Federal Ministry Of Health Research Articles

Audit of diagnosis and management of pneumothorax at Al Shaab Teaching Hospital

Introduction. A pneumothorax is defined as the presence of air within the pleural cavity, it is classified as spontaneous primary or secondary and traumatic iatrogenic and non-iatrogenic. Despite having Sudan national protocol for the management of pneumothorax, there appears to be wide variation in clinical practice in diagnosis and management of pneumothorax Aims and objectives. The audit aims to study the initial management of primary and secondary pneumothorax at Al SHAAB teaching hospital. Method. Data collection was made from patients’ records with a diagnosis of pneumothorax Results. Fifty-five patients who were admitted to the chest department were enrolled. The majority of patients were between 25-45 years of age (40%), male with a female ratio of 3:1. The main presenting symptoms were cough 50 (94.4%) and shortness of breath 44(80%) followed by chest pain 20(36.4). Twenty patients (36.4) were a smoker and 35 (63,.6%) were a non-smoker. Pulmonary tuberculosis is the leading cause of pneumothorax 33(60,1%) and bronchial asthma 4(7.3%) while primary spontaneous were 9(16.4%). Clinically and radiologically the right side is more affected than the left side 34(61.8%) and 19(16.4%) respectively, pure pneumothorax in29 (52.7%) and hydropneumothorax in 26(37.3%). The size of pneumothorax is large in 25 (45.5%), medium18 (32.7), and small in 12(21.8%). Thirty-nine (70.9%) were managed with chest tube thoracostomy, 12 (21.8) by simple aspiration, and 4 (7.3%) responded to the observation of patients for two weeks. Conclusion. There is suboptimal compliance to the Sudan protocol in the management of pneumothorax. Recommendations. We recommended federal ministry of health to avail the protocol of diagnosis and management of pneumothorax in all emergency departments, also we recommended training of all registrars of chest medicine in the protocol of diagnosis and management of pneumothorax.

The severity of mental health problems in healthcare professionals and its associated risk factors during COVID-19 pandemic

Objective: This study assesses the severity of mental health problems in healthcare professionals (HCPs) and its associated risk factors during COVID-19 pandemic at a tertiary hospital in Harar, Eastern Ethiopia.
 Methods: An institutional-based cross-sectional study was done from November 01 to 15, 2020. Data was collected by using a web-based self-administered questionnaire. Descriptive statistical analysis, cross tabs, and logistic regressions were utilized.
 Results: Out of 238 HCPs, 54.6% of them had a mental health problem. The prevalence of depression, anxiety, and stress was 44.1%, 48.3%, and 29.0%, respectively. Cigarette smoking was the only factor associated with depression. Being female, a cigarette smoker, and previously diagnosed with COVID-19 were associated with anxiety, while cigarette smoking and previous COVID-19 suspect had a significant association with stress.
 Conclusion: The burden of mental health problems among HCPs is high. The Federal Ministry of Health should incorporate psychosocial support for healthcare professionals during pandemics. This study highlights the need for developing policies to decrease mental health problems among HCPs during the COVID-19 pandemic.

Stakeholder-Analysis of the effects on the health care system in terms of digitization and introduction of the e-prescription in Germany

The Digitalization influences all areas of life and is more important than ever. A change in the health sector is also becoming overdue since years. The Federal Ministry of Health in Germany has recognized this and as a result, the health sector is currently experiencing new horizons into an even more digitalized future through progressive developments in e-health, e.g. by abolishing the paper prescription and introducing the e-prescription in Germany. The presented methodological SWOT analysis of such an e-health application, using the example of the e-prescription, is intended to illuminate the effects on key stakeholders in the healthcare system within the framework of a 360-degree evaluation from a technical and organizational perspective.

