An Ethiopian effort to improve access to intensive care units during the start of the COVID-19 pandemic, a lesson to improve access beyond COVID-19

Abstract

Abstract Introduction: At the start of the COVID - 19 pandemic, the biggest concern was the health systems ability to cope with the surge of patients. Low bed capacity and insufficient equipment, were some of the main concerns regarding the treatment of critically ill COVID – 19 patients. This manuscript aimed to document the efforts made to improve critical care capacity for COVID - 19 care and to explore the lessons learnt in improving access beyond COVID - 19. Methods: A systematic review was conducted of published and unpublished documents from the Ministry of Health, which included mentorship and coaching reports from the team deployed to individual ICUs. Furthermore, key informants from the Ministry of Health were interviewed. Results: There were 53 ICUs which had less than 300 beds, this amounts to a below 0.3 bed capacity per 100,000 people. The effort created an additional 200 beds in the COVID – 19 ICU, provided just-in-time training and simulation sessions for non- ICU clinicians which solved the shortage of professionals and the mentorship and coaching done in all ICUs and the leadership provided, improved critical care quality. The availability of mechanical ventilators increased by more than double from the base line.Conclusion: There was a significant improvement in level of ICU care delivered during the pandemic. It is recommended that the high level of motivation be maintained and there should be long-term investments put in place, which seek to improve service delivery beyond COVID -19 in Ethiopia. [Ethiop. J. Health Dev: 2021: 35(SI-4): 00-00]Key words: Intensive care units, resources, COVID 19.