Medical Oxygen as a Life-Saving Medicine: A rapid review of the oxygen landscape and innovative efforts in the World Health Organization Eastern Mediterranean Region in Response to COVID-19 and Beyond
Main Article Content
Abstract
Background: Medical oxygen is an essential treatment for life-threatening hypoxemic conditions and is commonly indicated for the clinical management of many leading causes of mortality. Many countries of the World Health Organization (WHO) Eastern Mediterranean Region (EMR) lacked robust medical oxygen systems prior to the COVID-19 (corona virus disease) pandemic and this situation was exacerbated by increased needs, particularly in remote and rural health facilities, resulting in many unfortunate deaths. The aim of this article is to describe the oxygen landscape in the region and the regional initiatives undertaken by countries and WHO.
Methodology: We conducted a rapid review to synthesize the available literature on the needs and availability of oxygen and its related resources and the regional initiatives undertaken. We conducted search in PubMed, relevant WHO and World Bank websites, and in general using google to understand the health of conditions that could benefit from the availability of medical oxygen, oxygen related resources including health workforce available for support and usage of medical oxygen, and the initiatives by WHO, countries and partners to improve the situation. We used a snowballing technique and reviewed all available databases for reports, surveys, assessments, and studies related to medical oxygen, besides WHO internal records, assessments, and consultation reports.
Results: The data on oxygen availability, supply demand gap, infrastructure facilities, and human resources were sparse. The regional initiatives have led to increase in resources, including human resources and oxygen production infrastructure. The Live Oxygen Platform (LOP), contributed to improved availability of quality data needed for supply-demand assessments.
Conclusion: A regional enterprise strategy to promote sustainable, decentralized, and contextualized production, supply, and monitoring of oxygen together with human resource support including training and placement by WHO, partners, and governments contributed to improved availability of oxygen in the region. Additionally, with the LOP, governments, WHO, and partners have access to better data availability for policy decision making and timely resource allocation.
Keywords:
Medical Oxygen, COVID-19, mortality, WHO Eastern Mediterranean Region, Workforce, Live oxygen platform, Oxygen scale-up, Oxygen roadmap
Article Details
How to Cite
KODAMA, Chiori et al.
Medical Oxygen as a Life-Saving Medicine: A rapid review of the oxygen landscape and innovative efforts in the World Health Organization Eastern Mediterranean Region in Response to COVID-19 and Beyond.
Medical Research Archives, [S.l.], v. 11, n. 7.2, july 2023.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/4162>. Date accessed: 21 nov. 2024.
doi: https://doi.org/10.18103/mra.v11i7.2.4162.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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2. Rojas-Marte G, Hashmi A, Khalid M, et al., Outcomes in Patients With COVID-19 Disease and High Oxygen Requirements. J Clin Med Res. 2021;13(1):26-37. DOI: https://doi.org/10.14740/jocmr4405
3. Gowda N R, Siddharth V, Kumar P, et al., Constrained Medical Oxygen Supply Chain in India During COVID-19: Red-tapism, the Elephant in the Room. Disaster Medicine and Public Health Preparedness, Volume 17, 2023, e296. DOI: https://doi.org/10.1017/dmp.2022.242
4. Bansal A, Ismail J. Medical Oxygen: A Lifesaving Drug During the COVID-19 Pandemic—Source and Distribution. Indian J Pediatr 89, 607–615 (2022). DOI: https://doi.org/10.1007/s12098-021-03978-0
5. Hvarfner A, Al-Djaber A, Ekström H. et al., Oxygen provision to severely ill COVID-19 patients at the peak of the 2020 pandemic in a Swedish district hospital. PLoS ONE 17(1): e0249984. https://doi.org/10.1371/journal.pone.0249984
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11. Wagner G, Nussbaumer-Streit B, Greimel J, et al., Trading certainty for speed - how much uncertainty are decisionmakers and guideline developers willing to accept when using rapid reviews: an international survey. BMC Medical Research Methodology volume 17, Article number: 121 (2017). DOI: https://doi.org/10.1186/s12874-017-0406-5
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13. Al-Aamri A, Al-Harrasi A A, Aal-Abdulsalam A K, et al. Forecasting the SARS COVID-19 pandemic and critical care resources threshold in the Gulf Cooperation Council (GCC) countries: population analysis of aggregate data. Global health original research. BMJ Open 2021;11:e044102. doi: 10.1136/bmjopen-2020-044102
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26. PATH. Quantification and costing tool: oxygen delivery sources. Path.org. Published May 2020. Accessed September 17, 2022. https://www.path.org/resources/quantification-and-costing-tools/
27. USAID. The Service Provision Assessment (SPA). Dhsprogram.com. Published May 2022. Accessed September 22, 2022. https://dhsprogram.com/methodology/Survey-Types/SPA.cfm
28. UNITAID. Unprecedented cooperation with global oxygen suppliers paves way to increase access for low- and middle-income countries to address C-19 crisis. Unitaid.org. Published June 2021. Access September 2022. https://unitaid.org/
https://unitaid.org/news-blog/unprecedented-cooperation-global-oxygen-suppliers-june-2021/#en
29. Every Breath Counts, Recommendations for improving pneumonia and hypoxemia indicators, Every Breath Counts Indicators Sub-Group. Stoppneumonia.org. Published August 2018. Accessed September 2017. https://stoppneumonia.org/wp-content/uploads/2020/06/EBC-Indicators-recommendations_6AUG18.pdf
30. Every Breath Counts, How to design and implement national oxygen scale-up: case study from Ethiopia. stoppneumonia.org. Published January 2022. Accessed September 17, 2022. https://stoppneumonia.org/how-to-design-and-implement-national-oxygen-road-maps-for-oxygen-scale-up-case-study-from-ethiopia/
31. Graham HR, Bagayana SM, Bakare AA, et al. Improving hospital oxygen systems for C-19 in low-resource settings: lessons from the field. Glob Health Sci Pract. 2020;8(4):858-862. https://doi.org/10.9745/GHSP-D-20-00224, accessed 18 September 2022.
