Cargando…

Measuring oxygen access: lessons from health facility assessments in Lagos, Nigeria

The COVID-19 pandemic has highlighted global oxygen system deficiencies and revealed gaps in how we understand and measure ‘oxygen access’. We present a case study on oxygen access from 58 health facilities in Lagos state, Nigeria. We found large differences in oxygen access between facilities (prim...

Descripción completa

Detalles Bibliográficos
Autores principales: Graham, Hamish R, Olojede, Omotayo E, Bakare, Ayobami A, Iuliano, Agnese, Olatunde, Oyaniyi, Isah, Adamu, Osebi, Adams, Ahmed, Tahlil, Burgess, Rochelle Ann, McCollum, Eric D, Colbourn, Tim, King, Carina, Uchendu, Obioma C, Falade, Adegoke G
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8336153/
https://www.ncbi.nlm.nih.gov/pubmed/34344666
http://dx.doi.org/10.1136/bmjgh-2021-006069
_version_ 1783733267148570624
author Graham, Hamish R
Olojede, Omotayo E
Bakare, Ayobami A
Iuliano, Agnese
Olatunde, Oyaniyi
Isah, Adamu
Osebi, Adams
Ahmed, Tahlil
Burgess, Rochelle Ann
McCollum, Eric D
Colbourn, Tim
King, Carina
Uchendu, Obioma C
Falade, Adegoke G
author_facet Graham, Hamish R
Olojede, Omotayo E
Bakare, Ayobami A
Iuliano, Agnese
Olatunde, Oyaniyi
Isah, Adamu
Osebi, Adams
Ahmed, Tahlil
Burgess, Rochelle Ann
McCollum, Eric D
Colbourn, Tim
King, Carina
Uchendu, Obioma C
Falade, Adegoke G
author_sort Graham, Hamish R
collection PubMed
description The COVID-19 pandemic has highlighted global oxygen system deficiencies and revealed gaps in how we understand and measure ‘oxygen access’. We present a case study on oxygen access from 58 health facilities in Lagos state, Nigeria. We found large differences in oxygen access between facilities (primary vs secondary, government vs private) and describe three key domains to consider when measuring oxygen access: availability, cost, use. Of 58 facilities surveyed, 8 (14%) of facilities had a functional pulse oximeter. Oximeters (N=27) were typically located in outpatient clinics (12/27, 44%), paediatric ward (6/27, 22%) or operating theatre (4/27, 15%). 34/58 (59%) facilities had a functional source of oxygen available on the day of inspection, of which 31 (91%) facilities had it available in a single ward area, typically the operating theatre or maternity ward. Oxygen services were free to patients at primary health centres, when available, but expensive in hospitals and private facilities, with the median cost for 2 days oxygen 13 000 (US$36) and 27 500 (US$77) Naira, respectively. We obtained limited data on the cost of oxygen services to facilities. Pulse oximetry use was low in secondary care facilities (32%, 21/65 patients had SpO(2) documented) and negligible in private facilities (2%, 3/177) and primary health centres (<1%, 2/608). We were unable to determine the proportion of hypoxaemic patients who received oxygen therapy with available data. However, triangulation of existing data suggested that no facilities were equipped to meet minimum oxygen demands. We highlight the importance of a multifaceted approach to measuring oxygen access that assesses access at the point-of-care and ideally at the patient-level. We propose standard metrics to report oxygen access and describe how these can be integrated into routine health information systems and existing health facility assessment tools.
format Online
Article
Text
id pubmed-8336153
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-83361532021-08-20 Measuring oxygen access: lessons from health facility assessments in Lagos, Nigeria Graham, Hamish R Olojede, Omotayo E Bakare, Ayobami A Iuliano, Agnese Olatunde, Oyaniyi Isah, Adamu Osebi, Adams Ahmed, Tahlil Burgess, Rochelle Ann McCollum, Eric D Colbourn, Tim King, Carina Uchendu, Obioma C Falade, Adegoke G BMJ Glob Health Practice The COVID-19 pandemic has highlighted global oxygen system deficiencies and revealed gaps in how we understand and measure ‘oxygen access’. We present a case study on oxygen access from 58 health facilities in Lagos state, Nigeria. We found large differences in oxygen access between facilities (primary vs secondary, government vs private) and describe three key domains to consider when measuring oxygen access: availability, cost, use. Of 58 facilities surveyed, 8 (14%) of facilities had a functional pulse oximeter. Oximeters (N=27) were typically located in outpatient clinics (12/27, 44%), paediatric ward (6/27, 22%) or operating theatre (4/27, 15%). 