The evaluation of the German SARS-CoV-2 test strategy - a multifactorial view

With SARS-CoV-2 in 2019 a coronavirus started circulating, for which the population showed no specific defense mechanisms of the immune system due to its clear distinction from the previously circulating coronavirus strains. Nevertheless, in 2021 there was a significant decrease in respiratory infections with a simultaneous significant increase in pandemic-related SARS-CoV-2 infections found. There is also a reduction in reported cases of respiratory diseases, especially in the pandemic year 2021. The aim of this study is to show optimizations in the test strategy during a pandemic and thus derive the improvement of civil protection. For Evaluation the data of GrippeWeb, the RKI’s Survstat® tool and the RKI’s reporting data on the new coronavirus were used. In addition, an evaluation of billing data from the EBM from 2017 to 2022 for the GOP 32816 as well as an evaluation of data on sick leave and illness statistics from 2019 to 2021 and the consideration of inpatient and outpatient health costs based on the data requested in writing from the Federal Ministry of Health was performed. The data from the Influenza Working Group shows an average of 300,000 annual reports for ARI per year. In 2019 it increased to 1,985,985 reports, in 2020 (5,453,017) and in 2021 to 29,681,158.There is also a correlation between the SARS-CoV-2 test frequency and the positive results, as well as an increase in the previously 6% positive rate for SARS-CoV-2 to over 50% in 2022. At the same time decreases the medical burden due to acute respiratory diseases (ARI) contrary to the increase of the acute respiratory diseases reported to the RKI with 2684%. What has been neglected so far is that corona viruses (HCoV) have been responsible for around 5- 10% of acute respiratory infections for decades. The comprehensive Covid-19 control measures, including the obligation to wear masks, apparently had no significant impact on reducing the spread of Covid-19, since there was also no decrease in infections with the adenovirus or RS virus in 2020 and 2021. Furthermore, an infection positive rate should not be used as a criterion for infection avoidance strategies and the recording of test results should always be validated and controlled. Only the testing of symptomatic persons should be remunerated and only these validated test results should be considered in the registration. In addition, the DIVI register for the inpatient area with recording of the main admission diagnosis and the data from the electronic transmission of sick notes to the health insurance companies for the outpatient area could be used in real time to decide on containment measures in the context of the pandemic.

Time, scope and resources: why U=U makes programmatic sense for Nigeria.

Nigeria's widespread mixed epidemiology HIV program has achieved a 26% reduction in new infections since 2010. New HIV infections in Nigeria remain higher in key populations, adolescent girls and young women. Treatment as prevention was a relatively new concept in Nigeria in 2016, with U=U adopted and launched in 2019 by the Federal Ministry of Health. This paper provides justification on why a sustained focus on U=U campaigns in Nigeria will contribute to the successes of the Nigerian HIV program, improving the possibility of HIV epidemic control and attaining equitable health outcomes for all sub populations in Nigeria.

The German influenza gap 2021 - a multifactorial view

The end of the 2019/2020 influenza season was already registered in early summer 2020, and in the following season. There was an nearly complete absence of influenza. So far, the sometimes strict Covid-19 containment measures with contact restrictions and the obligation to wear a mask have been mentioned as reasons. The further processing of this influenza gap showed multifactorial reasons also the lack of registration of influenza cases This study looks for further reaseons and from several perspectives in order to develop strategies for a representative recording of influenza cases derive. For Evaluation the data of GrippeWeb, the RKI’s Survstat® tool and the RKI’s reporting data on the new coronavirus were used. In addition, an evaluation of billing data from the EBM from 2017 to 2022 for the GOP 32816 as well as an evaluation of data on sick leave and illness statistics from 2019 to 2021 and the consideration of inpatient and outpatient health costs based on the data requested in writing from the Federal Ministry of Health was performed. In contrast to influenza A/B, the other viral respiratory pathogens (adenovirus, parainfluenza virus and RS virus) do not show any significant reduction. From 2020, the number of reports of respiratory infections to the RKI increased from an average of 300,000 annual reports by 2019 to 1,985,985 reports in 2020, over 5,453,017 reports in 2021 and to 29,681,158 in 2022. On the other hand cases of incapacity to work due to respiratory infections fell from 31.0% in 2019 to 15.3% in 2021. Influenza-specific diagnoses (ICD: J10.1-3) were encrypted 33,727 times in 2021, in 2020 there were still 109,846. In the outpatient sector in particular, the treatment costs are falling from 2019 to 2021. The reduction in influenza A and B from 2020 as a result of the comprehensive Covid-19 control measures, including the obligation to wear masks, cannot be considered a major reason; rather, the aspect of underreporting of influenza cases plays a significant role. Therefore, the reporting quantity of the sentinal practices should be considered and the recording of incapacity diagnoses should be taken into account.

