BACKGROUND: Early antenatal care visit is important for optimal care and health outcomes for women and children. In the study area, there is a lack of information about the time to initiation of antenatal care. So, this study aimed to determine the time to initiation of antenatal care visits and its predictors among pregnant women who delivered in Arba Minch town public health facilities.
METHODS: An institution-based retrospective follow-up study was performed among 432 women. A systematic random sampling technique was employed to select the study participants. The Kaplan-Meier survival curve was used to estimate the survival time. A Multivariable Cox proportional hazard regression model was fitted to identify predictors of the time to initiation of antenatal care. An adjusted hazard ratio with a 95% confidence interval was used to assess statistical significance.
RESULTS: The median survival time to antenatal care initiation was 18 weeks (95% CI = (17, 19)). Urban residence (AHR = 2.67; 95% CI = 1.52, 4.71), Tertiary and above level of education of the women (AHR = 1.90; 95% CI = 1.28, 2.81), having pregnancy-related complications in a previous pregnancy (AHR = 1.53; 95% CI = 1.08, 2.16), not having antenatal care for previous pregnancy (AHR = 0.39; 95% CI = 0.21, 0.71) and unplanned pregnancy (AHR = 0.66; 95% CI = 0.48, 0.91) were statistically significant predictors.
CONCLUSIONS: Half of the women initiate their antenatal care visit after 18 weeks of their pregnancy which is not in line with the recommendation of the World Health Organization. Urban residence, tertiary and above level of education of the women, having pregnancy-related complications in a previous pregnancy, not having previous antenatal care visits and unplanned pregnancy were predictors of the time to initiation of antenatal care. Therefore, targeted community outreach programs including educational campaigns regarding antenatal care for women who live in rural areas, who are less educated, and who have no previous antenatal care experience should be provided, and comprehensive family planning services to prevent unplanned pregnancy are needed.

BACKGROUND: The shortage of medicines and medical supplies remains to be a major issue that is facing public health facilities in Tanzania. This situation has been influenced by lack of consistency in the supply chain, increase in healthcare demand, poor regulatory system, insufficient funds, and lack of conducive infrastructure. Formerly, the Government initiatives such as engagement with the Prime Vendor System (PVS) demonstrated great assistance in getting rid of this challenge. Despite the operation of PVS, a recent shortage of medicines and medical supplies has been noticed.
OBJECTIVE: This study aimed to assess the effectiveness of PVS on the availability of medicine and medical supplies in the selected public health facilities in Arusha District Council.
METHODS: The study used a case study design with mixed research approach. The study involved 77 respondents which included 25 health facility in-charges, 50 patients, 1 District Pharmacist and 1 Prime Vendor. Questionnaires, interviews, and observation methods were used to collect data. Data collected covered a period of 2021-2022. Thematic analysis was used to analyze the qualitative data whereas descriptive analysis was used to analyze the quantitative data with the help of Excel and the Statistical Package for Social Sciences (SPSS) version 28.0.
RESULTS: The analysis indicates that PVS is not completely effective in supplying medicines and medical supplies due to its low capacity to conform to the orders placed by the public health facilities, a lack of supply competition, and a failure to adhere to contractual terms. Furthermore, at the time of data collection, the average availability of medicines and medical supplies at the selected public health facilities was 74.8%, while 80% of the selected public health facilities reported having a scarcity of medicines and medical supplies, and 92% of the interviewed patients reported having no full access to medicines.
CONCLUSIONS: Despite the shortcomings associated with the operation of the PVS, the system still seems to be very important for enhancing the availability of medicines and medical supplies once its effectiveness is strengthened. This study recommends a routine monitoring of PVS operations and timely interventions to reinforce an adherence to the contracted terms and improve PVS effectiveness.

