surveyed facilities, only 37 implemented the digital LMIS. Data was collected using interviewer-administered questionnaires. Out of 37 facilities using digital LMIS, 28 (75.7%) were functional. The average frequency of use across 27 sub-dashlets was 3.13 ± 0.67 out of 4. End users rated the digital LMIS performance as 3.21 ± 0.43 out of 5 (64.2%). Significant differences in LMIS performance related to organizational support were found due to varying end users’ experience and internet access ( P-value < .05). The digital LMIS performance from end users’ perspective was 64.2%, with significant differences in agreement related to health system and organizational support, influenced by internet access and users’ experience.

Introduction: Access to essential medicines is limited in developing countries mainly due to inefficiencies in health supply chain management, such as the absence of standard monitoring frameworks and poorly designed Logistics Management Information Systems (LMIS). Health supply chain managers need accurate and timely data for decision-making. However, routine health information systems suffer from poor data quality, reliance on paper-based reports, insufficient logistic formats, inadequate infrastructure, and limited human resources. Objective: This study evaluates the data quality of LMIS for health commodities in public health facilities in the Amhara National Regional State of Ethiopia. Methods: The study was conducted in Ethiopia’s Amhara National Regional State. The study employed an institution-based concurrent mixed-methods design. Data collection involved 102 facilities selected through multi-stage stratified random sampling, adhering to sampling criteria set by USAID’s Logistics Indicators Assessment Tool (LIAT). Data abstraction checklists were used to collect data. Results: Of the seven tracer medicines selected to evaluate data quality, there was substantial variability in inventory accuracy rates. Inventory discrepancies were significant, highlighting potential issues with manual and digital record-keeping systems, with overall mean physical and electronic inventory accuracy rates of 74.7% and 70.6%, respectively. Additionally, the Report and Requisition Form (RRF) showed trends of timely submission, with the overall mean percentage completeness for the seven tracer medicines at 90.2%. However, the data quality experienced fluctuations, with the overall average percentage of legality (authorization of LMIS reports) and the accuracy of the RRF at 77.2% and 76%, respectively. Conclusion and Recommendation: The evaluation of data quality revealed significant discrepancies in physical and electronic records, with notable fluctuations in completeness, legality, legibility, and accuracy within the health LMIS. To rectify these issues, robust data quality verification processes, clear guidelines, targeted interventions, strengthened monitoring systems, regular audits, and comprehensive training for health supply chain staff are needed.

Objectives: This study aimed to evaluate the performance of vaccine logistics management information systems at public health facilities in Amhara Region, Ethiopia.Methods: An institution-based concurrent explanatory mixed design was used at public health facilities in Amhara Region, Ethiopia. In total, 102 health facilities were selected using the multi-stage, stratified, random-sampling proportionate-to-size method. Data were collected using a structured data abstraction checklist from vaccine logistics management information system records. Additionally, experiences of Expanded Program for Immunization focal persons were gathered through interviewer-administered questionnaires.Results: Among the 102 health facilities surveyed, 99 (97.1%) provided vaccination services during the study period. On the day of the visit, the average availability and utilization rates of 15 vaccine logistics management information system forms were 44.1% and 40.5%, respectively. The mean inventory accuracy for tracer vaccines stood at 58.3% ± 45.1%. The overall average accuracy percentages for urban and rural vaccine request form reports were 73.4% and 69.6%, respectively.Conclusions: The performance of vaccine logistics management information systems in these public health facilities was suboptimal. Key issues identified include inconsistent use of recording forms, shortages of reporting forms, lack of digitalization, poor data quality, and a shortage of qualified staff. These findings underscore the urgent need for standardization of the vaccine logistics management information system and enhancement of data quality.