The Practice of Infant Sleep Position among Mothers in Jimma Town Public Health Institutions, Jimma, Oromia, South West Ethiopia, 2022.

One of the important interventions in the infantile period is the selection of appropriate infant sleeping position. Unsafe infant sleep position is associated with sudden unexpected death in infancy. Yet, little is known about the practice of infant sleep position in Ethiopia. This study aimed to assess the practice of infant sleep position among mothers attending mother and child health service in Jimma town public health institutions, South West Ethiopia, 2022. An institutional based cross-sectional study design was conducted on 409 women attending Maternal and child health service in Jimma town public health facilities. The data were collected using a pre-tested and semi- structured questionnaire. Binary Logistic regression was used to analyze the association between the practice infant sleeping positions and explanatory variables. The strength of association was evaluated using an odds ratio at a 95% confidence interval and a P-value ≤ .05 was considered to declare significant associations. Four hundred nine women participated in the study, with a response rate of 97%. The practice of recommended infant sleeping position (supine position) in this study was 33.5% [95% CI (28.9% - 38.6%)]. Being married Adjusted odds ratio (AOR) 2.6; 95% CI (1.04-6.48)), residence (AOR 1.88; 95% CI (1.1-3.31)) multi gravidity (AOR 1.6; 95% CI (1.02-2.59)) and having good knowledge of sleeping position (AOR 1.55; 95% CI (1.01-2.38)) were significantly associated with the practice of infant sleep position. The practice of medically recommended infant sleep position in this study was low. Being married, residence, multi gravidity and having good knowledge of sleeping position were significantly associated with the practice of infant sleep position. Therefore, considering these associated factors during health care provision and disseminating information on safe sleep practices for mothers is needed. Also, different stakeholders, including the federal ministry of health, health professionals, and health institutions at different levels, need to give attention to such problems in addition to the service to reduce infant mortality.

Magnitude and Factors Associated With Scabies Among Primary School Children in Goro Gutu Woreda, East Hararghe Zone, Ethiopia

Introduction: More than 300 million individuals worldwide suffer from scabies, which has a considerable morbidity rate, especially in underdeveloped countries. The Federal Ministry of Health has created rules for handling outbreaks in Ethiopia. Investigations are still being conducted only in a few areas, and health educators are making diagnoses even though they might overlook some cases. The prevalence of scabies among primary school students in Goro Gutu Woreda, east Hararghe zone, Oromia region, Ethiopia, was examined from October 20 to November 20, 2021. Methods: From October 20 to November 20, 2021, 460 students in Goro Gutu Woreda’s primary schools participated in this institutional-based cross-sectional study. A pre-tested, structured questionnaire and a physical exam were used to gather the data. Stata (version 15) was utilized to analyze the data. To find factors linked to scabies, bivariate and multivariate analyses were employed, and a P value less than 0.05 was considered statistically significant. Results: The overall magnitude of scabies was 11.4% [(95% confidence interval [CI]: 8, 14)]. Lower grade levels of (1-4 grade) (adjusted odds ratio [AOR]=3.09, 95% CI (1.32, 7.25)], families with illiterate fathers (AOR=2.68, 95% CI (1.32, 5.44)], and the lack of taking bath with water and soap [AOR=3.22, 95% CI (1.07, 9.66)] were significantly associated with scabies. Conclusion: According to the 2015 Ethiopian guidelines for controlling scabies outbreaks, schoolchildren in the Goro Gutu district of eastern Ethiopia had high scabies rates. These rates were closely connected with children’s grade level, fathers’ educational status, and how frequently they took baths with soap and water. It is advised that children in schools and communities behave more hygienically

Magnitude of Anemia and its Associated Factors Among Pregnant Women in Jowhar District, Somalia

