Availability of Oxygen and Other Essential Medical Products in COVID-19 Treatment Facilities of Nepal

Background: There is paucity of data globally regarding availability of essential medical products and oxygen supply in healthcare facilities to inform surge capacity and strategic healthcare development. Due to continued waves of COVID-19 pandemic caused by virus variants with increased transmissibility, many facilities worldwide, particularly in the Indian subcontinent, have reported sudden increase in demand for oxygen and its delivery systems to treat patients with COVID pneumonia. Therefore, we aimed to assess the status of essential medical products, oxygen supply, and methods of procurement in COVID-19 treatment facilities across Nepal.  Methods: We performed cross-sectional survey among 120 COVID-19 treatment facilities designated by the Government of Nepal in June 2020. Data were collected via an online semi-structured questionnaire based on validated healthcare capacity assessments. responded (49 clinics, 20 level hospitals).  Findings: Sixty-nine facilities responded (49 clinics, 20 hospitals). All 69 facilities reported at least one form of oxygen availability: 25 facilities (36%) had their own oxygen plant, 65% had oxygen concentrators, and 88% had portable oxygen cylinders. Majority (38/49; 77%) of clinics and 60% (12/20) of hospitals had sufficient stock (³5 pieces in clinics, >20 pieces in hospitals) of functional oxygen cylinders, which were generally procured through the private sector (78% of facilities with oxygen cylinders). Almost all clinics had at least one piece of pulse oximeter device, blood pressure measuring set, thermometer, thermal gun, and resuscitation kit (oral or nasal airway, suction), compared to approximately a half of hospitals which had sufficient quantity (>10 pieces) of these products.  Interpretation: It is crucial for hard-hit countries to timely map the availability and usage of essential medical products including oxygen in COVID-19 care hospitals. If needed, relevant policies and processes around oxygen production and supply should be revised. Furthermore, countries should not delay in adopting innovation for quicker, safer and sustainable production of medical oxygen to ensure continuous supply to the needy.  Funding Information: No funding was received to conduct this study. Declaration of Interests: We declare no competing interests. Ethics Approval Statement: The study was approved by the Ethical Review Board (ERB) of Nepal Health Research Council ((Ref: NHRC-ERB Reg. No. 267/2020P), and utilizes specific data collected from a larger study done “to assess the service availability and infection prevention status of hospitals in Nepal in the context of possible COVID-19 case management need”.