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When we think of hospitals, what may first come to mind is bright florescent lit hallways, the beeping sounds of heart monitors, cabinets filled with antibiotics and medicines, and plastic tubing of free-flowing oxygen hooked up to patients. In most regional or city hospitals across the world, this essential equipment and medicines are readily available and used to treat patients and save lives.
But for local health clinics in lower and middle income countries, which is the main access point for many peoples’ health needs, unfortunately, this is often not the case. Medical equipment can be expensive, complex, and difficult to transport. When looking at pneumonia – the biggest killer of children under five – access to basic support is often not available. In fact, approximately 4.2 million children with pneumonia who need oxygen currently do not have access to it.
“SPRINT” (Scaling Pneumonia Response Innovations) is UNICEF’s strategic initiative to expanding access to oxygen therapy and antibiotics, both of which are required to treat pneumonia. The programme was first launched in Senegal in January last year in partnership with the Government, and since then has helped increase access to treatment for thousands of children in the country.
This photo story will take you on the ground in Senegal, “sprinting” during the pandemic to bring pneumonia treatment closer to home for thousands of families.
1 - The tools of oxygen
Ensuring access to oxygen therapy is not the simplest of feats. Medical oxygen first needs to be concentrated, either chemically extracted from the ambient air (i.e. via an oxygen plant or concentrator) or vaporized from a liquid form and then either stored for transportation (i.e. via oxygen cylinders) or directly provided to patients (i.e. via a concentrator or a central piping system in a hospital). Administering oxygen to a patient requires many tools to understand the needs per patient and ensure the right amount of oxygen is given to that patient. Below we highlight just a few of the many tools required to build an oxygen system and how UNICEF Senegal and The Government have invested in ensuring they are available, not only at larger hospitals, but also at local health posts in the country.
The range of equipment necessary
The flow meter
The oxygen concentrator
The oxygen cylinder
The pulse oximeter
2 - The right way to provide oxygen
Purchasing equipment is only one part of the puzzle. There’s immense planning required to ensure the equipment is of the correct type, size and amount, and that there are maintenance plans in place, sufficient power available, and that people are trained to use the equipment properly. The photos below display three key programming pieces that SPRINT focuses on in country – the right sizing of equipment, the right planning for referrals and treatment, and the right training required to run the equipment.
The right size
The right plan
The right skills
3 - Amoxicillin dispersible tablets - the treatment
When a patient becomes severely ill or suffers respiratory distress, oxygen is crucial to keeping the person stable and well enough to receive a medical treatment. However, this usually does not resolve the underlying condition. For pneumonia, antibiotics are needed to stop the infection of the lungs and fend off the disease. For children, the recommended treatment in low-resource settings is the dispersible tablet form of amoxicillin, an innovative solution to the syrup form that requires refrigeration (which many homes don’t have access to) and measuring at home via caregivers (which has a high risk for error). With the dispersible tablet form, the medicine can be stored for long periods of time in ambient temperatures and can easily be administered by a parent to a child by simply dropping the tablet into a glass of water so it can be diluted before being consumed.
So, what is “SPRINT?”
SPRINT doesn’t focus on creating any new products or devices, but instead works to ensure access to already proven treatment to pneumonia. It’s a structured approach to implementing oxygen therapy and amoxicillin DT, consisting of first identifying the key bottlenecks and secondly utilizing existing knowledge to overcome these bottlenecks.
The ‘SPRINT model’ helps countries identify the most pressing challenges relative to their goals and guides them with relevant knowledge to help them meet their goals. It looks at key sectors of a country’s health and financial systems (i.e. national & local markets, supply chains, advocacy & demand, etc.) when delivering oxygen therapy and amoxicillin DT to ensure sustainability, as indicated in the image below.
Expanding the “SPRINT” to more countries
With over one year of the SPRINT programme in Senegal, the results are clear – 64 health clinics now have access to new oxygen equipment and 157 have the antibiotics necessary to treat children suffering from pneumonia. The new equipment has also supported the country to establish an oxygen response for COVID-19 by treating patients who have been severely affected by the disease.
The programme has also been introduced in Ghana, where 13 health facilities in the Eastern Region have gained access to equipment and/or antibiotics, including 75 oxygen concentrators, with plans to introduce SPRINT to more countries.
With supporting governments, partners, and donors, it is possible to limit the preventable deaths of children suffering from pneumonia.