Changes in the availability of medical oxygen and its clinical practice in Ethiopia during a national scale-up program: a time series design from thirty-two public hospitals

Author:

Tolla Habtamu SeyoumORCID,Asemere Yigeremu Abebe,Desale Alebel Yaregal,Woyessa Dinkineh Bikila,Fekadu Zinabie Feleke,Belete Alemayehu Berhanu,Battu Audrey,Lam Felix

Abstract

Abstract Background Oxygen therapy is a lifesaving treatment, however, in Ethiopia, oxygen is not readily available in many healthcare facilities. In 2015, the Federal Ministry of Health launched a national roadmap to increase access to oxygen. This study aims to evaluate whether availability of oxygen and its clinical practice in public hospitals of Ethiopia changed during the time the roadmap was being implemented. Methods Between December 2015 and December 2019, a multifaceted approach was undertaken to increase access to oxygen in public facilities in Ethiopia. The activities included formation of new policies, development of guidelines, procurement and maintenance of oxygen equipment, and training of healthcare workers. To evaluate whether access and use of oxygen changed during this period, facility-based surveys were conducted between December 2015 to December 2019. Primary data, including medical record reviews, were collected from 32 public hospitals bi-annually. A chi-square test that claimed P < 0.05 used to assess the statistical significance differences. Results The study was conducted in 32 public hospitals of Ethiopia, where capacity building and technical support interventions implemented. Of these 32 facilities, 15 (46.9%) were general hospitals, 10 (31.2%) were referral hospitals, and 7 (21.9%) were primary hospitals. Functional availability of oxygen has shown a statistically significant increase from 62 to 100% in the pediatric in-patient departments of general and referral hospitals (p-value < 0.001). Similarly, functional availability of pulse oximetry has shown a statistically significant increase from 45 to 96%. With regard to clinical practices, the blood oxygen saturation (SpO2) measurement at diagnosis increased from 10.2 to 75%, and SpO2 measurement at admission increased 20.5 to 83%. Conclusions Based on the intervention results, we conclude that multifaceted approaches targeting policy, healthcare workers’ capacity, increased device procurement, and device maintenance programs with on-site mentorship, can improve the availability of medical oxygen and pulse oximetry, as well as clinical practice of oxygen therapy in health facilities. Therefore, ensuring device availability along with regular technical support and close follow-up of healthcare workers and facilities are critical, and these interventions should be scaled further.

Funder

bill and melinda gates foundation

Publisher

Springer Science and Business Media LLC

Subject

Pediatrics, Perinatology and Child Health

Reference23 articles.

1. Duke T, Graham SM, Cherian MN, Ginsburg AS, English M, Howie S, et al. Oxygen is an essential medicine: a call for international action. Int J Tuberc Lung Dis. 2010;14(11):1362–8.

2. Subhi R, Adamson M, Campbell H, Weber M, Smith K, Duke T. The prevalence of hypoxaemia among ill children in developing countries: a systematic review. Lancet Infect Dis. 2009;9(4):219–27. https://doi.org/10.1016/S1473-3099(09)70071-4.

3. UNICEF Data: Monitoring the situation of children and women. 2020.

4. International Vaccine Access Center (IVAC), Johns Hopkins Bloomberg School of Public Health. Pneumonia andDiarrhea Progress Report 2020. 2020.

5. Herbert LJ, Wilson IH. Pulse oximetry in low-resource settings. Breathe. 2012;9(2):90–7. https://doi.org/10.1183/20734735.038612.

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