Title : 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
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 the 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 the 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, facilitybased 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 was used to assess the statistical significance differences.
Results: The study was conducted in 32 public hospitals in Ethiopia, where capacity-building and technical support interventions were 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 from 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 the clinical practice of oxygen therapy in health facilities. Therefore, ensuring device availability along withregular technical support and close follow-up of healthcare workers and facilities are critical, and these interventions should be scaled further. Keywords: Medical oxygen, Pulse oximetry, In-patient pediatrics.
Audience Take Away:
From this abstract presentation, the audience will gain valuable insights into the impact of a national roadmap aimed at increasing access to oxygen and improving clinical practices related to oxygen therapy in public hospitals in Ethiopia. Understand the importance of ensuring device availability, regular technical support, and continuous healthcare worker training and mentorship to sustain and scale these improvements. Moreover, recognize the critical role of medical oxygen and pulse oximetry in pediatric care and the importance of these interventions in enhancing healthcare delivery. In general, the presentation highlights the effectiveness of systematic interventions in addressing gaps in oxygen therapy infrastructure and clinical practices, providing actionable insights for policymakers, healthcare administrators, and practitioners working in resource-limited settings to improve healthcare outcomes related to respiratory care.
