Page 15 - GHES-2-3

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

• 180 h for maintenance and troubleshooting: 5,084 medical oxygen in all 36 states/UTs. Similar control rooms
candidates trained have been set up in all 36 states/UTs, which are in constant
touch with the central control room to raise timely alerts.
India’s “National Oxygen Stewardship Program,”
launched in December 2021, empowers health-care Regular video conferences have been conducted with all
36 states/UTs, the Department for Promotion of Industry
professionals, especially in resource-limited settings. It and Internal Trade, and the PESO on oxygen-related
equips technicians and clinicians with crucial skills for
the efficient and responsible use of medical oxygen. Key issues. Mapping of hospital-wise (public and private)
oxygen inventory (cylinders, LMO tanks, PSA plants,
features include:
concentrators) across the country is conducted on a timely
• District-level “Oxygen Stewards”: Trained individuals basis to guide states in augmenting oxygen availability as
spearhead local education on oxygen therapy and per the monthly projection of COVID-19 cases.
equipment upkeep (Ministry of Health and Family
Welfare, 2021c). 3.16. Financial management
• Extensive training: Over 1,600 participants across LMO tanks and MGPS have been installed through ECRP-II
738 districts have honed their skills in oxygen funds, which were further operationalized and secured
management. approval from the PESO. Daily review meetings have been
• Online PSA training: A separate program by the conducted to ensure that states/UTs fully utilize ECRP-II
Ministry of Skill Development and Entrepreneurship funds, with expenditures uploaded through the dedicated
trained 4,690 participants in 180-h maintenance and National Health Mission’s Performance Management
troubleshooting, while 6,825 completed a 10-h day-to- System portal, ensuring the real-time release of funds to
day operations course (Ministry of Health and Family strengthen sub-district-level healthcare facilities (Ministry
Welfare, 2022). of Health and Family Welfare, 2022).
This multi-pronged approach serves several purposes, 4. Discussion
including:
• Ensuring proper oxygen care in hospitals. In 2011, oxygen was considered and included in the
• Empowering local expertise for sustained National List of Essential Medicines of India (Ministry of
preparedness. Health & Family Welfare, 2011). The COVID-19 pandemic
• Building confidence in managing future needs. has posed an unprecedented challenge to India in general
and health systems in particular. Based on the WHO’s
Overall, the program empowers health-care analysis, more than 500,000 COVID-19 patients required
professionals to become stewards of this life-saving oxygen treatment each day in LMICs (WHO, 2021a). This
resource, promoting responsible and efficient oxygen use immense pressure exerted by the pandemic on the health
throughout India. system unraveled the inadequacies in crisis management,
3.14. Development of web application but it also provided an opportunity to strengthen the
system with a long-term strategic perspective. Despite
The Oxygen Demand Aggregation System (ODAS) is the unprecedented need for oxygen, India developed
designed to determine the requirement for medical innovative solutions to address the shortage of oxygen,
oxygen across all health-care facilities by considering as summarized in the present review. Strengthening the
bed availability and occupancy. It then combines these system to withstand future pandemics is the new mantra. It
requirements at the state level (National Health Authority, involves revamping the system to handle sudden increases
2023). A new platform called “OxyCare” (OC-MIS) in demand for health services without disrupting existing
(National Health Authority, 2023) tracks various medical services. This approach includes not only expanding
oxygen equipment, including PSA plants for generating the infrastructure but also providing matching human
oxygen, IoT devices for monitoring oxygen flow, oxygen resources and supplies. Effective capacity-building,
cylinders for storage, ventilators for patients needing planning, and responsive procurement and supply chain
respiratory support, oxygen concentrators for portable mechanisms are essential. In line with this vision, the GoI
oxygen supply, and even trained personnel to manage it all. is leaving no stone unturned to fortify the health system
(Ministry of Health and Family Welfare, 2021f). to combat present and future emergencies. In addition,
the 76 WHA has adopted the Access to Medical Oxygen
th
3.15. Monitoring with the state governments
Resolution to prevent deaths and ensure that no country
A central control room has been set up at the MoHFW of should face a shortage of medical oxygen in the future
India to monitor the efficient and adequate availability of (Every Breathe Counts, 2023).

Volume 2 Issue 3 (2024) 7 https://doi.org/10.36922/ghes.2023