Globally, anemia affected 1.62 billion people; of these, 56 million anemia cases were found in pregnant women. Anemia is a global public health problem that affects both developing and industrialized countries with major consequences of social and economic burdens. This study set out to determine the prevalence of anemia and its associated factors among pregnant women attending Antenatal Care at public hospitals in Jowhar district, South Somalia. A total of 376 study respondents were included in the study. Structured questionnaires and laboratory investigation was used to collect data. Data were analyzed using binary and multivariable logistic regression. The significance of the association was declared at a p-value < 0.05. The overall prevalence of anemia was 53.1%. Most of the participants were mild anemic (36.53%). The mean hemoglobin concentration of pregnant women was 10.7 ± 2.0 g/dl. In second trimester of pregnancy (AOR=0.32, 95%CI=0.12-0.83), taking meal less than two times per day (AOR=4.80, 95%CI=1.41-16.36), rare meat (AOR= 43.07, 95%CI=2.56-73.50) and fruit (AOR= 6.01, 95%CI= 1.05-34.33) consumption and lack of iron folic supplementation (AOR= 10.06, 95%CI= 1.51-67.05) were significantly associated with anemia among pregnant women. Findings indicated that more than half (53.1%) of the pregnant women were anemic, which is a severe public health problem according to WHO classifications. Therefore, the Federal Ministry of Health and its counterpart in Hir-Shabelle State should work together to tackle anemia through nutrition education and folic iron supplementation.

Childhood obesity prevention in schools and municipalities – the digital planning tool WEPI

Abstract Background The development of theory-based prevention efforts is complex and often not feasible in the daily work of project planners. Planning tools such as the Intervention Mapping Approach (IMA), which is a gold standard for project planning, cannot be used in practice without preconditions. How can prevention planning be evidence-based but also practical? Against this background, the research project WEPI was developed, funded by the Federal Ministry of Health, Germany. WEPI is a digital planning tool based on the IMA, that guides municipalities and schools in planning childhood obesity prevention efforts. Methods From April 2019 to October 2020, the planning tool was developed. In October 2020 and February 2021, WEPI was tested for the first time by selected municipalities (n = 4) in Bavaria and schools (n = 4) in Lower Saxony. Based on this, the modified planning tool was tested for a second time throughout Germany (05-11/2021). Handling and acceptance were evaluated in a questionnaire survey. Results The first test showed that content and technical aspects needed to be optimised in order to bring scientific demands and practical feasibility together. Six municipalities and eight educational institutions participated in the second test phase. The respondents (n = 14) indicated that WEPI facilitates structured project planning (86%) and supports collaboration with colleagues (64%). 93% would use the planning tool again. WEPI offers evidence-based methods for practical implementation as well as a download area, including a template for a project application or a project summary. This service was also evaluated as very helpful (64%). Conclusions Through step-by-step guidance, WEPI facilitates evidence-based project planning and ensures planning quality. Effort and benefit are in good proportion. Further optimisations are needed to improve the user-friendliness. Key messages • WEPI provides a comprehensive roadmap, helping practitioners to approach a structured project planning. • Practitioners’ participation promotes acceptance and provides a user-friendly development.

Satisfaction status and its associated factors on delivery service provided among women who gave birth at hawassa university comprehensive specialized hospital in southern Ethiopia 2022

Background: Despite the Ethiopian federal ministry of health implementing compassionate, respectful, and caring as one of the health sector transformation agendas to increase health service utilization, the level of maternal satisfaction with institutional delivery is still low and varies from region to region. In addition, no previous study was conducted in this study area. Therefore, the main objective of the study was to assess the level of women's satisfaction with institutional delivery services and associated factors among mothers who gave birth at Hawassa University's comprehensive specialized Hospital. Methods and Materials: Institutional based quantitative cross-sectional study was employed from April to May 2022 at Hawassa University's comprehensive specialized hospital. A total of 265 women who came to delivery service were included in the study and systematic sampling techniques was used to select study participant. A semi-structured questionnaire was used to collect data. The data was entered into EPI Data 3.1 version and transported to SPSS version 25 for data analysis. Binary and multi-regression were done for predictor variables associated at p-value <0.05 with the dependent variable. Result: A total of 265 mothers fully responded, making a response rate of 95.3%. This study found that 63% of study participants were satisfied and 37% of them were unsatisfied with the delivery and labor service. Participants' occupation, last pregnancy wanted, health conditions of the mother during and after delivery, media exposure to institutional delivery, total duration of labor, a surgical procedure done for women, the provider gives periodic updates on the progress of labor and explained what is being done and that to be expected were statistically associated with satisfaction status. Conclusion: The study showed that the overall satisfaction of the women with the delivery service provided by health care providers in the study area was relatively low. Therefore, all stakeholders should take immediate and appropriate action on those identified factors.