32. PATH. Strengthening Oxygen Ecosystem for C-19 and beyond in India. www.path.org. Published July 2022. Accessed July 27, 2023. https://www.path.org/resources/strengthening-oxygen-ecosystem-for-C-19-and-beyond-in-india/
33. PATH. Systemic Approach for Creating Sustainable Oxygen Supply and Improving Oxygen Access During India’s C-19 Crisis. Path.org. Published Dec 2021. Accessed July 27, 2023. https://network.exemplars.health/india-C-19-sos/b/best-practices/posts/path-oxygen C-19
34. PATH. Optimizing Oxygen Access and Reliability Opportunities for scaling access and applications to other medical devices. Published May 2020. Accessed July 27, 2023. https://www.path.org/resources/optimizing-oxygen-access-and-reliability-opportunities-scaling-access-and-applications-other-medical-devices/
35. The Federal Democratic Republic of Ethiopia. Ministry of Health National Medical Oxygen and Pulse Oximetry Scale Up Road Map (2016-2021). www.medbox.org. Published September 2016. Accessed July 27, 2023. https://www.medbox.org/pdf/5e148832db60a2044c2d35ae
36. Ministry of Health Republic of Liberia. National Roadmap to Increase Access to Medical Oxygen in Liberia, 2021-2024. www.stoppneumonia.org. Published October 2021. Accessed 27, 2023. https://stoppneumonia.org/wp-content/uploads/2022/05/National-Roadmap-for-Oxygen-Access-2021-2024-FINAL-FOR-PRINTING.pdf
37. Government of the Republic of Malawi. Ministry of Health. National Medical Oxygen Ecosystem Roadmap 2021–2026. www.stoppneumonia.org. Published October 2021. Accessed July 27, 2023. https://stoppneumonia.org/wp-content/uploads/2022/02/Malawi-National-Medical-Oxygen-Ecosystem-Roadmap-Final-Final.pdf
38. Federal Republic of Nigeria. National Strategy for Scale-up of Medical Oxygen in Health Facilities 2017-2022 Federal Ministry of Health. Medbox.org. Published 2017. Accessed July 27, 2023. https://www.medbox.org/pdf/5e148832db60a2044c2d4529
39. Ministry of Health Republic of Uganda National Scale-up of Medical Oxygen Implementation Plan 2018-2022. Health.go.ug. Published November 2018. Accessed July 27, 2023. https://www.health.go.ug/cause/national-scale-up-of-medical-oxygen-implementation-plan-2018-2022
40. WHO. Increasing access to medical oxygen. Recommendation of the executive board. February 1st, 2023. Accessed July 1st, 2023. https://apps.who.int/gb/ebwha/pdf_files/EB152/B152(4)-en.pdf
41. WHO Somalia Solar-powered medical oxygen systems saving lives in Somalia: using innovation to accelerate impact in a fragile setting. www.who.int. Published April 2021. Accessed July 27, 2023. https://www.emro.who.int/somalia/news/solar-powered-medical-oxygen-systems-saving-lives-in-somalia-using-innovation-to-accelerate-impact-in-a-fragile-setting.html
42. Kodama C, Kuniyoshi G, Abubakar A. Lessons learned during C-19: Building critical care/ICU capacity for resource limited countries with complex emergencies in the World Health Organization Eastern Mediterranean Region. J Glob Health. 2021 Jul 17;11:03088. doi: 10.7189/jogh.11.03088
43. Kodama C, Kuniyoshi G, et al., 2022. Building critical care capacity for resource-limited countries with complex emergencies in the World Health Organization Eastern Mediterranean Region: Developing and Implementing a Critical Care National Training Program in Yemen. European Society of Medicine, Published: October 31, 2022. https://doi.org/10.18103/mra.v10i10.3203