An Oxygen Supply Is Not Enough: A Qualitative Analysis of a Pressure Swing Adsorption Oxygen Plant Program in Ethiopian Hospitals.

IF 2.5 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Global Health: Science and Practice Pub Date : 2024-08-27 DOI:10.9745/GHSP-D-23-00515
Victoria Smith, Alana Changoor, Sarah Rummage, Haileab Fekadu Wolde, Ejigu Gebeye Zeleke, Getahun Mekonnen Belay, David Barash, James Stunkel, Cheri Reynolds
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Abstract

Background: In response to critical gaps in medical oxygen access, 2 pressure swing adsorption (PSA) oxygen production centers were established using an ecosystem-strengthening strategy in Amhara, Ethiopia, in 2019. A qualitative study was conducted to assess enablers and bottlenecks to oxygen access at the hospital level after installation.

Methods: A variety of hospital staff (clinicians, biomedical professionals, hospital administrators, and procurement teams) across 13 hospitals procuring oxygen from the plants participated in comprehensive, semistructured focus group discussions. A thematic framework analysis approach was used to identify key themes.

Findings: A total of 101 individuals participated in 26 focus groups in 2021, 2 years after plants were installed. Primary themes were accessibility of supply, affordability, and hospital readiness. Respondents indicated a substantial increase in their hospital's ability to access lower-cost oxygen, with many attributing this to the locality of plants and reduced transportation barriers. However, other challenges persisted, and the emergence of COVID-19 1 year after plant installation and a civil conflict exacerbated supply shortages. Investments in equipment, supplies, and training optimized clinical utilization of oxygen and were highlighted as a need for ongoing investment.

Conclusion: To achieve maximum impact, investments in large-scale oxygen systems must be accompanied by strategic plans to transport oxygen, reduce costs to hospitals, and provide support to clinical teams through equipment, supply procurement, and clinical training. These findings support comprehensive ecosystem approaches to strengthening oxygen access for sustainable impact.

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仅有氧气供应是不够的:埃塞俄比亚医院变压吸附制氧设备计划的定性分析。
背景:为应对医用氧气供应方面的严重缺口,2019 年在埃塞俄比亚阿姆哈拉采用生态系统强化战略建立了 2 个变压吸附(PSA)制氧中心。我们开展了一项定性研究,以评估安装后医院层面氧气获取的促进因素和瓶颈:从工厂采购氧气的 13 家医院的各类医院工作人员(临床医生、生物医学专业人员、医院管理人员和采购团队)参加了全面的半结构化焦点小组讨论。采用主题框架分析方法确定了关键主题:共有 101 人参加了 2021 年(即工厂安装两年后)的 26 个焦点小组。主要议题是供应的可获得性、可负担性和医院的准备情况。受访者表示,他们所在医院获得低成本氧气的能力大幅提高,许多人将此归功于工厂的地理位置和交通障碍的减少。然而,其他挑战依然存在,工厂安装一年后出现的 COVID-19 以及国内冲突加剧了供应短缺。在设备、供应和培训方面的投资优化了氧气的临床利用,并强调了持续投资的必要性:为取得最大效果,在投资大型供氧系统的同时,还必须制定氧气运输战略计划,降低医院成本,并通过设备、供应品采购和临床培训为临床团队提供支持。这些研究结果支持采用全面的生态系统方法来加强氧气的使用,以实现可持续的影响。
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来源期刊
Global Health: Science and Practice
Global Health: Science and Practice Medicine-Health Policy
CiteScore
3.50
自引率
7.50%
发文量
178
审稿时长
22 weeks
期刊介绍: Global Health: Science and Practice (GHSP) is a no-fee, open-access, peer-reviewed, online journal aimed to improve health practice, especially in low- and middle-income countries. Our goal is to reach those who design, implement, manage, evaluate, and otherwise support health programs. We are especially interested in advancing knowledge on practical program implementation issues, with information on what programs entail and how they are implemented. GHSP is currently indexed in PubMed, PubMed Central, POPLINE, EBSCO, SCOPUS,. the Web of Science Emerging Sources Citation Index, and the USAID Development Experience Clearinghouse (DEC). TOPICS: Issued four times a year, GHSP will include articles on all global health topics, covering diverse programming models and a wide range of cross-cutting issues that impact and support health systems. Examples include but are not limited to: Health: Addiction and harm reduction, Child Health, Communicable and Emerging Diseases, Disaster Preparedness and Response, Environmental Health, Family Planning/Reproductive Health, HIV/AIDS, Malaria, Maternal Health, Neglected Tropical Diseases, Non-Communicable Diseases/Injuries, Nutrition, Tuberculosis, Water and Sanitation. Cross-Cutting Issues: Epidemiology, Gender, Health Communication/Healthy Behavior, Health Policy and Advocacy, Health Systems, Human Resources/Training, Knowledge Management, Logistics and Supply Chain Management, Management and Governance, mHealth/eHealth/digital health, Monitoring and Evaluation, Scale Up, Youth.
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