Assist International, Ripon, CA, USA.
Grand Challenges Canada, Toronto, Canada.
Glob Health Sci Pract. 2024 Aug 27;12(4). doi: 10.9745/GHSP-D-23-00515.
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.
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.
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.
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.
为应对医疗用氧获取方面的重大缺口，埃塞俄比亚阿姆哈拉州于 2019 年采用增强生态系统战略设立了 2 个变压吸附（PSA）制氧生产中心。本研究开展了一项定性研究，以评估安装后医院层面氧气获取的推动因素和瓶颈。
共有来自采购制氧设备的 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）参与了本次全面、半结构式焦点小组讨论。采用主题框架分析方法来识别关键主题。
2021 年，在安装制氧设备 2 年后，共有 101 人参加了 26 个焦点小组。主要主题包括供应的可及性、可负担性和医院准备情况。受访者表示，他们医院获取低成本氧气的能力有了实质性提高，许多人将这归因于制氧厂的位置和减少了运输障碍。然而，其他挑战仍然存在，制氧设备安装 1 年后出现的 COVID-19 疫情和一场内战加剧了供应短缺。投资设备、用品和培训优化了氧气的临床使用，被认为是需要持续投资的领域。
为了实现最大影响，必须在投资大型制氧系统的同时，制定战略计划来运输氧气、降低医院成本，并通过设备、供应采购和临床培训为临床团队提供支持。这些发现支持采取全面的生态系统方法来增强氧气获取，以实现可持续的影响。
