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Cefazolin access and use in Ethiopia: A policy implication

Healthcare systems in resource-limited nations have been challenged by the shortage of essential medicines. This study explores cefazolin access and uses history in the Ethiopian healthcare delivery system, for possible policy implications. An exploratory qualitative study was conducted from July to...

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Autores principales: Alemkere, Getachew, Teshome, Asres, Temesgen, Gobezie, Abebe, Getnet, Degefaw, Yidnekachew, Tilahun, Hiwot, Getahun, Workineh, Girma, Eshetu, Amogne, Wondwossen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021613/
https://www.ncbi.nlm.nih.gov/pubmed/36962932
http://dx.doi.org/10.1371/journal.pgph.0001421
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author Alemkere, Getachew
Teshome, Asres
Temesgen, Gobezie
Abebe, Getnet
Degefaw, Yidnekachew
Tilahun, Hiwot
Getahun, Workineh
Girma, Eshetu
Amogne, Wondwossen
author_facet Alemkere, Getachew
Teshome, Asres
Temesgen, Gobezie
Abebe, Getnet
Degefaw, Yidnekachew
Tilahun, Hiwot
Getahun, Workineh
Girma, Eshetu
Amogne, Wondwossen
author_sort Alemkere, Getachew
collection PubMed
description Healthcare systems in resource-limited nations have been challenged by the shortage of essential medicines. This study explores cefazolin access and uses history in the Ethiopian healthcare delivery system, for possible policy implications. An exploratory qualitative study was conducted from July to August 2021. Semi-structured questions and observation guides were used to extract necessary data from people, documents, and field visits to hospitals, government supply agencies, and pharmaceutical business firms. The data were transcribed, coded, organized into themes, and presented. Cefazoline is the recommended first-line surgical antibiotic prophylaxis (SAP) in the Ethiopian Standard Treatment Guideline (STG) and is included in the national Essential Medicine List (EML). However, it was not available for use in the Ethiopian pharmaceutical markets for years. While the shortage might stem from supply-demand mismatches, multiple unknown issues exist in the background of the shortage. This is evidenced by the removal of cefazolin from the recent government procurement list regardless of the recommendation set in the national EML and STG. This study found a historic shortage of cefazolin in Ethiopian healthcare settings. This implies that the antibiotic availability in the pull market may not reflect required usage at facilities for several reasons including the misalignment of national guidelines and national procurement processes, and miscommunication between pharmacies and clinicians at sites on drug availability. Changing the essential medicines list and/or procurement requests without active review of the supply chain system and prescribing practices at facilities can lead to the elimination of necessary antimicrobial agents from the national public health sector supply.
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spelling pubmed-100216132023-03-17 Cefazolin access and use in Ethiopia: A policy implication Alemkere, Getachew Teshome, Asres Temesgen, Gobezie Abebe, Getnet Degefaw, Yidnekachew Tilahun, Hiwot Getahun, Workineh Girma, Eshetu Amogne, Wondwossen PLOS Glob Public Health Research Article Healthcare systems in resource-limited nations have been challenged by the shortage of essential medicines. This study explores cefazolin access and uses history in the Ethiopian healthcare delivery system, for possible policy implications. An exploratory qualitative study was conducted from July to August 2021. Semi-structured questions and observation guides were used to extract necessary data from people, documents, and field visits to hospitals, government supply agencies, and pharmaceutical business firms. The data were transcribed, coded, organized into themes, and presented. Cefazoline is the recommended first-line surgical antibiotic prophylaxis (SAP) in the Ethiopian Standard Treatment Guideline (STG) and is included in the national Essential Medicine List (EML). However, it was not available for use in the Ethiopian pharmaceutical markets for years. While the shortage might stem from supply-demand mismatches, multiple unknown issues exist in the background of the shortage. This is evidenced by the removal of cefazolin from the recent government procurement list regardless of the recommendation set in the national EML and STG. This study found a historic shortage of cefazolin in Ethiopian healthcare settings. This implies that the antibiotic availability in the pull market may not reflect required usage at facilities for several reasons including the misalignment of national guidelines and national procurement processes, and miscommunication between pharmacies and clinicians at sites on drug availability. Changing the essential medicines list and/or procurement requests without active review of the supply chain system and prescribing practices at facilities can lead to the elimination of necessary antimicrobial agents from the national public health sector supply. Public Library of Science 2023-01-17 /pmc/articles/PMC10021613/ /pubmed/36962932 http://dx.doi.org/10.1371/journal.pgph.0001421 Text en © 2023 Alemkere et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Alemkere, Getachew
Teshome, Asres
Temesgen, Gobezie
Abebe, Getnet
Degefaw, Yidnekachew
Tilahun, Hiwot
Getahun, Workineh
Girma, Eshetu
Amogne, Wondwossen
Cefazolin access and use in Ethiopia: A policy implication
title Cefazolin access and use in Ethiopia: A policy implication
title_full Cefazolin access and use in Ethiopia: A policy implication
title_fullStr Cefazolin access and use in Ethiopia: A policy implication
title_full_unstemmed Cefazolin access and use in Ethiopia: A policy implication
title_short Cefazolin access and use in Ethiopia: A policy implication
title_sort cefazolin access and use in ethiopia: a policy implication
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021613/
https://www.ncbi.nlm.nih.gov/pubmed/36962932
http://dx.doi.org/10.1371/journal.pgph.0001421
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