By Goodluck Musinguzi
Mulago National Referral Hospital is producing 3 million liters of oxygen per day after 4 plants started functioning in November 2020. According to the National Scale Up of Medical Oxygen Implementing plan 2018-2022, aims to increase availability and utilization of oxygen in
higher level facilities.
Each Referral Hospital has a medical oxygen plant making it 14 plus other 3 added to Entebbe, Mbarara and Kayunga hospitals. Until 2012, there was no oxygen plan in Uganda. Government was buying from Nairobi or private companies in the country.
China Sinopharm International Corporation was contracted to build the plant at US$1.08 million (Shs 2.9 billion), a big undertaking from the hospital’s 2012/2013 capital development budget of 5.02 billion.
Sinopharm subcontracted BHL, a local company to maintain the plant till 2020. Fan Ping, BHL general manager visited the plant with a technician to monitor its operation and also maintenance.
The hospital in the past was using a rental oxygen tank from British Oxygen Company, Kenya (BOC) and cylinders for back up. The tank would be refilled after two weeks.
With that tank, the hospital was restricted by distance; about 25 meters to the medical building, 50 meter distance to public buildings and the supply chain of the cylinders from delivery, transport to the wards and application all were likely avenues for delays.
CURRENT SUPPLY OF OXYGEN IN UGANDA
When Dr Diana Atwine became Permanent Secretary Ministry of Health, a 5 year National Scale Up of Medical Oxygen Implementing plan 2018-2022 was developed.
She said Medical oxygen is a lifesaving commodity, the lack of which can lead to severe complications and death. The government has made great strides in increasing access to medical oxygen by increasing the manufacturing capacity through the installation of oxygen plants at all Regional Referral Hospitals.
Dr Diana Atwine added that “As the country moves towards improving the supply of medical oxygen countrywide, there is need for a coordinated framework within which associated interventions will be implemented.
The National medical oxygen scale up implementation plan articulates a holistic approach to improving demand and supply of medical oxygen in Uganda”.
Specifically, the plan aims to put in place coherent and harmonized implementation of key interventions to achieve an optimal medical
oxygen supply model. This will be done by leveraging various programs for which medical oxygen is a key therapeutic element.
The plan focusses on four main objectives: (i) to provide policy basis to direct decision making to scale up medical oxygen supply; (ii) to secure maintenance of medical oxygen equipment and supply
of spare parts through the regional workshops and the National Medical Stores; (iii) to provide a framework for training of Health Workers and Biomedical Engineers/Technicians in rational use, operation, care, handling and basic maintenance of oxygen therapy equipment; and (iv) to provide
an advocacy instrument to secure funding to support medical oxygen scale up interventions.
The scale up plan outlines the key strategies to realize an optimal supply model, including: increasing manufacturing capacity, establishment of guidelines on training and supervision, development of a dedicated procurement and distribution system for oxygen equipment and accessories, maintenance and repair system, coordination and financing arrangements, and a monitoring and evaluation framework.
In-order to achieve the targets set out in the plan, both public and private sector partners need to jointly collaborate in the promotion of all components of the plan through established linkages at the national and sub national level.
Dr Diana Atwine urged all stakeholders to join hands and ensure that the required resources are mobilized through this plan to significantly improve access to medical oxygen, especially in the higher levels of health care nationwide.
Uganda has 25 medical oxygen plants currently served (8 at Mulago NRH and 14 at Regional Referral Hospitals). Oxygen supply to peripheral public health facilities is currently managed by the National Medical
Stores (NMS) while in some cases the health facilities deliver and pick cylinders from the regional plants at their own cost.
NMS was sourcing oxygen from Mulago hospital before and was using one
dedicated truck that picked up cylinders from the facilities, fills them at Mulago hospital and returns them to the facilities, transporting a maximum of 50 large cylinders at a time. This posed a challenge.
With Covid19 Supplemental oxygen is the first essential step for the treatment. Oxygen has become more essential than ever but luckily there was a plan that has helped to avert a crisis.