UNASSIGNED: Although cervical cancer is the most prevalent cancer in women and has a high morbidity, mortality, and low quality of life burden among human immune virus-positive women, there is little evidence of it in northeastern Ethiopia.
UNASSIGNED: Sought to determine the magnitude and associated factors of cervical cancer screening among human immune virus-positive women in public health facilities in northeastern Ethiopia.
UNASSIGNED: A multicentered, institution-based cross-sectional study with 401 participants using the systematic random sampling technique was employed. The data was gathered through personal interviews and chart reviews. The predictors were established via multivariate logistic regression analysis.
UNASSIGNED: The magnitude of cervical cancer screening was 19.2% (15.7%-22.9%). Multiparity, bad obstetric history, hearing about cervical cancer, recommendations from medical professionals, duration of antiretroviral therapy >10 years, a family record of cervical cancer, and knowing cervical cancer were revealed to be predictors of testing for cervical cancer.
UNASSIGNED: The magnitude of cervical cancer screening was 19.2% (15.7%-22.9%). Multiparity, bad obstetric history, hearing about cervical cancer, recommendations from medical professionals, duration of antiretroviral therapy >10 years, a family record of cervical cancer, and knowing cervical cancer were revealed to be predictors of testing for cervical cancer.

UNASSIGNED: Job satisfaction is essential in stimulating productivity and efficiency in the health sector. Dissatisfied employees are likely to leave, which places an added burden considering the shortage of health workers. Rehabilitation professionals form a critical component of the public health workforce.
UNASSIGNED: The aim of the study was to document the level of job satisfaction and factors associated with job satisfaction among rehabilitation professionals employed in public health facilities in KwaZulu-Natal.
UNASSIGNED: A cross-sectional survey was conducted. A self-administered questionnaire was utilized. A Chi-square test and logistic regression were used to assess associations and to identify factors associated with job satisfaction. A p-value less than 0.05 was deemed statistically significant.
UNASSIGNED: Most participants (59%) reported a low level of overall job satisfaction. The participants were dissatisfied about not getting recognition for work related to their specific professions (61.3 %) and not being considered for career advancement (74.3 %). In addition, inadequate financial rewards (87.2%) and benefits (71.3%) were also linked to low job satisfaction.
UNASSIGNED: Participants displayed a low level of job satisfaction. Rehabilitation services should be prioritized, and appropriate recognition should be granted to rehabilitation professionals in order to enhance job satisfaction.

BACKGROUND: TB remains one of the leading causes of death in Nigeria, and despite progress in treatment coverage, a 56% gap in national case notifications remains. This gap is attributable in part to underdiagnosis due to missed cases in health facilities. The TB Surge intervention presented an opportunity to address barriers to optimal case detection in public health facilities.
METHODS: KNCV Nigeria implemented the TB Surge intervention under the USAID-funded TB-LON Project in 1,041 public facilities from June 2020 to September 2022. Trained ad-hoc staff screened hospital attendees, linked identified presumptive TB cases to diagnosis and confirmed TB cases to treatment. Data were reported using the Commcare application. Robust project monitoring was used to address gaps.
RESULTS: Of a total of 12,195,874 hospital attendees screened for TB, 729,369 identified as presumptive TB were tested and 65,029 TB cases were diagnosed; 8% of the TB cases were children. Overall TB yield was 9%. Medical ward service delivery point had the highest TB yield of 21%. The number needed to test was 11 and the number needed to screen was 188.
CONCLUSIONS: The TB Surge intervention was of strategic importance in addressing missed cases and barriers to prompt TB diagnosis in health facilities.
BACKGROUND: La TB reste l’une des principales causes de décès au Nigeria et, malgré les progrès réalisés en matière de couverture thérapeutique, il subsiste un écart de 56% dans la déclaration des cas à l’échelon national. Cet écart s’explique en partie par le sous-diagnostic dû aux cas manqués dans les centres de santé. L’intervention TB Surge a permis de lever les obstacles à la détection optimale des cas dans les centres de santé publique.
UNASSIGNED: KNCV Nigeria a mis en œuvre l’intervention TB Surge dans le cadre du projet TB-LON financé par l’USAID dans 1 041 centres publics de juin 2020 à septembre 2022. Le personnel ad hoc formé a dépisté les personnes présentes à l’hôpital, lié les cas de TB présomptifs identifiés au diagnostic et les cas de TB confirmés au traitement. Les données ont été communiquées à l’aide de l’application Commcare. Un suivi rigoureux du projet a permis de combler les lacunes.
UNASSIGNED: Sur un total de 12 195 874 patients hospitalisés ayant fait l’objet d’un dépistage de la TB, 729 369 cas présumés de TB ont été testés et 65 029 cas de TB ont été diagnostiqués ; 8% des cas de TB étaient des enfants. Le rendement global de la TB était de 9%. Le point de prestation de services du service médical a enregistré le taux de TB le plus élevé (21%). Le nombre de tests nécessaires était de 11 et le nombre de dépistages nécessaires de 188.
CONCLUSIONS: L’intervention TB Surge a été d’une importance stratégique pour traiter les cas non détectés et les entraves à un diagnostic rapide de la TB dans les centres de santé.

