1. Highlights on National Oxygen and Pulse Oximetry Scale Up in Ethiopia
July 13th 2016

2. Pneumonia and other newborn issues are the major drivers of child mortality in Ethiopia
Causes of Child Mortality
The Federal Ministry of Health (FMOH) developed a National Newborn and Child Survival Strategy (2015/16 to 2019/20)
Targeted reductions in child mortality:
Strategy is expected to prevent deaths of 415,688 under Five and 210,234 neonates by 2020
Oxygen management is a vital component of combatting pneumonia-related issues for newborns and under five
Pneumonia (18%)
Asphyxia (14%)
Prematurity (11%)
Newborn infection (9%)
Diarrhea (9%)
Metric
2015 (current)
2020 (target)
>5 Mortality 59 29
IMR 51 20
NMR 28 11

3. Ability to detect and treat hypoxemia in neonates & children is critical but there are presently significant limitations in Ethiopia
Issue/Key indicator
Facility
%**
Proportion of health facilities that have O2 consumption and stock monitoring mechanism
Health Centre 3%
Hospital
26%
Proportion of health facilities have trained biomedical engineers/technicians to perform O2 equipment maintenance 0%
41%
Proportion of facilities that think there are enough re-filling sources to meet needs 9%
47%
Availability of fully functional O2 device 2%
Hospital (IPD)
62%
HCWs trained on O2 therapy or have SOPs/job aids on O2 use
14%
Functional pulse oximeter available
45%
Source: CHAI/FMOH/PFSA baseline survey Dec 2015 3

4. FMOH recently developed an ambitious roadmap for the national scale-up of oxygen management that builds upon existing initiatives
Existing initiatives specific to O2/POx
Ambitious targets in the current national oxygen roadmap
O2 equipment, pulse oximeters, and related supplies listed in national equipment and emergency medicines list
Pulse oximeters and O2 concentrators available at hospital level only
Health centers have been supplied with O2 cylinders in the last 3 years but functionality has been significantly low
One functional public O2 plant with two more plants currently under construction
However, no clear policies and implementation tools in place to prioritize oxygen management and pulse oximetry on a national scale
All health centers in the country (~3,800) to be equipped with oxygen concentrators by 2019
All health centers to start using pulse oximetry by the end of 2018
All health posts (~17,000) to be equipped with appropriate pulse oximetry by 2020
Comprehensive implementation of pulse oximetry and oxygen management at all hospitals (~800) by the end of 2018
Construction and operationalization of O2 plants in at least 13 referral hospitals by 2020

5. Increasing sustainable funding to support oxygen supply systems
The road map has targeted six key implementation areas that require coordinated support from all stakeholders 1 2 3
Provide policy basis and decision support to health facilities to scale up oxygen supply
Set up and roll out supply and logistics chain systems for oxygen supply
Ensure sustainable supplies for hypoxemia diagnostics and related consumables 4 5 6
Establish a mechanism for maintenance of oxygen equipment and supply of spare parts
Institute a system of building capacity of HCWs on utilization of oxygen
Increasing sustainable funding to support oxygen supply systems

6. Human resource training, mentoring and SS
While detail implementation plan and specific areas of support are refined, FMOH will most likely need support from IPs and donors around below gaps:
Human resource training, mentoring and SS
Training/sensitization on utilization
Training/sensitization on program management
Biomedical engineering /maintenance training
FMOH encourages integrations into existing systems
Establishing systems and capacity for distribution and refilling
Sustainable systems and capacity for maintenance
Market shaping around O2 devices including O2 plants
Financing for technology procurement/establishment