34/58 (59%) facilities had a functional source of oxygen available on the day of inspection, of which 31 (91%) facilities had it available in a single ward area, typically the operating theatre or maternity ward. Oxygen services were free to patients at primary health centres, when available, but expensive in hospitals and private facilities, with the median cost for 2 days oxygen 13 000 (US$36) and 27 500 (US$77) Naira, respectively. We obtained limited data on the cost of oxygen services to facilities. Pulse oximetry use was low in secondary care facilities (32%, 21/65 patients had SpO(2) documented) and negligible in private facilities (2%, 3/177) and primary health centres (<1%, 2/608). We were unable to determine the proportion of hypoxaemic patients who received oxygen therapy with available data. However, triangulation of existing data suggested that no facilities were equipped to meet minimum oxygen demands. We highlight the importance of a multifaceted approach to measuring oxygen access that assesses access at the point-of-care and ideally at the patient-level. We propose standard metrics to report oxygen access and describe how these can be integrated into routine health information systems and existing health facility assessment tools. BMJ Publishing Group 2021-08-03 /pmc/articles/PMC8336153/ /pubmed/34344666 http://dx.doi.org/10.1136/bmjgh-2021-006069 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Practice
Graham, Hamish R
Olojede, Omotayo E
Bakare, Ayobami A
Iuliano, Agnese
Olatunde, Oyaniyi
Isah, Adamu
Osebi, Adams
Ahmed, Tahlil
Burgess, Rochelle Ann
McCollum, Eric D
Colbourn, Tim
King, Carina
Uchendu, Obioma C
Falade, Adegoke G
Measuring oxygen access: lessons from health facility assessments in Lagos, Nigeria
title Measuring oxygen access: lessons from health facility assessments in Lagos, Nigeria
title_full Measuring oxygen access: lessons from health facility assessments in Lagos, Nigeria
title_fullStr Measuring oxygen access: lessons from health facility assessments in Lagos, Nigeria
title_full_unstemmed Measuring oxygen access: lessons from health facility assessments in Lagos, Nigeria
title_short Measuring oxygen access: lessons from health facility assessments in Lagos, Nigeria
title_sort measuring oxygen access: lessons from health facility assessments in lagos, nigeria
topic Practice
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8336153/
https://www.ncbi.nlm.nih.gov/pubmed/34344666
http://dx.doi.org/10.1136/bmjgh-2021-006069
work_keys_str_mv AT grahamhamishr measuringoxygenaccesslessonsfromhealthfacilityassessmentsinlagosnigeria
AT olojedeomotayoe measuringoxygenaccesslessonsfromhealthfacilityassessmentsinlagosnigeria
AT bakareayobamia measuringoxygenaccesslessonsfromhealthfacilityassessmentsinlagosnigeria
AT iulianoagnese measuringoxygenaccesslessonsfromhealthfacilityassessmentsinlagosnigeria
AT olatundeoyaniyi measuringoxygenaccesslessonsfromhealthfacilityassessmentsinlagosnigeria
AT isahadamu measuringoxygenaccesslessonsfromhealthfacilityassessmentsinlagosnigeria
AT osebiadams measuringoxygenaccesslessonsfromhealthfacilityassessmentsinlagosnigeria
AT ahmedtahlil measuringoxygenaccesslessonsfromhealthfacilityassessmentsinlagosnigeria
AT burgessrochelleann measuringoxygenaccesslessonsfromhealthfacilityassessmentsinlagosnigeria
AT mccollumericd measuringoxygenaccesslessonsfromhealthfacilityassessmentsinlagosnigeria
AT colbourntim measuringoxygenaccesslessonsfromhealthfacilityassessmentsinlagosnigeria
AT kingcarina measuringoxygenaccesslessonsfromhealthfacilityassessmentsinlagosnigeria
AT uchenduobiomac measuringoxygenaccesslessonsfromhealthfacilityassessmentsinlagosnigeria
AT faladeadegokeg measuringoxygenaccesslessonsfromhealthfacilityassessmentsinlagosnigeria
AT measuringoxygenaccesslessonsfromhealthfacilityassessmentsinlagosnigeria