Abstract
BackgroundOxygen is an essential medical therapy that is poorly available globally. We evaluated the quality of oxygen therapy in 12 secondary-level Nigerian hospitals, including access to oxygen equipment, equipment functionality, healthcare worker knowledge and appropriateness of use.MethodsWe conducted a three-part evaluation of oxygen access and use involving: (1) facility assessment (including technical evaluation of oxygen equipment), (2) clinical audit (children and neonates admitted January 2014–December 2015) and (3) survey of healthcare worker training and experience on the clinical use of oxygen (November 2015).ResultsOxygen access for children and newborns is compromised by faulty equipment, lack of pulse oximetry and inadequate care practices. One hospital used pulse oximetry for paediatric care. Eleven hospitals had some access to oxygen supplies. Testing of 57 oxygen concentrators revealed two (3.5%) that were ‘fit for use’. Overall, 14.4% (3708/25 677) of children and neonates received oxygen some time during their admission; 19.4% (1944/10 000) of hypoxaemic children received oxygen; 38.5% (1217/3161) of children who received oxygen therapy were not hypoxaemic.ConclusionsOxygen access for children in Nigerian hospitals is poor, and likely results in substantial excess mortality. To improve oxygen access for children globally we must focus on actual provision of oxygen to patients—not simply the presence of oxygen equipment at the facility level. This requires a systematic approach to improve both oxygen (access [including equipment, maintenance and affordability]) and oxygen use (including pulse oximetry, guidelines and continuing education).
Highlights
Oxygen is an essential medication that is important for treating hypoxaemia from pneumonia, other lung diseases and many other conditions and situations.[1]
Global estimates suggest that at least 10–15% of children hospitalized with pneumonia, malaria or meningitis, and about 20% of sick neonates, have hypoxaemia.[2]
This study aimed to evaluate the quality of oxygen therapy currently available to children and neonates in 12 secondarylevel Nigerian hospitals, including: (1) functionality of oxygen source(s); (2) appropriateness of oxygen use; and (3) healthcare workers’ knowledge and experience using oxygen therapy
Summary
Oxygen is an essential medication that is important for treating hypoxaemia from pneumonia, other lung diseases and many other conditions (e.g. sepsis, meningitis, trauma and complications of prematurity) and situations (e.g. emergency, obstetric and perioperative care).[1] Global estimates suggest that at least 10–15% of children hospitalized with pneumonia, malaria or meningitis, and about 20% of sick neonates, have hypoxaemia.[2] Hypoxaemia is a major risk factor for death—increasing the odds of death fivefold among children with acute lower respiratory infection.[3] Improving the provision of oxygen to children in hospital can reduce inpatient childhood mortality by 10–20%, and pneumonia mortality by. International Health and global recognition as an essential medicine, oxygen therapy is poorly available for many sick children and adults globally.[1,6]. Oxygen is an essential medical therapy that is poorly available globally. We evaluated the quality of oxygen therapy in 12 secondary-level Nigerian hospitals, including access to oxygen equipment, equipment functionality, healthcare worker knowledge and appropriateness of use
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