Assessment of unsafe disposal of unused and expired medicines practices among households in North-west Nigeria

Background: Unsafe disposal of unwanted medicines continues to be of global concern. Data on such disposal practices among households and the availability of national drug disposal programmes are limited in Nigeria. This study was carried out to assess the practice of unsafe disposal of unused and expired medicines in north-west Nigeria. Methods: This was a cross-sectional study with participants recruited into the study using an online survey (via Google Forms®) and face-to-face interviews. A hyperlink to the online questionnaire was shared with the targeted population through emails and social media platforms. Results: A total of 319 valid responses were included in the analysis, of which 60.2% reported practicing unsafe disposal of unused and expired medications. The most utilized disposal methods were discarding in the domestic dustbin (52.6%), burning (10.6%), toilet sink (9.4%), and water drain (9.4%). Frequently involved medicines were analgesics (32.6%), antibiotics (24.4%), and antimalarials (21.7%). Most of the practice resulted from non-adherence (34.9%), self-medication (23.6%), polypharmacy (23.4%), adverse effects (18.1%), and incidental ingestion by children (9.4%). Participants (86.2%) are aware of the health hazards related to the practice, and (95.3%) were willing to comply with the RUM concept. Conclusion: Given the high prevalence of unsafe disposal practices of unused and expired medicines in the community vis-à-vis their ecotoxicological implications, a spontaneous review of the current national medicines' disposal regulations jointly by the Federal Ministry of Health and the Federal Ministry of Environment that would include interventions such as Return Unused Medicines is highly recommended.

On the Road to Net Zero Health Care Systems: Governance for Sustainable Health Care in the United Kingdom and Germany.

Health care lies at the forefront of the impacts of climate change. Since the health sector is a major polluting and emission intensive sector, it remains a crucial challenge to address sustainability. The English National Health System (NHS) aims to be the first in the world to achieve net zero in all emission classes (Scope 1–3). In Germany, sustainability in health care is being driven bottom-up, while the Federal Ministry of Health at the time of the research in early 2021 takes no active stance on a net zero health care system. This article analyses the approaches to sustainability in the two different health care systems, explores common challenges, and draws recommendations to support the transition of the sector to a net zero future. An exploratory mixed method approach was taken applying qualitative and quantitative methods. This includes high-level expert interviews and an online survey from the United Kingdom (UK) and Germany. Results reveal the complex nature of health care systems and the need for engraining a systems-thinking approach. The findings call for the legal embedding of sustainability into the key principles of health care in Germany, endorses the ambition of the national health care systems in the UK, recommends collaborative cross-sector approaches for sustainability, and highlights the need for increased public awareness on the interrelation between human and planetary health to enable governance for sustainable health care.

Predictive performance and clinical application of COV50, a urinary proteomic biomarker in early COVID-19 infection: a prospective multicentre cohort study

