How prepared is Mozambique to treat COVID-19 patients? A new approach for estimating oxygen service availability, oxygen treatment capacity, and population access to oxygen-ready treatment facilities

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Abstract

Background

This study aims to assess the COVID-19 response preparedness of the Mozambican health system by 1) determining the location of oxygen-ready public health facilities, 2) estimating the oxygen treatment capacity, and 3) determining the population coverage of oxygen-ready health facilities in Mozambique.

Methods

This analysis utilizes information on the availability of oxygen sources and delivery apparatuses to determine if a health facility is ready to deliver oxygen therapy to patients in need, and estimates how many patients can be treated with continuous oxygen flow for a 7-day period based on the available oxygen equipment at health facilities. Using GIS mapping software, the study team modeled varying travel times to oxygen-ready facilities to estimate the proportion of the population with access to care.

Results

0.4% of all health facilities in Mozambique are prepared to deliver oxygen therapy to patients, for a cumulative total of 283.9 to 406.0 patients-weeks given the existing national capacity, under varying assumptions including ability to divert oxygen from a single source to multiple patients. 35% of the population in Mozambique has adequate access within one-hour driving time of an oxygen-ready health facility. This varies widely by region; 89.1% of the population of Maputo City was captured by the one-hour driving time network, as compared ot 4.4% of the population of Niassa province.

Conclusions

The Mozambican health system faces the dual challenges of under-resourced health facilities and low geographic accessibility to healthcare as it prepares to confront the COVID-19 pandemic. This analysis also illustrates the disparity between provinces in preparedness to deliver oxygen therapy to patient, with Cabo Delgado and Nampula being particularly under-resourced.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12939-021-01403-8.

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Individual-level changes in self-rated health before and during the economic crisis in Europe

Dawit Shawel Abebe, Anne Grete Tøge, Espen Dahl (2016)

Background Changes over time in self-rated health (SRH) are increasingly documented during the current economic crisis, though whether these are due to selection, causation, or methodological artefacts is unclear. This study accordingly investigates changes in SRH, and social inequalities in these changes, before and during the economic crisis in 23 European countries. Methods We used balanced panel data, 2005–2011, from the European Union Statistics on Income and Living Conditions (EU-SILC). We included the working-age population (25–60 years old) living in 23 European countries. The data cover 65,618 respondents, 2005–2007 (pre-recession cohort), and 43,188 respondents, 2008–2011 (recession cohort). The data analyses used mixed-effects ordinal logistic regression models considering the degree of recession (i.e., pre, mild, and severe). Results Individual-level changes in SRH over time indicted a stable trend during the pre-recession period, while a significant increasing trend in fair and poor SRH was found in the mild- and severe-recession cohorts. Micro-level demographic and socio-economic status (SES) factors (i.e., age, gender, education, and transitions to employment/unemployment), and macro-level factors such as welfare generosity are significantly associated with SRH trends across the degrees of recession. Conclusions The current economic crisis accounts for an increasing trend in fair and poor SRH among the general working-age population of Europe. Despite the general SES inequalities in SRH, the health of vulnerable groups has been affected the same way before and during the current recession. Electronic supplementary material The online version of this article (doi:10.1186/s12939-015-0290-8) contains supplementary material, which is available to authorized users.

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Seasonal variation in geographical access to maternal health services in regions of southern Mozambique

Prestige Makanga, Nadine Schuurman, Charfudin Sacoor … (2017)