Antenatal care (ANC) is a critical intervention, and providing high-quality care results in positive maternal and neonatal outcomes. A facility-based cross-sectional study design was used among 4 public health facilities in Dessie Town, and 421 pregnant mothers were selected by a systematic random sampling technique. Data were collected using observation and interview through a pretested questionnaire, then entered and analyzed using EpiData 4.7 and SPSS 26. Finally, predictors of the quality of the ANC service were identified using multivariate logistic regression. Overall, 270 women (64%) were satisfied with ANC services in this study. Only 49 (70%) attributes of structural quality and 32 items (69.56%) of process quality attributes were met, which is inadequate and needs improvement. Mothers aged 20 to 24 (AOR = 3.067; 95% CI = 1.416, 6.641); mothers who took 30 min and more to get to the health facility (AOR = 2.745; 95% CI = 1.475, 5.111); mothers who had a choice of care providers (AOR = 2.829; 95% CI = 1.676, 4.777); merchants (AOR = 2.310; 95% CI = 1.077, 4.955); and farmers (AOR = 2.111; 95% CI = 1.138, 3.8) were positive predictors of women\'s satisfaction with ANC services. Although ANC client satisfaction was good, structure-quality attributes and process-related quality were inadequate and needed significant improvement. This implies that urgent interventions are needed to improve process and input quality attributes.

BACKGROUND: Delivery of quality healthcare is significantly based on the level of commitment among health facilities. This includes building a strong system with the continued availability of tracer commodities. Human resources, financing, health information provision, and technologies integrated into the care environment have been vital in defining improved care.
METHODS: This was a cross-sectional study conducted in health facilities in Tana River County. A census method was used where all 62 health facilities across different tiers of healthcare delivery were considered. Out of 62 facilities, 60 participated in the study. A structured questionnaire and a checklist were used to collect data. Data were analysed using both descriptive and inferential statistics at 0.05 level of significance. Statistical Package for Social Sciences version 26 was used for data analysis.
RESULTS: Majority of the participants were nurses (71.7%), male (68.3%), and diploma holders (78.3%). The mean availability of the tracer commodities was 68.73%. The human resource-related factors influencing availability were personnel training on commodity management (β = 4.56, 95%CI 2.29-11.21, p = 0.012) and presence of pharmaceutical technicians dispensing commodities (β = 2.85, 95%CI 1.29-5.21, p = 0.005) Financial factors investigated revealed that those who were in county hospitals (β = 19.11, 95%CI 7.39-30.83, p = 0.002) and facilities which has disbursement of budgetary allocation on time (β = 12.08, 95%CI 3.11-23.57, p = 0.002) had higher availability of tracer commodities.
CONCLUSIONS: There was moderate availability of tracer commodities which was influenced by training, personnel, level of the facility, and budget allocation on time.

UNASSIGNED: The decline in healthcare workforce is a global trend that is alarming in low and middle-income countries (LMIC) in LMIC and many countries worldwide, pharmacists plays critical role in healthcare, many of which are not limited to patient care, research and development, health promotion. However, growing dissatisfaction among pharmacists working in public health facilities has become increasingly common and can have severe public health consequence. Job dissatisfaction ranks among the most significant factors influencing healthcare employees to seek career changes, reduce productivity, and possibly migrate to more promising opportunities, thereby posing a public health threat in the region.\' Furthermore, healthcare professionals are crucial to the functionality of a healthcare system, with human resources standing as a critical element ensuring organizational success vis-a-vis other dependent factors to optimize efficiency and effectiveness.
UNASSIGNED: To examine the job satisfaction of pharmacists working in public health facilities in Nigeria.
UNASSIGNED: A descriptive, cross-sectional study on pharmacists\' job satisfaction was carried out between march and July 2023, to determine the job satisfaction of pharmacists working in primary, secondary, and tertiary healthcare facilities in Nigeria. Data were gathered using an anonymous online validated questionnaire adapted from the Minnesota questionnaire short form and the Job Description Index (JDI) (Measuring Job Satisfaction - Tools, Scales, and Methods).
UNASSIGNED: The study identified an overall low job satisfaction level of 65%. Major influencers included facility conditions, co-worker relations, and remuneration. The demographic data revealed a dominance of female pharmacists in general hospital settings, with a significant proportion aged between 23 and 36 years. Remuneration emerged as a universal concern across different age groups, reflecting Nigeria\'s prevailing economic challenges. Interestingly, satisfaction with the working facility decreased with age, suggesting that enthusiasm and optimism wane over time. Relationship dynamics with co-workers showed positive progression with age, whereas satisfaction with pay remained universally low.
UNASSIGNED: The study underscores the need for a comprehensive strategic review in the health sector, focusing on remuneration, working conditions, and inter-personal relationships to boost job satisfaction and retention. Further research might delve deeper into specific allowances and the impact of home ownership on satisfaction.

