The Ethiopian Government is moving aggressively to expand access to oxygen, especially to drive down maternal and child deaths. Learn how the Clinton Health Access Initiative is supporting this critical effort.

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
The Federal Ministry of Health (FMOH)
developed a National Newborn and Child
Survival Strategy (2015/16 to 2019/20)
o Targeted reductions in child mortality:
o Strategy is expected to prevent deaths
of 415,688 under Five and 210,234
neonates by 2020
o 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%)
2
Metric 2015 (current) 2020 (target)
>5 Mortality 59 29
IMR 51 20
NMR 28 11
Causes of Child Mortality

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
Health Centre 0%
Hospital 41%
Proportion of facilities that think there are enough re-filling
sources to meet needs
Health Centre 9%
Hospital 47%
Availability of fully functional O2 device
Health Centre 2%
Hospital (IPD) 62%
HCWs trained on O2 therapy or have SOPs/job aids on O2 use
Health Centre 0%
Hospital 14%
Functional pulse oximeter available
Health Centre 0%
Hospital (IPD) 45%
3Source: CHAI/FMOH/PFSA baseline survey Dec 2015

4. • 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
Existing initiatives specific to O2/POx
Ambitious targets in the current
national oxygen roadmap
4
FMOH recently developed an ambitious roadmap for the national
scale-up of oxygen management that builds upon existing initiatives

5. 5
The road map has targeted six key implementation areas that
require coordinated support from all stakeholders
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
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
1 2 3
4 5 6

6. 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