Background Geographic proximity to health facilities is a known determinant of access to maternal care. Methods of quantifying geographical access to care have largely ignored the impact of precipitation and flooding. Further, travel has largely been imagined as unimodal where one transport mode is used for entire journeys to seek care. This study proposes a new approach for modeling potential spatio-temporal access by evaluating the impact of precipitation and floods on access to maternal health services using multiple transport modes, in southern Mozambique. Methods A facility assessment was used to classify 56 health centres. GPS coordinates of the health facilities were acquired from the Ministry of Health while roads were digitized and classified from high-resolution satellite images. Data on the geographic distribution of populations of women of reproductive age, pregnancies and births within the preceding 12 months, and transport options available to pregnant women were collected from a household census. Daily precipitation and flood data were used to model the impact of severe weather on access for a 17-month timeline. Travel times to the nearest health facilities were calculated using the closest facility tool in ArcGIS software. Results Forty-six and 87 percent of pregnant women lived within a 1-h of the nearest primary care centre using walking or public transport modes respectively. The populations within these catchments dropped by 9 and 5% respectively at the peak of the wet season. For journeys that would have commenced with walking to primary facilities, 64% of women lived within 2 h of life-saving care, while for those that began journeys with public transport, the same 2-hour catchment would have contained 95% of the women population. The population of women within two hours of life-saving care dropped by 9% for secondary facilities and 18% for tertiary facilities during the wet season. Conclusions Seasonal variation in access to maternal care should not be imagined through a dichotomous and static lens of wet and dry seasons, as access continually fluctuates in both. This new approach for modelling spatio-temporal access allows for the GIS output to be utilized not only for health services planning, but also to aid near real time community-level delivery of maternal health services.

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Barriers to effective communication between family physicians and patients in walk-in centre setting in Dubai: a cross-sectional survey

AH Albahri, AS Abushibs, NS Abushibs … (2018)

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Author and article information

Contributors

Langan Denhard:

ORCID: http://orcid.org/0000-0003-1362-4958

ldenhar1@alumni.jh.edu

Journal

Journal ID (nlm-ta): Int J Equity Health

Journal ID (iso-abbrev): Int J Equity Health

Title: International Journal for Equity in Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1475-9276

Publication date (Electronic): 6 April 2021

Publication date PMC-release: 6 April 2021

Publication date Collection: 2021

Volume: 20

Electronic Location Identifier: 90

Affiliations

[1 ]GRID grid.21107.35, ISNI 0000 0001 2171 9311, Johns Hopkins Bloomberg School of Public Health, ; Baltimore, Maryland USA

[2 ]GRID grid.21107.35, ISNI 0000 0001 2171 9311, Johns Hopkins University School of Medicine, ; Baltimore, Maryland USA

[3 ]GRID grid.419229.5, Programa de Sistemas de Saúde, , Instituto Nacional de Saúde, ; Maputo, Mozambique

[4 ]World Health Organization, Maputo, Mozambique

[5 ]Hlayisa Project- Nweti, Maputo, Mozambique

Author information

Langan Denhard http://orcid.org/0000-0003-1362-4958

Article

Publisher ID: 1403

DOI: 10.1186/s12939-021-01403-8

PMC ID: 8022128

PubMed ID: 33823863

SO-VID: 71d2d0ed-b65a-4a95-8f3e-ebb8e13107c0

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 4 November 2020

Date accepted : 7 February 2021

Funding

Funded by: FundRef http://data.crossref.org/fundingdata/funder/10.13039/100000865, Bill & Melinda Gates Foundation (BMGF);

Award ID: INV-006966

Custom metadata

ScienceOpen disciplines: Health & Social care

Keywords: geographic information systems,covid-19,oxygen,preparedness,mozambique,modelling

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ScienceOpen disciplines: Health & Social care

Keywords: geographic information systems, covid-19, oxygen, preparedness, mozambique, modelling

How prepared is Mozambique to treat COVID-19 patients? A new approach for estimating oxygen service availability, oxygen treatment capacity, and population access to oxygen-ready treatment facilities

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Novel Coronavirus Disease COVID-19

Most cited references 9

Individual-level changes in self-rated health before and during the economic crisis in Europe

Seasonal variation in geographical access to maternal health services in regions of southern Mozambique

Barriers to effective communication between family physicians and patients in walk-in centre setting in Dubai: a cross-sectional survey

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