UNASSIGNED: In developing countries like Ethiopia, medicines wastage becomes a major healthcare system challenge. However, data that displayed the type, extent, and contributing factors of medicines wastage were limited.
UNASSIGNED: A health facility-based explanatory sequential mixed study was conducted from December 2021 to February 2022. One drug and therapeutics committee (DTC) and one store man per health facility, working during the study period were included for their perception of medicines wastage and possible causes. As key informants, 1 Chief Executive Officer (CEO) and 1pharmacy head were also included per facility. In total, 80 participants were included in this study. The quantitative data to determine the magnitude of medicine wastage were collected using a structured interviewer-administered questionnaire and analyzed using SPSS version 25.
UNASSIGNED: The overall medicines wastage in the three consecutive years was 6.3%. The trend over the three years indicated that medicines wastage is 6.5%, 5.9%, and 6.5% in 2011, 2012, and 2013 Ethiopian Fiscal Year (EFY), respectively. The medicine wastage rate has been increasing nearly by 3% between 2011/2012 and 2012/2013. The main sources of wastage of medicines were expiry (99.3%). The perceived reasons for such medicine\'s wastage were near-expiry medicines (<6 months) being delivered to the health facilities by suppliers, poor communication and coordination with key stakeholders, and the presence of overstocked medicines due to improper forecasting of need in the facilities.
UNASSIGNED: There is an excessive rate of medicines wastage which needs immediate mitigation by exchanging nearly expired medicines with other health facilities, communicating with suppliers and even prescribers, using auditable pharmaceutical transactions and services (APTS), providing continuous training, pursuing quality and safety medicines reuse scheme, implementation of pharmacist waste-reducing activities in all stages of the pharmaceutical supply chain, reducing medication amounts in stock, and through the use of electronic stock management tools.

BACKGROUND: The level of health professional work engagement affects retention, burnout, job satisfaction, patient satisfaction, and outcomes; however, there is a paucity of evidence that benefit health professional work engagement. Therefore, this study aimed to assess work engagement and associated factors among health professionals at public health facilities in the Bench-Sheko zone in southwest Ethiopia.
METHODS: Facility-based cross-sectional study was conducted among 605 health professionals from 29 March to 29 April 2021. A simple random sampling technique was used to select the participants. Data were collected using a self-administered questionnaire. Linear regression was fitted and those variables with p-value < 0.2 in simple linear regression were entered into multiple linear regression analysis. Unstandardized β-coefficient with 95% CI and p-value < 0.05 were used as the cut of points to determine the factors associated with work engagement.
RESULTS: Mean score percentage of work engagement was 71.8%. Health center staff (β = 0.31; 95% CI: 0.22, 0.40), married professionals (β = 0.10; 95% CI: 0.005, 0.17), co-worker support (β = 0.06; 95% CI: 0.004, 0.11), role clarity (β = 0.14; 95% CI: 0.07, 0.21), reward (β = 0.10; 95% CI: 0.05, 0.15), resilience (β = 0.14 95%; CI: 0.07, 0.21), self-efficacy (β = 0.24; 95% CI: 0.16, 0.31) and optimism (β = 0.20; 95% CI: 0.15, 0.26) were positively associated with work engagement. On the contrary, cognitive demand (β= -0.06; 95% CI: -0.11, -0.01) was negatively associated with work engagement.
CONCLUSIONS: In this study, health professionals had a moderate level of work engagement. Health facilities shall improve their culture of co-worker support, role clarity, reward, resilience, self-efficacy, and optimism to enhance work engagement. Future researchers shall be done further studies to evaluate the relationship between cognitive demand and work engagement among health professionals.