Page 11 - GHES-2-3

Global Health Economics and
Sustainability
Medical oxygen during COVID-19 pandemic

by AV using purposive sampling. All authors have over (iv) Infrastructure augmentation
7 years of experience working in the public health sector in (v) Ensuring uninterrupted supply of medical oxygen
India. KS and AV have prior experience developing search (vi) Capacity building
strategies and have published systematic reviews in peer- (vii) Development of web applications
reviewed journals. (viii) Monitoring and coordination with state
governments.
2.3. Data sources
Searches were conducted in PubMed, Scopus, and Google 3. Results
Scholar databases using the search terms “Coronavirus,” During the COVID-19 pandemic, an abrupt spike in
“COVID-19,” “Oxygen,” and “Medical oxygen.” Additional demand for medical oxygen, a life-saving treatment
gray literature searches were also conducted among for a large number of patients with moderate-to-severe
various Government of India ministries, including the clinical manifestations of COVID-19, was observed. This
Ministry of Health and Family Welfare (MoHFW), sudden increase in demand highlighted the need for rapid
Ministry of Commerce, Ministry of Housing and Urban assessment and scaling up of medical oxygen infrastructure
Affairs (MoHUA), Ministry of Home Affairs (MHA), in the country. The following strategies and interventions
Department of Industrial Policy and Promotion (DIPP), were implemented to augment the oxygen capacities and
and Press Information Bureau (PIB) publications. Searches ensure uninterrupted supplies in the states/UTs.
also included guidelines, websites, and Indian newspapers
such as Hindustan Times, Times of India, and Indian 3.1. Inter-departmental and ministerial
Express. Other sources included United Nations (UN) coordination
organizations and non-governmental organizations such India’s fight against the oxygen shortage received a boost
as the WHO, United Nations Development Programme with the establishment of the Programme Management
(UNDP), World Bank, UNICEF, and Asian Development Unit for Medical Oxygen (PMU-MO) by the MoHFW.
Bank (ADB). Hand searches of relevant bibliographies This team, funded and coordinated by ADB, became the
were also conducted to identify additional studies. There central hub for planning, building, and tracking oxygen
were no restrictions based on the study design for inclusion plants across the country. Close collaboration was key, and
in this review. Studies, reviews, or documents discussing the PMU-MO coordinated with different ministries such
oxygen management during the COVID-19 pandemic as MoHUA, Ministry of Commerce, Ministry of Railways,
in India were eligible for inclusion. Studies, reviews, or and Ministry of Road Transport and Highways with respect
documents based outside of India were excluded. Citations to site allocation, site changes, implementation planning,
of the included articles were further scanned for potential and achievement of milestones within set timelines
inclusions of additional eligible studies. (Every Breathe Counts, 2023; WHO, 2023). Nodal officers

2.4. Screening and data extraction also worked in close coordination with agencies such
as the Central Medical Services Society (CMSS), HLL
Title and abstract (Ti-Ab) screening was conducted Infra Tech Service Limited (HITES), and the Defence,
independently by two authors (AA and AV) to identify Research and Development Organization (DRDO) for the
potentially eligible articles. This procedure was followed implementation, delivery, installation, and commissioning
by a full-text screening of the included documents, of the pressure swing adsorption (PSA) plants for oxygen
performed independently by two authors (KS and AV). generation (Unitaid, 2023). The PMU-MO collaborated
Disagreements during the Ti-Ab stage were resolved by with various executing organizations, such as the
mutual discussion, while disagreements during the full- Central Public Works Department, National Highways
text stage were resolved in consultation with AA. Thematic Authority of India, and National Buildings Construction
analysis using a deductive approach was employed to Corporation India Limited. These organizations supported
report the actions taken by the GoI to tackle the medical the development of site layouts and the construction of
oxygen shortage during the COVID-19 pandemic in India. oxygen plants at designated locations. In addition, the
Qualitative data on oxygen crisis management during PMU-MO maintained consistent communication with
the COVID-19 pandemic in India were extracted in state governments to evaluate and collect information
consultation with all three authors based on predefined about their oxygen needs. This ongoing assessment enabled
and emerging themes as given below: them to provide essential resources, such as liquid medical
(i) Inter-departmental and ministerial coordination oxygen (LMO), PSA plants, oxygen cylinders, LMO storage
(ii) Oxygen supply and oxygen therapy tanks, oxygen concentrators, and more, to assist the states
(iii) Constitution of an empowered group effectively (Every Breathe Counts, 2023).

Volume 2 Issue 3 (2024) 3 https://doi.org/10.36922/ghes.2023