BackgroundThe SARS-CoV-2 pandemic is a worldwide challenge. The CRIT-CoV-U pilot study generated a urinary proteomic biomarker consisting of 50 peptides (COV50), which predicted death and disease progression from SARS-CoV-2. After the interim analysis presented for the German Government, here, we aimed to analyse the full dataset to consolidate the findings and propose potential clinical applications of this biomarker.MethodsCRIT-CoV-U was a prospective multicentre cohort study. In eight European countries (Austria, France, Germany, Greece, North Macedonia, Poland, Spain, and Sweden), 1012 adults with PCR-confirmed COVID-19 were followed up for death and progression along the 8-point WHO scale. Capillary electrophoresis coupled with mass spectrometry was used for urinary proteomic profiling. Statistical methods included logistic regression and receiver operating characteristic curve analysis with a comparison of the area under curve (AUC) between nested models. Hospitalisation costs were derived from the care facility corresponding with the Markov chain probability of reaching WHO scores ranging from 3 to 8 and flat-rate hospitalisation costs adjusted for the gross per capita domestic product of each country.FindingsFrom June 30 to Nov 19, 2020, 228 participants were recruited, and from April 30, 2020, to April 14, 2021, 784 participants were recruited, resulting in a total of 1012 participants. The entry WHO scores were 1–3 in 445 (44%) participants, 4–5 in 529 (52%) participants, and 6 in 38 (4%) participants; and of all participants, 119 died and 271 had disease progression. The odds ratio (OR) associated with COV50 in all 1012 participants for death was 2·44 (95% CI 2·05–2·92) unadjusted and 1·67 (1·34–2·07) when adjusted for sex, age, BMI, comorbidities, and baseline WHO score; and for disease progression, the OR was 1·79 (1·60–2·01) when unadjusted and 1·63 (1·41–1·91) when adjusted (p<0·0001 for all). The predictive accuracy of the optimised COV50 thresholds was 74·4% (71·6–77·1%) for mortality (threshold 0·47) and 67·4% (64·4–70·3%) for disease progression (threshold 0·04). When adjusted for covariables and the baseline WHO score, these thresholds improved AUCs from 0·835 to 0·853 (p=0·033) for death and from 0·697 to 0·730 (p=0·0008) for progression. Of 196 participants who received ambulatory care, 194 (99%) did not reach the 0·04 threshold. The cost reductions associated with 1 day less hospitalisation per 1000 participants were million Euro (M€) 0·887 (5–95% percentile interval 0·730–1·039) in participants at a low risk (COV50 <0·04) and M€2·098 (1·839-2·365) in participants at a high risk (COV50 ≥0·04).InterpretationThe urinary proteomic COV50 marker might be predictive of adverse COVID-19 outcomes. Even in people with mild-to-moderate PCR-confirmed infections (WHO scores 1–4), the 0·04 COV50 threshold justifies earlier drug treatment, thereby potentially reducing the number of days in hospital and associated costs.FundingGerman Federal Ministry of Health.

Under-Nutrition and Associated Factors Among Lactating Mothers in Ethiopia: A Systematic Review and Meta-analysis.

Under-nutrition (body mass index < 18.5kg/m2) is a global problem with an increasing trend in recent years. The burden is high in low and middle-income countries, especially in Africa. Lactating mothers are among the most vulnerable groups for under nutrition; particularly in sub-Saharan Africa. In Ethiopia, the prevalence of under-nutrition among this group is inconsistent and inconclusive. Therefore, we aimed to assess the pooled prevalence of under-nutrition and its associated factors among lactating mothers in Ethiopia. To write this review and meta-analysis, we followed the preferred reporting items for systematic review and meta-analysis guidelines. Primary articles were searched from PubMed, Hinari, Cochrane Library, science direct databases, Google, and Google scholar. STATA version 16 software and a standardized Microsoft excel format were used for analysis and data extraction, respectively. Heterogeneity between studies was checked. To determine the pooled prevalence of under-nutrition, we used a random-effect model. Begg's and Egger's tests were done to detect publication bias. Subgroup analysis was also steered and association was uttered by a pooled odds ratio with 95% CI. The pooled prevalence of under-nutrition among lactating mothers was 23.84% [95% CI (19.40, 28.27)]. Educational status (no formal education) {Pooled OR 2.30 [95% CI (1.34, 3.96)]} was significantly associated with under-nutrition. The pooled prevalence of under-nutrition was high. Maternal educational status was significantly associated with under-nutrition. Therefore, the federal ministry of health and the concerned stakeholders should give attention to these most vulnerable groups and strengthen the implementation of the previously designed strategies.

MHealth guideline training for non-communicable diseases in primary care facilities in Nigeria: a mixed methods pilot study

ObjectiveTo pilot the use of a scalable innovative mobile health (mHealth) non-communicable diseases (NCDs) training application for nurses at the primary care level.DesignMixed methods pilot of mHealth training on NCD...

Preparedness of governmental hospitals for COVID 19 prevention and care in Eastern Amhara region, Amhara Ethiopia, 2020

