Availability of Medical Oxygen and its Clinical Practice in Thirty Two Public Hospitals of Ethiopia: A Cross-Sectional Time-Series Design

Abstract Background: Oxygen is an essential medicine that saves many children dying of hypoxemia from pneumonia. Nearly more than 95% of deaths occur in developing countries. Similarly, the prevalence of pneumonia is high in Ethiopia. Oxygen therapy is a lifesaving treatment, however, the appropriate use and administration of oxygen in clinical practice is often challenging without knowledge of its potential risks and benefits. Therefore, the study aims to assess the functional availability of oxygen devices and its clinical practice in public hospitals of Ethiopia.Methods: A facility-based cross-sectional time-series design was conducted from December 2015 to December 2019. Primary data was collected from 32 public hospitals bi-annually. Similarly, medical record charts were reviewed retrospectively biannually using interviewer-administered structured questionnaires. A chi-square test that claimed P<0.05 used to assess the statistical significance differences.Results: The study was conducted in thirty-two public hospitals of Ethiopia, where capacity building and technical support interventions implemented. Of which, 15 (46.9%) were General hospitals, and the remaining 10 (31.2%) and 7 (21.9%) were Referral and Primary hospitals respectively. Multifaceted approaches such as on-site and off-site capacity building of healthcare workers, regular mentorship, technical assistance, development of guideline/manuals, oxygen device procurement and maintenance were provided to healthcare workers and health facilities. Functional availability of oxygen has shown a statistically significant increase from 62% to 100% in Pediatric In-patient Department of general and referral hospitals (p-value < 0.001). Similarly, functional availability of Pulse Oximetry has shown statistically significant increased from 45% to 96%. With regard to the clinical practice, SpO2 measurement at diagnosis and admission has increased from 10.2% to 75% and 20.5% to 83% respectively.Conclusions: Based on the intervention results, we can conclude that multifaceted approaches targeting healthcare workers capacity, increased device procurement and on-site device maintenance with on-site mentorship can improve the availability of medical oxygen and pulse oximetry and 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 key and the initiative needs to be scaled-up.