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Changes in the Availability of Medical Oxygen and Its Clinical Practice in Ethiopia


Assignment Task

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

Oxygen is a vital part of life. However, although oxygen therapy is a life-saving treatment, oxygen is not widely available in many Ethiopian Healthcare Institutions. The Federal Ministry of Health released a nationwide strategy in 2015 to improve oxygen access. The goal of this study is to see if oxygen availability and clinical practice in Ethiopian public hospitals altered during the implementation of the strategy.

Between December 2015 and December 2019, Ethiopia conducted a comprehensive effort to increase oxygen services. The program involved the creation and implementation of new policies and procedures, the purchase of oxygen equipment and pulse oximetry, the development of healthcare worker capacity, and routine program monitoring. A time series design was used in the research. Since the end of 2015, a variety of treatments have been offered and monitored prospectively to examine the availability and functionality of pulse oximetry and oxygen devices at regular intervals. Furthermore, between 2017 and 2019, retrospective assessments of medical records of children aged 0 to 59 months were done in the 32 model hospitals for hypoxemia diagnosis and oxygen therapy. A total of 32 public hospitals were chosen as model sites. Since 2016, when a baseline was established in 2015, the pulse oximetry and oxygen device functionality assessment has been performed every six months. After advancements in device operation, the medical records review procedure for hypoxemia diagnosis and oxygen therapy assessments began in 2017. All medical charts of children under the age of five admitted to the pediatric ward at each hospital were screened. A total of ten medical charts were chosen at random. 320 charts were reviewed in each round, for a total of 1600 medical charts reviewed over the course of the project’s five rounds. The primary list was created using the pediatric ward admission registry; charts were chosen at random from Medical Record Numbers (MRNs) of severe pneumonia under the age of five children encountered in the previous six months. To create 10 medical records at random, the primary list (all severe pneumonia patients under the age of five) was divided by ten to yield K. Then, every Kth interval, medical records were chosen from the primary list.

Of the clinics incorporated on the study wherein 15 (46.9%), 10 (31.2%), and 7 (21.9%) are general emergency clinics, reference medical clinics, and essential emergency clinics, respectively serve an

expected catchment populace of 51 million. Investigating disaggregated information, essential clinics have a limit of one prepared BME/Ts while, at general clinics, there were up to nine prepared BME/Ts. All around, the greatest number of arranged BME/Ts were found in general centers followed by reference facilities. Moreover, valuable availability of oxygen has shown an immense augmentation from 62% at benchmark December 2015 to 100% at end-line (December 2019) in Pediatric IPD of general and reference facilities. Furthermore, availability of valuable oxygen was 100% in Newborn Intensive Care Units (NICU), across all clinical facility types. While the availability of helpful oxygen was 100% at PIPDs of general and reference clinical centers upon the appearance of the visit. And the availability of oxygen uncovered an extending design and has remained close 100% since the third round Supportive Supervision (SS). Moreover, the openness of pulse oximetry was 96% at PIPD of general and reference crisis centers upon the appearance of the visit. All around, the useful availability of pulse oximetry has shown a quantifiably immense augmentation from 45% at standard (December 2015 to 96% in December 2019 in pediatric IPD of general and reference clinical facilities. Out of the clinical records of 272 youths overviewed with pulse oximetry at examination or any point during attestation, the larger section, 210 (not really settled to have hypoxemia (SpO2

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