Background: The COVID-19 pandemic led to the most substantial health crisis in the 21st Century. This pandemic interrupted the supply of essential commodities for human beings. Among the essential commodities for human survival, disruption of the supply of essential health commodities has become a global concern. Objective: The study aimed to systematically analyze published articles on the challenges, impacts, and prospects of the global health commodities’ supply chain in the era of the COVID-19 pandemic. Methods: A standard searching strategy was conducted in seven research databases to retrieve pertinent articles. Finally, 459 articles were retrieved for further screening, and only 13 articles were selected for final synthesis. Results: Almost 38.5% of the studies targeted the supply chain of health commodities used to treat HIV, TB, and malaria. Lockdown policies, travel restrictions, lack of transportation, low manufacturing capacity, and rising costs were the significant challenges indicated for the supply interruption of essential health commodities and COVID-19 vaccines. Findings indicated that the supply interruption of essential health commodities leads to a devastating impact on global health. Conclusion: Global medicine shortages due to the pandemic crisis can have a devastatingly harmful impact on patient outcomes and might result in a devastatingly long-lasting effect on the health of the world community. Supply-related challenges of the COVID-19 vaccine affect countries’ ambitions for achieving herd immunity quickly. Monitoring the pandemic’s effect on the health commodities’ supply system and designing a short-term and long-term resilient health supply chain system that can cope with current and future health catastrophes is pivotal.

Background: Continuing Professional Development (CPD) in pharmacy is a lifelong learning approach whereby individual pharmacists are responsible for updating and broadening their knowledge, skills, and attitudes. This is vital to ensure the delivery of high-quality patient care services. However, there is a lack of available data revealing the CPD needs of Ethiopian pharmacists. Thus, the objective of this study was to identify CPD training needs of pharmacists practicing in Ethiopia. Methods: An institution-based cross-sectional study design with a quantitative approach was employed in this study. This assessment involved 640 pharmacists representing various sectors of the profession. Data were collected through a combination of an online platform and a face-to-face questionnaire administered in person. Result: A total of 634 participants completed and returned the questionnaires, resulting in an impressive response rate of 99.1%. A significant majority (74.1%) of the participants possessed bachelor’s degree in pharmacy (B. Pharm). Pharmaceutical Logistics and Pharmacy administration was preferentially selected as a prior CPD course by 36% of participants, of them while Pharmacotherapy (17%), Leadership/Governance (13%), Community Pharmacy (12%), Research and Development (11%) were also the subsequent top choices by participants. Off-site face-to-face lectures (59.2%), Hybrid (face-to-face + e-learning) (54.8%), and on-site on-the-job training (45.5%) were the most convenient means of CPD course delivery. On the other hand, the participants least favored print-based or correspondence programs for CPD course delivery. Conclusions: CPD holds great importance in the professional lives of pharmacists. It is critical for pharmacists, CPD providers, and those responsible for accrediting CPD programs to recognize the specific CPD requirements, preferred methods of delivery, and obstacles involved. This understanding is vital for establishing priorities and effectively planning CPD activities. In light of this, our study identified the most preferred CPD training courses and convenient delivery methods for pharmacists in Ethiopia. We recommend that CPD providers and accrediting bodies in Ethiopia refer to our findings when approving CPD courses.

The irrational use of the drugs becomes a worldwide problem than lack of drug information

Optimal chemotherapy management is substandard in low and middle-income countries. We aimed to identify major gaps to design interventional strategies for improved chemotherapy management at Tikur Anbessa Specialized Hospital (TASH), Ethiopia. This study was conducted using an observational checklist, open-ended questions, record review, and key informant interviews of department heads and focal persons at TASH. Findings were categorized into specific themes that developed. Chemotherapy represented 60.2% of the hospital medication budget. Drug utilization was quantified via monthly consumption documentation and forecasting. However, unreliable data resulted in frequent stockouts (unavailability of the item when it is needed) of chemotherapy with only 67.8% availability. Thirteen healthcare personnel (9 nurses, 2 pharmacists and 2 hospital cleaners) were interviewed: all clinical staff but neither of hospital cleaners believed that they were at risk of hazardous agents. Challenges identified included inadequate and frequent stockouts (unavailability of the item when it is needed) of personal protective equipment, lack of standardized guidelines for chemotherapy handling, admixture, and disposal, lack of designated preparation rooms, and lack of training. All nine nurses handled chemotherapy admixtures despite only two nurses previously receiving in-service training. Most of the participants had never witnessed the disposal of anticancer drugs. Prompted by the results of this study, a dialogue was initiated among members of TASH, the American Cancer Society and the University of North Carolina to implement action-oriented projects to address the gaps identified at TASH. These gaps directly and indirectly affect care and treatment outcomes of patients at a large cancer center. Collaborations with well-resourced centers are potential models for improving chemotherapy management.