Pulse oximetry in Nigeria A.A Bakare H.R Graham A.G Falade 5/19/2019 4th WHO GLOBAL FORUM ON MEDICAL DEVICES

4th WHO GLOBAL FORUM ON MEDICAL DEVICES Disclosure Funding: Bill and Melinda Gates Foundation Conflict of Interest: None 5/19/2019 4th WHO GLOBAL FORUM ON MEDICAL DEVICES

4th WHO GLOBAL FORUM ON MEDICAL DEVICES Introduction Oxygen is life. It is critical to patients survival Pulse oximetry A simple device that has been in existence for about 2 decades New to many health workers in low resource settings Introducing pulse oximetry and oxygen system may be challenging in real world setting, most especially in developing countries 5/19/2019 4th WHO GLOBAL FORUM ON MEDICAL DEVICES

4th WHO GLOBAL FORUM ON MEDICAL DEVICES 5/19/2019 Oxygen equipment Oxygen concentrators Flow meter Reliable power supply Oxygen tubing and nasal prongs Pulse oximetry, paediatric sensors Protocols for use of oxygen Training Maintenance and spare parts Oxygen analyser (flow, %) Recording and monitoring 5/19/2019 4th WHO GLOBAL FORUM ON MEDICAL DEVICES

4th WHO GLOBAL FORUM ON MEDICAL DEVICES 5/19/2019 Central stakeholders meeting very good. Helped to garner support for project buy in. But key people may be left out. There was wrong perception from other staff 5/19/2019 4th WHO GLOBAL FORUM ON MEDICAL DEVICES

Pulse oximetry in Nigeria 4th WHO GLOBAL FORUM ON MEDICAL DEVICES 5/19/2019 Pulse oximetry in Nigeria Perspectives from nurses/doctors Perspectives from caregivers HCWs’ perspectives It makes our works easier: know who needs oxygen, aids patients monitoring i.e HR. Helps to convince parents on need for oxygen therapy Patients/caregivers perspectives: 1. HCWs provide adequate care 5/19/2019 4th WHO GLOBAL FORUM ON MEDICAL DEVICES

4th WHO GLOBAL FORUM ON MEDICAL DEVICES Pulse oximetry adoption 12 secondary-level facilities in southwest Nigeria 5/19/2019 4th WHO GLOBAL FORUM ON MEDICAL DEVICES

4th WHO GLOBAL FORUM ON MEDICAL DEVICES Our approaches Stakeholders identification Administrators, accountants, head nurses Vision sharing Promotion of local ownership Training (Practical) Supportive supervision and feedback 5/19/2019 4th WHO GLOBAL FORUM ON MEDICAL DEVICES

Pulse oximetry training Communicates ‘why’ learners should change practice, not just ‘what’ they should do, and articulates this as a shared vision that learners can ‘own’. Connects new knowledge and practices with existing knowledge and practices. Is hands-on and enhances problem-solving abilities so that learners can understand the real-world application 5/19/2019 4th WHO GLOBAL FORUM ON MEDICAL DEVICES

Pulse oximetry training Includes practical application for learners to apply newly acquired knowledge, including ongoing support to re-enforce learning and support the gradual process of change. Involves clinical leaders who will have ongoing influence through supervision, recognising their role, expertise, and relationships with other staff. Builds team-work through joint learning and problem-solving with colleagues. 5/19/2019 4th WHO GLOBAL FORUM ON MEDICAL DEVICES

Sustainable financing for pulse oximetry and oxygen services Every patient pays a token Charge is facility dependent Promote pulse oximetry service Record keeping by facility nurses 5/19/2019 4th WHO GLOBAL FORUM ON MEDICAL DEVICES

4th WHO GLOBAL FORUM ON MEDICAL DEVICES Acknowledgements BMGF University College Hospital, Ibadan, Nigeria University of Melbourne, Melbourne, Australia University of Ibadan, Ibadan, Nigeria Clinton Health Access Initiative Nigeria 5/19/2019 4th WHO GLOBAL FORUM ON MEDICAL DEVICES