BackgroundCoronavirus disease affects the world in multidisciplinary ways. In Ethiopia, it affects many people, including health professionals. Health institutions should have been ready to handle COVID-19 cases and protect their staff from this pandemic. Hospitals in eastern Amhara provide services for more than 30 million people. ObjectivesTo assess the readiness of government hospitals in eastern Amhara for coronavirus disease prevention and treatment in 2019. MethodsThe institutional-based descriptive cross-sectional study design was conducted in 28 governmental hospitals in the eastern Amhara region. A structured checklist exported to the word processing system online link was created. Randomly selected nurses in each hospital were virtually trained and collected the data; the link was shared with them. We use SPSS version 23 for data cleaning and analysis. For data summary and presentation, frequency, mean, tables, graphs, and text were used. Using concept analysis, different sections of these hospitals were assessed. A linear regression was done and Pearson correlation coefficient (r) values were used to measure the degree of relationship between dependent and independent variables. ResultsThis study indicates that more than half (57.14%) responded "no" to the questions, suggesting unpreparedness. The age of the hospital (r = 0.25), distance from the regional capital city (r = 0.113), distance from the capital city (r = 0.125), and location of the hospital (r = 0.094) had little relationship with the readiness of the hospital for COVID-19 disease prevention and care. Conclusion and recommendationIn this most hospitals were not ready to handle COVID-19 cases and couldn't protect staff from this pandemic. Therefore, local and regional health offices and the federal ministry of health, as well as other health organizations, should enhance their capacity to fight COVID 19.

Effect of Health Education through Community Leaders on Increase Utilization of Households Regarding LLINs in Intervention and Control Villages of New Halfa Locality-Kassala State (2017-2020)

The long-lasting insecticidal nets (LLIN) are effective against prevention of malaria and its utilization has been proven to save lives. Despite the mass distribution of LLIN, Nigeria remains the country with the highest malaria burden in Africa. . The current study aimed to assess the effect of Health Education through Community leaders on increased knowledge of Households Regarding malaria control, treatment and prevention in intervention and control villages of New Halfa Locality-Kassala State (2017-2020). Randomized community trials (Controlled intervention study) in New Halfa locality among two communities were randomly assigned to intervention group which receive health education messages regarding the use of LLINs and control group where there is no health education. Standard Questionnaire was use to collect data from the head of household at each village. The information collected should include the owner and using LLINs, distributed to household. The observation the conditions of LLINs. This Questionnaire was done with committee for integrated vector management - Federal Ministry of Health and WHO. The major source of information was TV in control (23.2%) and intervention villages (22.8%) with no significant difference, p&gt; 0.05. There was no significant difference between intervention and control regarding sleeping under net last night (p=.87). The proportion of households slept under nets was not significantly slightly increased in intervention villages (51.9%) compared to control villages (48.1%). The most reasons for not sleeping under nets in control and intervention villages was significantly were no mosquito, no need, hot weather, bad feeling, owner absence and other reasons not mentioned. The frequency distribution of number of bed nets per household. The number of bed nets per household in control villages was found to be 3.7(1.9%) during survey I , 3.1 (1.5%) during survey П and 3.2 (1.6%) during the survey Ш with mean of 3.2 (1.6%). However, the number of bed nets in intervention villages during surveyI , survey П, survey were found 3.7 (1.9%), 3.2 (1.4%) and 2.9 (1.4%) respectively with mean of 3.3 (1.7%). The number of households in control group during survey I was 2541 (44.8%), survey П 1838 (32.4%) and during survey Ш 1300 (22.9%). While the number of households in intervention villages during survey I 2526 (41.8%), survey П 1997 (33.1%) and during survey Ш was 1514 (25.1%). The ownership of bed nets was 100% in control village during surveyI, survey П and survey Ш, but the ownership was slightly decreased in intervention villages during survey I (99.4%) and during survey Ш (99.6%). Regarding use of nets, the use of bed nets during survey I in control villages was found high 70.8% compared to intervention villages (64.1%) while remarkable increased in bed nets use during survey П (82%) and survey Ш ( 55.8%) in intervention villages compared to control villages (74.8%), (47%) respectively. This may be due to health education packages. It can be concluded that the overall knowledge was fair in the present study. This could be attributed to the media campaign sessions during net distribution and to the role of community leaders in these campaigns. Also in other words this study has demonstrated the effectiveness of health education as vital tool for improving the knowledge of malaria and utilization of LLINs.

Effect of Health Education through Community Leaders on Increase Utilization of Households Regarding LLINs in Intervention and Control Villages of New Halfa Locality-Kassala State (2017-2020)

The long-lasting insecticidal nets (LLIN) are effective against prevention of malaria and its utilization has been proven to save lives. Despite the mass distribution of LLIN, Nigeria remains the country with the highest malaria burden in Africa. . The current study aimed to assess the effect of Health Education through Community leaders on increased knowledge of Households Regarding malaria control, treatment and prevention in intervention and control villages of New Halfa Locality-Kassala State (2017-2020). Randomized community trials (Controlled intervention study) in New Halfa locality among two communities were randomly assigned to intervention group which receive health education messages regarding the use of LLINs and control group where there is no health education. Standard Questionnaire was use to collect data from the head of household at each village. The information collected should include the owner and using LLINs, distributed to household. The observation the conditions of LLINs. This Questionnaire was done with committee for integrated vector management - Federal Ministry of Health and WHO. The major source of information was TV in control (23.2%) and intervention villages (22.8%) with no significant difference, p&gt; 0.05. There was no significant difference between intervention and control regarding sleeping under net last night (p=.87). The proportion of households slept under nets was not significantly slightly increased in intervention villages (51.9%) compared to control villages (48.1%). The most reasons for not sleeping under nets in control and intervention villages was significantly were no mosquito, no need, hot weather, bad feeling, owner absence and other reasons not mentioned. The frequency distribution of number of bed nets per household. The number of bed nets per household in control villages was found to be 3.7(1.9%) during survey I , 3.1 (1.5%) during survey П and 3.2 (1.6%) during the survey Ш with mean of 3.2 (1.6%). However, the number of bed nets in intervention villages during surveyI , survey П, survey were found 3.7 (1.9%), 3.2 (1.4%) and 2.9 (1.4%) respectively with mean of 3.3 (1.7%). The number of households in control group during survey I was 2541 (44.8%), survey П 1838 (32.4%) and during survey Ш 1300 (22.9%). While the number of households in intervention villages during survey I 2526 (41.8%), survey П 1997 (33.1%) and during survey Ш was 1514 (25.1%). The ownership of bed nets was 100% in control village during surveyI, survey П and survey Ш, but the ownership was slightly decreased in intervention villages during survey I (99.4%) and during survey Ш (99.6%). Regarding use of nets, the use of bed nets during survey I in control villages was found high 70.8% compared to intervention villages (64.1%) while remarkable increased in bed nets use during survey П (82%) and survey Ш ( 55.8%) in intervention villages compared to control villages (74.8%), (47%) respectively. This may be due to health education packages. It can be concluded that the overall knowledge was fair in the present study. This could be attributed to the media campaign sessions during net distribution and to the role of community leaders in these campaigns. Also in other words this study has demonstrated the effectiveness of health education as vital tool for improving the knowledge of malaria and utilization of LLINs.

Measuring Organizational Culture in Ethiopia's Primary Care System: Validation of a Practical Survey Tool for Managers.

Organizational culture has been widely recognized as predictive of health system performance and improved outcomes across various healthcare settings. Research on organizational culture in healthcare has been largely conducted in high-income settings, and validated scales to measure this concept in primary healthcare systems in low- and middle-income country (LMIC) settings are lacking. Our study aimed to validate a tool to measure organizational culture in the context of the Ethiopian Primary Healthcare Transformation Initiative (PTI), a collaborative of the Federal Ministry of Health (FMoH) and the Yale Global Health Leadership Initiative to strengthen primary healthcare system performance in Ethiopia. Following established survey development and adaptation guidelines, we adapted a 31-item US-based organizational culture scale using (1) cognitive interviewing, (2) testing with 1176 district and zonal health officials from four regions in Ethiopia, and (3) exploratory factor analysis (EFA). Based on the results of cognitive interviewing, an adapted 30-item survey was piloted. The factor analyses of 1034 complete surveys (88% complete responses) identified five constructs of the scale which demonstrated strong validity and internal consistency: learning and problem solving, psychological safety, resistance to change, time for improvement, and commitment to the organization. Of the 30 a priori items, 26 items loaded well on the five constructs (loading values 0.40-0.86), and 4 items failed to load. Cronbach alpha coefficients were 0.86 for the scale as a whole and ranged from 0.65 to 0.90 for the subscales. The five-factor solution accounted for 62% of total variance in culture scores across respondents. Through validation and factor analyses, we generated a 26-item scale for measuring organizational culture in public primary healthcare systems in LMIC settings. This validated tool can be useful for managers, implementers, policy-makers, and researchers to assess and improve organizational culture in support of improved primary healthcare system performance.